Pregnancy Category None

Uses. This drug has no officially approved medical use in the United States. Elsewhere (such as Sweden, France, and Great Britain) the substance is administered for sedation and pain relief, much like morphine. For example, phenoperidine is used to calm patients and to cloud unpleasant memory of procedures such as a cataract operation or sticking tubes down passages in the throat or lungs. Phenoperidine is also used in major dental work, such as extraction of wisdom teeth. The substance has been recommended for children in intensive-care units, partly because it normally has modest impact on heart and breathing functions when used in a medical context. Medical practitioners report the drug also has excellent anesthesia results in elderly abdominal surgery patients. Very young and very old populations can be among the most challenging for safe drug treatment, so these favorable results are especially important for evaluating the drug. Phenoperidine takes effect quickly and has a relatively prolonged time of therapeutic action.

One study found phenoperidine, morphine, and fentanyl to have about equivalent value for anesthesia, although the drugs are not equivalent in strength. For example, intravenous doses of fentanyl are 6 times stronger than phenoperidine, and phenoperidine is 5 to 10 times stronger than morphine. A study found phenoperidine as effective as heroin in relieving pain from cesarean section. Body chemistry transforms a portion of a phenoperidine dose into meperidine.

Drawbacks. Unwanted effects can include itching, nausea, vomiting, and breathing trouble. Reports exist of heart and brain damage caused by medical doses.

Abuse factors. Dependence can develop.

Drug interactions. Reports indicate phenoperidine can reduce blood pressure, and the compound is suspected of interacting with propranolol (a drug used to control high blood pressure), thereby producing extremely low blood pressure. Cases of major circulatory collapse are known.

Cancer. Not enough scientific information to report.

Pregnancy. Experimentation with mice has shown birth defects to be less likely from phenoperidine than from other drugs with similar medical uses, but that finding does not mean the substance is safe for use during pregnancy. Clinical observations have detected no fetal or newborn injury when pheno-peridine was used as an anesthetic in childbirth.

Additional scientific information may be found in:

Grummitt, R.M., and V.A. Goat. "Intracranial Pressure after Phenoperidine." Anaesthesia 39 (1984): 565-67.

Macrae, D.J., et al. "Double-Blind Comparison of the Efficacy of Extradural Dia-morphine, Extradural Phenoperidine and I.m. Diamorphine Following Caesar-ean Section." British Journal of Anaesthesia 59 (1987): 354-59. "Phenoperidine HCl." In Therapeutic Drugs, ed. C. Dollery. 2d ed. New York: Churchill

Livingstone, 1999. P89-P90. Werner, D., et al. "A Comparison of Diazepam and Phenoperidine in Premedication for Upper Gastrointestinal Endoscopy: A Randomized Double Blind Controlled Study." European Journal of Clinical Pharmacology 22 (1982): 143-45. Whalley, D.G., et al. "A Comparison of the Incidence of Cardiac Arrhythmia during Two Methods of Anaesthesia for Dental Extractions." British Journal of Anaesthesia 48 (1976): 1207-10.

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