{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:16:26Z","timestamp":1773285386012,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,1,16]],"date-time":"2012-01-16T00:00:00Z","timestamp":1326672000000},"content-version":"vor","delay-in-days":2785,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2004,6]]},"abstract":"<jats:p><jats:bold>Study Objectives.<\/jats:bold> To report a classic case of normeperidine toxicity, and to present institution\u2010specific data on meperidine usage patterns and the frequency of adverse drug reactions (ADRs).<\/jats:p><jats:p><jats:bold>Methods.<\/jats:bold> A chart review was conducted of patients at high risk for ADRs. High\u2010risk patients were identified through the pharmacy computer system as those with renal insufficiency (creatinine clearance \u2264 50 ml\/min), those receiving meperidine with patient\u2010controlled analgesia (PCA), or those receiving more than 200 mg\/day of intravenous meperidine for multiple days.<\/jats:p><jats:p><jats:bold>Results.<\/jats:bold> Twenty\u2010five percent of patients who received meperidine had some degree of renal insufficiency. The average daily dose of meperidine was 230 mg; cumulative doses ranged from 10\u20137200 mg. Adverse drug reactions documented in 20 (14%) of 141 patients were confusion, anxiety, nervousness, hallucinations, twitching, and seizure. Sixteen of the 20 patients received meperidine by PCA pump or a combination of PCA and intravenous administration. Patients with ADRs to meperidine were older (58.5 vs 46.4 yrs, p=0.004), received more concomitant benzodiazepines (65.0% vs 4.1%, p&lt;0.0001), and had a longer hospital stay (median 9.5 vs 4.6 days, p&lt;0.001) than those who did not experience an ADR. A significant difference was found in cumulative PCA doses between patients with and without documented ADRs (median meperidine dose 863 and 455 mg, respectively, p=0.0157). Doses were directly correlated with both renal function (p&lt;0.05) and length of stay (p&lt;0.008). Dosing, duration, and frequency of ADRs for patients using PCA differed significantly between prescribing services (p&lt;0.01).<\/jats:p><jats:p><jats:bold>Conclusion.<\/jats:bold> Patients using PCA meperidine are at particularly high risk of experiencing ADRs based on cumulative doses and duration of treatment. Adverse drug reactions were documented in approximately 14% of patients. Our results warrant restriction of PCA meperidine and evaluation of meperidine usage policies to improve pain management services and decrease the frequency of ADRs.<\/jats:p>","DOI":"10.1592\/phco.24.8.776.36066","type":"journal-article","created":{"date-parts":[[2004,7,20]],"date-time":"2004-07-20T11:47:51Z","timestamp":1090324071000},"page":"776-783","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Meperidine Is Alive and Well in the New Millennium: Evaluation of Meperidine Usage Patterns and Frequency of Adverse Drug Reactions"],"prefix":"10.1002","volume":"24","author":[{"given":"Charles F.","family":"Seifert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shalyn","family":"Kennedy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,16]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530230060032"},{"key":"e_1_2_1_3_2","volume-title":"Acute pain management: operative or medical procedures and trauma: clinical practice guideline. 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