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what any key link opens

psx:substance/pethidine/proposal/contraindication/15314cab-575d-486b-830d-efd5093e9b2a

proposal2026-05-10recordapproved

derived from · upstream

none recorded

feeds · downstream

Closure of psx:substance/pethidine/proposal/contraindication/15314cab-575d-486b-830d-efd5093e9b2a: 0 upstream, 1 downstream.

psx:substance/pethidine/proposal/contraindication/15314cab-575d-486b-830d-efd5093e9b2a
└─ derived_from  value/contraindication/0b9ce30e-3e73-4597-bd33-918547ccc6b4@1

indented by distance from this node, not by parentage

1Provenance card

the boundary, as counts

Sources

2517 with DOI

6 strong · 13 moderate · 6 weak

Compilations

22026-05-10T18:49:07.477Z

pipeline-v5 · prompt hash not recorded — run predates 2026-09

Decisions

34last ruled 2026-06-04

0 awaiting a ruling

Issued documents

42026-10-19T20:33:34.671Z

notice · info card · emergency

Searches

181 with no results

queries and counts on the build

Claims checked

8835 supported

35 supported · 53 not

Correspondence

0received

consent field ships in Phase 4

Edges

266

derivations recorded for this entity

Complete over 25 sources, 2 compilations, and 34 decisions.Not here: the private journal (never).Working material — drafts, discards, unsupported claims — is listed below and readable on the working page.Cite: psychedex.org/substances/pethidine/archive

2Build

one panel per compilation run

generation run 2026-05-09

24 min failedmodel not recordedplan not recordedrun/d5522d5b…

research

no artifact

draft

no artifact

audit

no artifact

verify

no artifact

simplify

no artifact

publish

no artifact

Selection

results seen0
selected by the model0
consumed as sources25

Verification

claims checked0
supported0
partially supported0
not supported0
inconclusive0
  • record
  • seen / partial
  • working

The model's own caveats

none raised on this run

Reproduce

inputs
25 source keys (listed under Sources)
plan
not recorded — template version, prompt hash and git SHA are written from 2026-09 onward
model
not recorded
streams
none — agent transcripts are persisted from 2026-09 onward

generation run 2026-05-10

62 min completedmodel pipeline-v5plan not recordedrun/6a2c3b9d…

research

citationsRegistryrecordresearchOutputworking

draft

articleDraftworking

audit

articleAuditedworking

verify

verificationResultworking

simplify

articleSimplifiedworking

publish

runMetarecordrunSummaryrecord

Selection

results seen140
selected by the model29
consumed as sources25

Verification

claims checked88
supported35
partially supported0
not supported0
inconclusive53
  • record
  • seen / partial
  • working

The model's own caveats

  • taper_silent
  • safety_note

Reproduce

inputs
25 source keys (listed under Sources)
plan
not recorded — template version, prompt hash and git SHA are written from 2026-09 onward
model
pipeline-v5
streams
none — agent transcripts are persisted from 2026-09 onward
18 searches — query, source, results, what was kept and why
18 searches for this run
#sourcequeryseenkeptrationale
1OpenAlexmeperidine pethidine opioid pharmacology10——
2OpenAlexmeperidine normeperidine seizure neurotoxicity accumulation10——
3OpenAlexpethidine labor pain obstetric analgesia neonatal effects82Relevant to clinical use in labor, adverse effects in neonates, and comparison with epidural
4OpenAlexmeperidine pethidine serotonin syndrome MAOI interaction104Directly relevant to serotonin syndrome risk and MAOI interactions with pethidine
5PubMed · absencepethidine meperidine pharmacology receptor binding opioid0——
6PubChempethidine11Primary source for verified chemical identity data
7OpenAlexmeperidine pethidine pharmacokinetics norpethidine metabolism CYP102Directly relevant to pethidine metabolism via CYP2B6 and pharmacodynamic profile
8OpenAlexmeperidine critical review clinical neurotoxicity normeperidine seizure102Both review articles specifically describe meperidine pharmacology including unique features vs other opioids
9UK Governmentpethidine controlled drugs classification UK11Official government source for legal classification
10HandWikiPethidine pharmacology pharmacokinetics history legal status13Comprehensive single-source pharmacological reference
11OpenAlexmeperidine normeperidine seizure neurotoxicity accumulation renal failure104All directly relevant to normeperidine neurotoxicity and pharmacokinetics
12WebSearchpethidine meperidine discovery 1939 Eisleb Schaumann IG Farben first synthetic opioid history101Historical data for discovery section
13WebSearchpethidine meperidine DEA Schedule II legal status UK Misuse Drugs Act international scheduling102Cross-referenced legal status across jurisdictions
14WebSearchmeperidine pethidine SMILES canonical CAS number 57-42-1 physical properties melting point103Physical-chemical data for chemical identity section
15WebSearchmeperidine pethidine 2023 Beers Criteria potentially inappropriate medications older adults avoid101Key safety-relevant clinical guideline
16NCBI Bookshelf (StatPearls)meperidine pharmacology11Current clinical reference
17Multiple API and web sourcesSynthesis of pharmacological, pharmacokinetic, historical, safety, and legal data for research output271Comprehensive coverage for research output document
18Research output writingWrite 01-research-output.md11—
88 claims by section — every cited sentence, checked against its source
safety28 · 12 ok

