Meperidine and normeperidine levels following meperidine administration during labor

Kuhnert, Betty R.; Kuhnert, Paul M.; Tu, Ann-Sheng L.; Lin, Denis C. K.; Foltz, Roger L.

doi:10.1016/0002-9378(79)90310-7

Cited by 41 publications

(8 citation statements)

References 13 publications

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“…This finding was also supported by the results of Kuhnert et al, [167] who compared the cord vein and artery concentration of pethidine. As pethidine may induce neonatal respiratory depression, sedation and psychomotor impairment, these adverse effects increase with its dosage and with the dose-delivery interval (for review see Morselli and Rovei I169 ]).…”

Section: Pethidine (Meperidine)supporting

confidence: 83%

See 1 more Smart Citation

Placental Transfer of Drugs Administered to the Mother

Pacifici

Nottoli

1995

Clinical Pharmacokinetics

282

119

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Drugs administered to mothers have the potential to cross the placenta and reach the fetus. Under particular circumstances, the comparison of the drug concentration in the maternal and fetal plasma may give an idea of the exposure of the fetus to the maternally administered drugs. In this review drugs are classified according to their type of transfer across the placenta. Several drugs rapidly cross the placenta and pharmacologically significant concentrations equilibrate in maternal and fetal plasma. Their transfer is termed 'complete'. Other drugs cross the placenta incompletely, and their concentrations are lower in the fetal than in maternal plasma. The majority of drugs fit into 1 of these 2 groups. A limited number of drugs reach greater concentrations in fetal than maternal plasma. It is said that these drugs have an 'exceeding' transfer. The impression prevails that suxamethonium chloride (succinylcholine chloride) and doxorubicin do not cross the placenta. However, a careful analysis of the literature suggests that this impression is wrong and that all drugs cross the placenta, although the extent transfer varies considerably. The following parameters were considered as possible factors determining the extent of placental transfer: (i) the molecular weight of the drug; (ii) the pKa (pH at which the drug is 50% ionised); and (iii) the extent of drug binding to the plasma protein. Drugs with molecular weights greater than 500D have an incomplete transfer across the human placenta. Strongly dissociated acid drug molecules should have an incomplete transfer, but this does not seem to be an absolute rule. For example, ampicillin and methicillin transfer completely and they are strongly dissociated at physiological pH. The extent of drug binding to plasma protein does not influence the type of drug transfer across the human placenta.

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Section: Pethidine (Meperidine)supporting

confidence: 83%

“…Pethidine 50mg was administered intravenously to 30 patients at term; [167] the dose-delivery interval ranged between a few minutes and 6 hours. The average cord to maternal ratio for pethidine and its metabolite norpethidine were 0.81 and 0.87, respectively.…”

Section: Pethidine (Meperidine)mentioning

confidence: 99%

Placental Transfer of Drugs Administered to the Mother

Pacifici

Nottoli

1995

Clinical Pharmacokinetics

282

119

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“…The potentially harmful effects of parenteral pethidine in neonates were demonstrated approximately three decades ago. [9][10][11][12][13][14][15] Breastfed infants of mothers who receive repeated post-caesarean doses of intravenous (i.v.) pethidine show diminished alertness on day 3-4 of life.…”

Section: Introductionmentioning

confidence: 99%

Estimation of infant dose and exposure to pethidine and norpethidine via breast milk following patient-controlled epidural pethidine for analgesia post caesarean delivery

Al-Tamimi¹,

Ilett

Paech

et al. 2011

International Journal of Obstetric Anesthesia

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“…The study was terminated after an interim analysis revealed significant pain relief in the meperidine group. Neonatal side effects of meperidine have been well documented [2, [6][7][8] and occur as a result of the drug's prolonged half-life (2.5-3 h in the mother and 18-23 h in the neonate [9]) and accumulation of active metabolites (e.g. normeperidine, which has a half-life of 60 h in the neonate).…”

Section: Meperidinementioning

confidence: 99%