2.0 Meperidine has not been shown to have any unique benefit in the treatment of pain due to acute pancreatitis. 3.0 Routine use of meperidine prior to the first dose of amphotericin is inappropriate. If a patient does develop rigors, prophylactic use prior to subsequent doses is warranted. In cases of meperidine neurotoxicity, naloxone should not be used. Naloxone does not reverse the effects of normeperidine, and may actually precipitate seizure activity as the sedative effects of meperidine are reversed allowing the full effect of normeperidine to act on the central nervous system.
Naloxone is effective in reversing episodes of apnea induced by meperidine.
In all cases, meperidine should be given with caution. The initial dose should be reduced in all patients with decreased renal or hepatic function, and in the elderly. 4.0 Meperidine should be used with caution in patients with atrial flutter or other supraventricular tachycardias. R.N. M.S., Paul Hutson, Pharm.