  • Acute pethidine overdose produces the classical opioid triad of respiratory depression, decreased consciousness, and — in a notable departure from other opioids — mydriasis (not miosis) and tachycardia (not bradycardia) due to concurrent anticholinergic activitysupported

    Notably does NOT cause miosis (unlike other opioids). Common adverse effects: nausea, vomiting, respiratory depression, constipation, addiction. aapm.119156

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • MAOI + pethidine: can produce hyperthermia, agitation, clonus, and death. The reaction may be excitatory (serotonin syndrome) or depressant (coma, respiratory failure, hypotension)supported

    Serotonergic drugs including meperidine can cause serotonin syndrome when combined with MAOIs. 5-HT reuptake inhibitors are contraindicated. 001c.39576

  • MAOI + pethidine: can produce hyperthermia, agitation, clonus, and death. The reaction may be excitatory (serotonin syndrome) or depressant (coma, respiratory failure, hypotension)supported

    Serotonin syndrome may result from coadministration of pethidine with MAOIs or SSRIs. pmid:9747665

  • SSRI + pethidine: serotonin syndrome risk documented; combination requires extreme cautionsupported

    Tramadol and meperidine (not morphine) induce serotonin syndrome-like behaviors in SERT-deficient mice. s146114570900011x

  • Claim in safety — inconclusiveinconclusiveworking →

  • SERT-deficient mice demonstrate exaggerated serotonergic responses to meperidine, confirming the transporter-mediated mechanismsupported

    Tramadol and meperidine (not morphine) induce serotonin syndrome-like behaviors in SERT-deficient mice. Exaggerated in SERT-/- mice. Response blocked by 5-HT1A antagonist WAY 100635. s146114570900011x

  • High-dose or prolonged use produces cognitive dysfunction and delirium — particularly in elderly patients, where pethidine is associated with higher delirium rates than alternative opioids.supported

    Meperidine listed as PIM to always avoid in older adults due to neurotoxicity (normeperidine accumulation), delirium risk, ineffectiveness at oral doses, and availability of safer alternatives. jgs.18372

  • High-dose or prolonged use produces cognitive dysfunction and delirium — particularly in elderly patients, where pethidine is associated with higher delirium rates than alternative opioids.supported

    Cognitive dysfunction from opioids in cancer; elevation of opioid metabolites (including normeperidine) in renal impairment contributes to cognitive dysfunction. cncr.10389

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • SSRIs combined with pethidine also produce serotonin syndrome, confirmed in both animal models and clinical reportssupported

    Tramadol and meperidine (not morphine) induce serotonin syndrome-like behaviors in SERT-deficient mice. Exaggerated in SERT-/- mice. s146114570900011x

  • Claim in safety — inconclusiveinconclusiveworking →

  • MAOI use within 14 days — serotonin syndrome or severe CNS/respiratory depression; this is the single most dangerous contraindication in opioid pharmacologysupported

    Serotonergic drugs including meperidine can cause serotonin syndrome when combined with MAOIs. 5-HT reuptake inhibitors are contraindicated. 001c.39576

  • MAOI use within 14 days — serotonin syndrome or severe CNS/respiratory depression; this is the single most dangerous contraindication in opioid pharmacologysupported

    Serotonin syndrome may result from coadministration of pethidine with MAOIs or SSRIs. pmid:9747665

  • Claim in safety — inconclusiveinconclusiveworking →

  • Older adults — 2023 AGS Beers Criteria: always avoid; delirium risk, normeperidine toxicity, inefficacy at common oral dosessupported

