Talk:Pethidine

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I think this article is a great example of writing for general knowledge by an expert. It will always be a matter of judgement for the primary contributor but my preference would be to tend toward the more technical detail as opposed to "dumbing down" for wider consumption. We consult an Encyclopaedia precisely when we either don't know about something or are seeking more information. Thus we expect to encounter new knowledge for the price of new words.

Many fields of enquiry have a specific terminology at various stages of difference to common language. For example the word "Energy" has a specific meaning to a physicist but possibly something different to a person discussing para-psychological phenomena (both players being laymen in the other's field). To move an entry description toward more laymens terms would, in my opinion, risk confusion of the form I find myself in when talking to my own brother on issues of para-normal 'energy'.

Contents 1 ===================== 2 Confusing or unclear for some readers? 3 a good reference to add 4 Recreational use 5 Intravenous?! 6 The chemical structure and name in the article

[edit] =====================

Fantastic article!

Now would someone kindly add a section that makes sense in English?

216.150.207.190 18:26, 26 March 2007 (UTC)Alastor

This is a hard debate because Wikipedia wants to be as accurate as possible but where is the line regarding technicality and laymens terms? I'll do some research. Scottydude 18:29, 26 March 2007 (UTC)

A useful way to approach this is to use the lead section. The lead section on this article (frankly, like most articles), does not follow Wikipedia's style guide. Most material in the current lead section should be moved to one or more subsections, e.g. "Clinical usage". The lead can then be rewritten to summarise the main points of the article. It can become more accessible just by removing detail, but it is also possible to avoid the worst of the jargon. Above all, remember that Wikipedia is not a specialist textbook, but written for a general audience. That doesn't mean it has to dumb down, but it has to be written smart. Notinasnaid 21:17, 27 March 2007 (UTC)

I added a lot of the more jargonish stuff to the front of the article when it was still much shorter than it is now, with the intent of later revising it to make it more accessible. I just never got around to it - best of intentions, etc. I'm also writing from a specialist's standpoint. Sometimes we fall into the trap of assuming what's "common knowledge" to us, is common knowledge to everyone else. Also, since I wrote a good part of the article in its current form, when I look at it to revise it, I'm doing so with a biased eye. I know what I mean when I write something, even if the point isn't clear to anyone outside of myself.

Another thing I've been meaning to do is to move a lot of the particulars about the toxicity of pethidine to a new article on norpethidine, since it's responsible for most of the adverse effects unique to pethidine administration. There's a lot of myth and misperception surrounding the use and side effects of opioids, especially for pain management, and a lot of it involves pethidine being safer/better than the alternatives when the opposite is really true. So if I drive some points in with a cudgel (or try to), or lard some parts up with jargon, that's why.

If someone is able to rejigger the lead section/move some stuff to subsections so the top is more accessible, that would be welcome. IMO, Wikipedia is first and foremost for a general audience, but that doesn't preclude the addition of information that's primarily of interest to specialists. They (we?) use Wikipedia, too. Porkchopmcmoose 22:07, 13 April 2007 (UTC)

===== POV? =====too much beating around the bush. demerol is for people who are past a certain pain threshold that most over the counter drugs would be able to fight, and people who are IN PAIN want to know how it works, symptoms, side effects, etc. no one cares when it was synthesized. remember, not everyone reading wikipedia is as smart or adept as some may think. in other words, i'm finding alot of these medical articles do not get to the point. its an encyclepedia for christ sake. just explain the item in question, a little background, applications, reasons for it's existence, and overall POINT.

From reading this article it is easy to conclude this is never the drug of choice for alleviation of moderate to severe pain. Is this a fair conclusion to make? I thought that meperidine and midazolam, was as recently as 2002 the most commonly used combination of drugs for "moderate sedation." (Also, I have never heard of this drug referred to as "pethidine" before.) 69.140.164.142 04:19, 11 April 2007 (UTC)

"Pethidine" is what meperidine's called outside of North America. And it's almost never the drug of choice for any kind of pain, save for brief endoscopy procedures, or where someone is allergic to all other alternatives. Several countries and numerous institutions have curtailed its usage, and while it's still popular with some clinicians, the most up-to-date guidelines for the treatment of pain emphasize that meperidine is 'not' the drug of choice for the treatment of pain, especially chronic pain. I have been careful to reference everything thoroughly – if you peruse the literature, you'll be hard-pressed to find anything good said about meperidine in recent years.

I think it'd be appropriate to include more about its continuing popularity among clinicians. Just because a drug is widely used, doesn't mean it's particularly effective. Medicine is as susceptible to faddishness and as any other profession, and for decades the misperception that meperidine is less toxic, less addictive, and equally effective compared to its alternatives has been promulgated to the point that it's just something that "everyone just knows" - received wisdom passed down from person to person. Most of the doctors practicing today, at least, in the United States, went to medical school when the stuff was considered the sine qua non for pain management. And most doctors' knowledge of the particulars of pharmacology is limited to what they learned in a semester devoted to the topic in med school, and what they hear from pharmaceutical company representatives. So a lot of them continue to abide by outdated standards or prescribe medications with worse side effect profiles than their alternatives because that's what they're familiar with. DPT - Demerol-Phenergan-Thorazine is still a widely used combination for pediatric sedation despite the fact that all three are outmoded drugs with profound side effects and less effectiveness than more modern cocktails. But clinicians keep using DPT, anyways, even though superior alternatives are available. "Just because it's popular doesn't mean it's true."

In short: if the article seems to emphasize the deleterious effects of meperidine/pethidine, that's because it reflects the state of the science today. Porkchopmcmoose 22:07, 13 April 2007 (UTC)

[edit] Confusing or unclear for some readers?

I'm not a doctor, but there is not much confusing or unclear stuff for me in the article. What parts exactly are confusing for some readers? Who are those "some readers"? Thanks.--84.163.123.27 02:12, 28 April 2007 (UTC)

[edit] a good reference to add

Meperidine: a critical review.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=11782820&query_hl=4&itool=pubmed_docsum

Already there — reference no. 6 as of this writing. You're right; it's a fantastic reference. Porkchopmcmoose 19:57, 22 May 2007 (UTC)

[edit] Recreational use

I would like to see something about the recreational use of this drug.

[edit] Intravenous?!

At the beginning, it says the drug may be administered intravenusly while at the end it says that it should never be given intravenously... which is right? soldierx40k (talk) 22:59, 19 December 2007 (UTC) Yes, which is right. Someone gave me some and I want to try it by shooting it. —Preceding unsigned comment added by Timber666666 (talk • contribs) 05:02, 24 January 2008 (UTC)

[edit] The chemical structure and name in the article

The chemical structure and name used in the article appear to be inaccurate. A piperadine structure has a N in the cyclical ring with 5 carbons. The number 1 structure has the methyl group and the number 4 carbon has the phenyl group and the ethyl ester. The structural name and picture didn't make sense to me so I looked on the web for other articles on meperidine which corroborated my curiosity. I suggest the name and structure be corrected.--Ajschindler (talk) 16:19, 1 May 2008 (UTC)

The chemical structure and the names are correct. Сасусlе 01:42, 2 May 2008 (UTC)