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pethidine
Pethidine (INN, AAN, BAN) or meperidine (USAN) is a once popular synthetic opioid analgesic of the phenylpiperidine class.〔 Synthesized in 1939 as a potential anticholinergic agent by the German chemist Otto Eisleb, its analgesic properties were first recognized by Otto Schaumann while working for IG Farben, Germany.
Pethidine is indicated for the treatment of moderate to severe pain, and is delivered as a hydrochloride salt in tablets, as a syrup, or by intramuscular, subcutaneous, or intravenous injection. For much of the 20th century, pethidine was the opioid of choice for many physicians; in 1975, 60% of doctors prescribed it for acute pain and 22% for chronic severe pain.
Compared with morphine, pethidine was thought to be safer, carry a lower risk of addiction, and to be superior in treating the pain associated with biliary spasm or renal colic due to its putative anticholinergic effects.〔 These were later discovered to be all myths, and it carried an at least equal risk of addiction, possessed no advantageous effects on biliary spasm or renal colic compared to other opioids, and due to its toxic metabolite, norpethidine, was more toxic than other opioids, especially during long-term use.〔 The norpethidine metabolite was found to have serotonergic effects, so pethidine could, unlike most opioids, contribute to serotonin syndrome.〔〔
==Medical uses==
Pethidine is the most widely used opioid in labour and delivery but has fallen out of favour in some countries such as the United States in favour of other opioids, due to its potential drug interactions (especially with serotonergics) and its neurotoxic metabolite, norpethidine. It is still commonly used in the United Kingdom and New Zealand, and is the preferred opioid in the United Kingdom for use during labour. Pethidine is the preferred painkiller for diverticulitis, because it decreases intestinal intraluminal pressure.〔Blueprints - Family Medicine (3rd edition)〕
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