    Meperidine listed as PIM to always avoid in older adults due to neurotoxicity (normeperidine accumulation), delirium risk, ineffectiveness at oral doses, and availability of safer alternatives. jgs.18372

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Concurrent SSRI use — serotonin syndrome risksupported

    Tramadol and meperidine (not morphine) induce serotonin syndrome-like behaviors in SERT-deficient mice. s146114570900011x

  • Claim in safety — inconclusiveinconclusiveworking →

pharmacology17 · 8 ok

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Pethidine is a full agonist at the μ-opioid receptor (MOR), which mediates its primary analgesic, sedative, euphoric, and respiratory depressant effectssupported

    Meperidine described as phenylpiperidine, mu-opioid receptor agonist. Common adverse effects: nausea, vomiting, respiratory depression, constipation, addiction. aapm.119156

  • μ-Opioid receptor agonism — full agonist activity producing analgesia, sedation, respiratory depression, euphoria, constipation, and physical dependencesupported

    Meperidine described as phenylpiperidine, mu-opioid receptor agonist. Common adverse effects: nausea, vomiting, respiratory depression, constipation, addiction. aapm.119156

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Serotonin transporter (SERT) inhibition — pethidine blocks serotonin reuptake, producing serotonin syndrome risk when combined with MAOIs or SSRIs; this property is shared with tramadol but absent from morphine, fentanyl, and most other clinical opioidssupported

    Tramadol and meperidine (not morphine) induce serotonin syndrome-like behaviors in SERT-deficient mice. Exaggerated in SERT-/- mice. s146114570900011x

  • Serotonin transporter (SERT) inhibition — pethidine blocks serotonin reuptake, producing serotonin syndrome risk when combined with MAOIs or SSRIs; this property is shared with tramadol but absent from morphine, fentanyl, and most other clinical opioidssupported

    Serotonin syndrome may result from coadministration of pethidine with MAOIs or SSRIs. pmid:9747665

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Anticholinergic (atropine-like) activity — produces tachycardia (not bradycardia), mydriasis (not miosis), dry mouth, and urinary retention; pethidine notably does not cause pupil constriction, in contrast to virtually all other clinical opioidssupported

    Notably does NOT cause miosis (unlike other opioids). aapm.119156

  • Anticholinergic (atropine-like) activity — produces tachycardia (not bradycardia), mydriasis (not miosis), dry mouth, and urinary retention; pethidine notably does not cause pupil constriction, in contrast to virtually all other clinical opioidssupported

    has atropine-like effects on heart rate (unlike fentanyl analogues). pmid:9747665

  • Histamine release — causes vasodilation, pruritus, and hypotension; not seen with the fentanyl familysupported

    Pethidine causes histamine release and myocardial depression... unlike fentanyl analogues. pmid:9747665

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • High-risk populations include patients with renal failure, cancer patients on high cumulative doses, sickle cell disease patients, and the elderly.supported

    Meperidine listed as PIM to always avoid in older adults due to neurotoxicity (normeperidine accumulation), delirium risk. jgs.18372

clinical-evidence9 · 3 ok

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

  • Subramani et al. (2020) conducted a systematic review and Bayesian network meta-analysis of intrathecal lipophilic opioids for shivering prevention during caesarean delivery under spinal anaesthesia, encompassing 21 randomised controlled trials (N = 1,433 patients)supported

    Meta-analysis: IT meperidine significantly reduced shivering incidence (OR 0.12, 95%CrI 0.05-0.29) in cesarean delivery under spinal anesthesia. s12871-020-01116-5

  • Kimberger et al. (2007) conducted a volunteer study demonstrating that meperidine and skin surface warming additively reduce the shivering threshold, providing mechanistic confirmation that the anti-shivering effect operates through a central thermoregulatory mechanism (κ-opioid mediated) rather than simply raising core temperature.supported

    Meperidine and skin warming each linearly lower vasoconstriction and shivering thresholds. Combination reduced shivering threshold to 33.8C with only mild sedation and no respiratory toxicity. cc5709

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

  • The 2023 American Geriatrics Society Beers Criteria classified meperidine as a medication to always avoid in older adults, based on moderate-quality evidence with a strong recommendation against usesupported

    Meperidine listed as PIM to always avoid in older adults due to neurotoxicity (normeperidine accumulation), delirium risk, ineffectiveness at oral doses, and availability of safer alternatives. Strong recommendation, moderate evidence. jgs.18372

