Meperidine and Central Neurotoxicity
Authors: LINDA A. HERSHEY
Journal: Annals of Internal Medicine (1983)

Editorials1 April 1983Meperidine and Central NeurotoxicityLINDA A. HERSHEY, M.D., PH.D.LINDA A. HERSHEY, M.D., PH.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-4-548 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptKaiko and associates (1) have recently reported in Annals of Neurology on the excitatory effects in the central nervous system of meperidine. Of 67 patients with cancer who received this drug for relief of postoperative or chronic pain, 48 had agitation, tremors, myoclonus, or seizures while taking meperidine (for further details, see the abstract reprinted in the "From Other Pages" section this month). The findings in this elegant study illustrate several important principles of clinical pharmacology.An active metabolite of a drug is sometimes as likely to cause an adverse drug reaction as the parent drug itself. Kaiko and associates...References1. KAIKOFOLEYGRABINSKI RKP. Central nervous system excitatory effects of meperidine in cancer patients. Ann Neurol. 1983;13:180-5. CrossrefMedlineGoogle Scholar2. SZETOINTURRISIHONDE HCR. Accumulation of normeperidine, an active metabolite of meperidine, in patients with renal failure or cancer. Ann Intern Med. 1977;86:738-40. LinkGoogle Scholar3. STRONGPARKERATKINSON JMA. Identification of glycinexylidide in patients treated with intravenous lidocaine. Clin Pharmacol Ther. 1973;14:67-72. CrossrefMedlineGoogle Scholar4. STRONGMAYFIELDATKINSONBURRISRAYMONWEBSTER JDABFL. Pharmacological activity, metabolism, and pharmacokinetics of glycinexylidide. Clin Pharmacol Ther. 1975;17:184-94. CrossrefMedlineGoogle Scholar5. RIVERA-CALIMLIMCASTANEDALASAGNA LLL. Effects of mode of management on plasma chlorpromazine in psychiatric patients. Clin Pharmcol Ther. 1973;14:978-86. CrossrefMedlineGoogle Scholar6. EDMONDSASHFORDBRENNERSAUNDERS MRMA. Cimetidine: does neurotoxicity occur? J R Soc Med. 1979;72:172-5. CrossrefMedlineGoogle Scholar7. SMITHLERNERWEINSTEIN HPL. Neurotoxicity and "massive" intravenous therapy with penicillin. Arch Intern Med. 1967;120:47-53. CrossrefMedlineGoogle Scholar8. THOMSONMELMONRICHARDSON PKJ. Lidocaine pharmacokinetics in advanced heart failure, liver disease and renal failure in humans. Ann Intern Med. 1973;78:499-508. LinkGoogle Scholar9. LOGOTHETIS J. Spontaneous epileptic seizures and electroencephalographic changes in the course of phenothiazine therapy. Neurology. 1967;17:869-77. CrossrefMedlineGoogle Scholar10. BETTSKALRACOOPERJEAVONS TPRP. Epileptic fits as a probable side-effect of amitriptyline. Lancet. 1968;1:390-2. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byComparative Safety Profiles of Sedatives Commonly Used in Clinical Practice: A 10-Year Nationwide Pharmacovigilance Study in KoreaConscious Intravenous Sedation in DentistryPerioperative Implications of End-stage Renal Disease in Orthopaedic SurgeryPain Management in the Emergency DepartmentRegioselective biotransformation of CNS drugs and its clinical impact on adverse drug reactionsDrug-Induced Movement Disorders: Emergencies and ManagementSubstance abuse and movement disordersIllicit Drugs II: Opioids, Cocaine, and OthersCancer Pain and AnalgesiaPain Management in the Emergency DepartmentOpioidsLes opioïdesPharmacokinetic Considerations in Clinical ToxicologyOpioid MetabolitesOpioidsToxicology in the critically ill patientAdult Toxicology in Critical CareaAdverse effects of sedatives in childrenNeurologic Complications of Substance AbuseSeizures, Ethanol, and Recreationally Abused DrugsFentanyl NeurotoxicityOpioids and Designer DrugsLytic/“DPT” Cocktail: Time for Rational and Safe AlternativesAnalytic Reviews : Neuropsychiatric Toxicity of MeperidineMeperidine usage in patients with sickle cell crisisIn replyOpioid analgesics and narcotic antagonists 1 April 1983Volume 98, Issue 4Page: 548-549KeywordsAdverse reactionsCentral nervous systemClinical pharmacologyDrugsEpileptic seizuresMetabolitesMyoclonusNeurology Issue Published: 1 April 1983 PDF downloadLoading ...