[e-drug] Pethidine/meperidine safety & analgesic efficacy vs morphine (cont)

[jdartnell@tg.com.au]

E-drug: Pethidine/meperidine safety & analgesic efficacy vs morphine (cont)
---------------------------------------------

The latest Therapeutic Guidelines: Analgesic (Version 4) has this to say in
the Getting To Know Your Drugs section:

'Pethidine is unsuitable for chronic pain relief and it should not be used
for more than 72 hours for shorter-term analgesia, eg postoperatively.
Pethidine may be indicated in some clinical circumstances. Its shorter
half-life and the greater metabolic capacity of the neonate for pethidine
makes it preferable to morphine during labour. There is no evidence to
support the preferential use of pethidine in gallbladder or pancreatic
disease.'

[Therapeutic Guidelines: Analgesic, Version 4. Therapeutic Guidelines
Limited; 2002.]

There are also the problems from serious drug interactions with 
pethidine such as serotonin syndrome when used with MAOIs, and the 
marked addictive qualities of the drug.

In the next release of eTG complete (October 2002) pethidine is recommended
(with a regimen) for obstetric pain but not for any other indications.

There is a good review of the use of pethidine in Australian Prescriber
which is on the web.
http://www.australianprescriber.com/magazines/vol25no1/pethidine.htm
[Molloy A. Does pethidine still have a place in therapy? Aust Prescr
2002;25:12-3]

Jonathan Dartnell
Production Manager
Therapeutic Guidelines
Level 2, 55 Flemington Road, North Melbourne, Vic 3051, Australia
Telephone: 61 3 9326 9959
Facsimile: 61 3 9326 5632
Email: jdartnell@tg.com.au
Website: http//www.tg.com.au
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