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

history7 · 2 ok

  • The 2023 AGS Beers Criteria classified it as a medication to always avoid in older adults.supported

    2023 Beers Criteria update. Meperidine listed as PIM to always avoid in older adults. jgs.18372

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Pethidine retains limited clinical use in specific niches: treatment of postoperative and post-anaesthetic shivering (where its κ-opioid activity provides unique efficacy), and in some jurisdictions as a labour analgesic, though Cochrane evidence suggests inferior efficacy and more adverse effects compared to alternativessupported

    Meperidine and skin warming each linearly lower vasoconstriction and shivering thresholds. cc5709

  • Claim in history — inconclusiveinconclusiveworking →

pharmacokinetic-detail6 · 1 ok

  • Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →

  • Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →

  • Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →

  • Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →

  • Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →

  • A mouse pharmacokinetic study demonstrated significant 24-hour rhythms in both pethidine and normeperidine Cmax and AUC, with higher plasma concentrations during the dark (active) phasesupported

    Significant 24-h rhythm in pethidine analgesia in mice. Cmax and AUC of pethidine and norpethidine higher during dark phase. journal.pone.0102054

receptor-pharmacology6 · 3 ok

  • Pethidine inhibits the serotonin transporter (SERT), an action confirmed both by serotonin syndrome induction in clinical settings and by exaggerated serotonergic responses in SERT-deficient micesupported

    Tramadol and meperidine (not morphine) induce serotonin syndrome-like behaviors in SERT-deficient mice. Exaggerated in SERT-/- mice. s146114570900011x

  • Claim in receptor-pharmacology — inconclusiveinconclusiveworking →

  • Claim in receptor-pharmacology — inconclusiveinconclusiveworking →

  • Claim in receptor-pharmacology — inconclusiveinconclusiveworking →

  • Pethidine exhibits anticholinergic activity that is clinically relevant: mydriasis (unique among common opioids), tachycardia, dry mouth, and urinary retention are directly attributable to muscarinic receptor antagonismsupported

    Notably does NOT cause miosis (unlike other opioids). aapm.119156

  • Pethidine exhibits anticholinergic activity that is clinically relevant: mydriasis (unique among common opioids), tachycardia, dry mouth, and urinary retention are directly attributable to muscarinic receptor antagonismsupported

    has atropine-like effects on heart rate (unlike fentanyl analogues). pmid:9747665

neuroscience5 · 2 ok

  • Claim in neuroscience — inconclusiveinconclusiveworking →

  • Circadian neuropharmacology: Mouse data demonstrate circadian variation in pethidine PK. Does time-of-day affect efficacy, toxicity threshold, or abuse potential in humans?supported

    Significant 24-h rhythm in pethidine analgesia in mice. Cmax and AUC of pethidine and norpethidine higher during dark phase. journal.pone.0102054

  • Claim in neuroscience — inconclusiveinconclusiveworking →

  • Claim in neuroscience — inconclusiveinconclusiveworking →

  • SERT inhibition elevates synaptic serotonin concentrations in raphe-cortical projectionssupported

    Tramadol and meperidine (not morphine) induce serotonin syndrome-like behaviors in SERT-deficient mice. Exaggerated in SERT-/- mice. Response blocked by 5-HT1A antagonist WAY 100635. s146114570900011x

summary5 · 1 ok

  • Claim in summary — inconclusiveinconclusiveworking →

  • Claim in summary — inconclusiveinconclusiveworking →

  • Claim in summary — inconclusiveinconclusiveworking →

  • Claim in summary — inconclusiveinconclusiveworking →

  • The 2023 AGS Beers Criteria lists pethidine as a medication to always avoid in older adultssupported

    2023 Beers Criteria update. Meperidine listed as PIM to always avoid in older adults due to neurotoxicity (normeperidine accumulation), delirium risk, ineffectiveness at oral doses, and availability of safer alternatives. Strong recommendation, moderate evidence. jgs.18372

comparative-pharmacology4 · 2 ok

  • Claim in comparative-pharmacology — inconclusiveinconclusiveworking →

  • Tramadol shares pethidine's dual mechanism of opioid agonism and serotonin reuptake inhibition, making both compounds unusual among clinical opioids in producing serotonin syndrome risksupported

    Tramadol and meperidine (not morphine) induce serotonin syndrome-like behaviors in SERT-deficient mice. s146114570900011x

  • Fentanyl does not cause histamine releasesupported

    Pethidine causes histamine release and myocardial depression... unlike fentanyl analogues. pmid:9747665

