Medical Drug Interactions: Effect increased by MAO inhibitors, TCAs, phenothiazine, fluoxetine ant other serotonin uptake inhibitors.
Medical Drug Interactions: Dilantin decreases effect. Aggravates adverse effects of isoniazid. Don’t use if MAO inhibitor given in previous 14 days, not with Eldepryl.
Precautions: Use with caution with pulmonary, hepatic and renal disorders, history of seizures. Some preparations contain sulfides; watch out if allergic to sulfides.
Meperidine and Promethazine (Mepergan)
Same action, use and effects as individual components. Main side effect is dry mouth.
Synthetic, Meperidine Group
Fentanyl Transdermal System (Duragesic Patches)
Action: Same as Meperidine.
Use: Management of chronic pain.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Dry mouth, dysesthesias. Orthostatic hypotension and laryngospasm.
Medical Considerations: >10%; Hypotension, bradycardia, CNS depression, drowsiness, sedation, nausea, vomiting, constipation and respiratory depression.
Medical Considerations: 1-10%; cardiac arrhythmias, confusion, biliary tract spasm, miosis.
Medical Considerations: <1%; Circulatory depression, convulsions, paradoxical CNS excitation or delirium, dizziness, erythema, pruritis, rash, hives, itching, cold and clammy skin, urinary tract spasm, bronchospasm and muscle rigidity.
Dental Drug Interactions: Effects increased with other CNS depressants and skeletal muscle depressants. Increased anticholinergic effect with anticholinergics. Additive hypotension with nitrous oxide and benzodiazepines.
Medical Drug Interactions: Effects increased by chlorpromazine and cimetidine. Additive hypotension with phenothiazines.
Precautions: Don’t use with myasthenia gravis. Use with caution with respiratory depression, severe liver or renal insufficiency and bradycardia.
Elderly more prone enhanced analgesia, CNS depression and constipation. Pregnancy B (D if high dose at term or for prolonged period).