Central Nervous System Toxicity Associated With Meperidine Use in Hepatic Disease

摘要: Meperidine-associated central nervous system (CNS) excitatory toxicities are believed to be caused by accumulation of the active metabolite normeperidine. Normeperidine is eliminated kidneys and accumulates in patients with renal insufficiency, sickle cell disease, cancer. In cirrhosis, metabolism meperidine decreased, leading parent drug possible CNS depressive effects similar hepatic encephalopathy. Although elimination normeperidine decreased as well these patients, ratio generally low, narcotic usually predominate. This first reported case a patient alcoholic hepatitis normal function. Administration multiple doses disease should discouraged.