Contraindications of Pethidine Administration:

  • Hypersensitivity to Pethidine.
  • Respiratory depression, or where respiratory reserve is depleted (acute bronchial asthma, chronic airway disease, severe emphysema, severe chronic bronchitis, kyphoscoliosis).
  • Head injury, raised intracranial pressure (apart form introducing monitoring and diagnostic problems, hypercapnia associated with respiratory depression can itself result in elevated intracranial pressure), brain tumour.
  • Cardiac arrythmias, especially supraventricular tachycardias, cor pulmonale. Pethidine has a vagolytic action and may produce a significant increase in the ventricular response rate.
  • Concurrent use of monoamine oxidase inhibitors (MAOI’s), including selegeline, or use of MAOI’s within two weeks prior.
  • The combination of monoamine oxidase inhibitors and pethidine has caused hypotension, hypertension, excitation, rigidity, hyperpyrexia and/or convulsions and in some cases fatalities have been reported. This combination should be avoided.
  • Pre-eclampsia, eclampsia.
  • Convulsive states such as status epilepticus, tetanus and strychnine poisoning, due to the stimulatory effects of pethidine on the spinal cord.
  • Diabetic acidosis where there is a danger of coma.
  • Acute alcoholism or delirium tremens.
  • Severe liver disease, incipient hepatic encephalopathy.
  • Patients with a low platelet count, coagulation disorders or receiving anticoagulant treatment.

Reference medsafe-pdf

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