  • Claim in comparative-pharmacology — inconclusiveinconclusiveworking →

chemistry1 · 1 ok

  • Pethidine is the prototype member of the 4-phenylpiperidine opioid analgesic class — a family defined by a phenyl ring attached at the 4-position of a piperidine ringsupported

    Meperidine described as phenylpiperidine, mu-opioid receptor agonist. aapm.119156

3Sources

25 consumed · sorted by year · feeds = sections resting on it

Sources
yearsourcetierstatusfeeds
2024Lorazepam UK controlled drug classificationUK Home Officeurl:2526b8ac32790ba2weakconsumedcited only
2024Meperidine - StatPearls (NCBI Bookshelf)Preuss CV, et al.url:05970c7a69e0f448weakconsumedcited only
2024Meperidine chemical properties: CAS 57-42-1, SMILES, physical constantsChemicalBookurl:328aec25ba6fb926weakconsumedcited only
2024Pethidine (CID 4058) - Chemical IdentityPubChem · PubChem Database (NCBI)url:e0da5e9df4cc35a1moderateconsumedcited only
2023American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults.American Geriatrics Society · Journal of the American Geriatrics Societydoi:10.1111/jgs.18372strongconsumed5 sections
2023Pethidine pharmacology, pharmacokinetics, history, legal statusHandWiki Chemistryurl:c32e7cf9949f2e0eweakconsumedcited only
2022Clinically Relevant Drug Interactions with Monoamine Oxidase InhibitorsEdinoff AN, Swinford CR, Odisho AS, Burroughs CR, Stark CW · Health Psychology Researchdoi:10.52965/001c.39576moderateconsumed1 section
2021Full Opioid Agonists and Tramadol: Pharmacological and Clinical Considerations.Edinoff AN, Kaplan LA, Khan S, Petersen M, Sauce E, Causey CD, Cornett EM, Imani F, Moradi Moghadam O, Kaye AM, Kaye AD · Anesthesiology and Pain Medicinedoi:10.5812/aapm.119156moderateconsumed7 sections
2020Effect of intrathecal lipophilic opioids on the incidence of shivering in women undergoing cesarean delivery after spinal anesthesia: a systematic review and bayesian network meta-analysisSubramani Y, Nagappa M, Kumar K, et al. · BMC Anesthesiologydoi:10.1186/s12871-020-01116-5strongconsumed1 section
2019The Mechanisms Involved in Morphine Addiction: An OverviewListos J, Lupina M, Talarek S, Mazur AJ, Orzelska-Gorka J · International Journal of Molecular Sciencesdoi:10.3390/ijms20174302moderateconsumed2 sections
2016Insights into CYP2B6-mediated drug-drug interactionsHedrich WD, Hassan HE, Wang H · Acta Pharmaceutica Sinica Bdoi:10.1016/j.apsb.2016.07.016moderateconsumed3 sections
2016Opioid Drugs in Patients With Liver Disease: A Systematic ReviewSoleimanpour H, Safari S, Shahsavari Nia K, Sanaie S, Alavian SM · Hepatitis Monthlydoi:10.5812/hepatmon.32636strongconsumed3 sections
2015Practice Guidelines for Obstetric AnesthesiaApfelbaum JL, Hawkins JL, Bateman B, et al. · Anesthesiologydoi:10.1097/aln.0000000000000935moderateconsumed1 section
2014Chronopharmacodynamics and Chronopharmacokinetics of Pethidine in MiceZhang C, Yu Z, Li X, Xu Y, Liu D · PLoS ONEdoi:10.1371/journal.pone.0102054moderateconsumed2 sections
2012Pain management for women in labour: an overview of systematic reviewsJones L, Othman M, Dowswell T, Alfirević Ž, Gates S · Cochrane Database of Systematic Reviewsdoi:10.1002/14651858.cd009234.pub2strongconsumed2 sections
2009Tramadol and another atypical opioid meperidine have exaggerated serotonin syndrome behavioural effects, but decreased analgesic effects, in genetically deficient serotonin transporter (SERT) mice.Fox MA, Jensen CL, Murphy DL · The International Journal of Neuropsychopharmacologydoi:10.1017/s146114570900011xstrongconsumedcited only
2008Meperidine for Acute Sickle Cell Pain in the Emergency Department: Revisited ControversyBallas SK · Annals of Emergency Medicinedoi:10.1016/j.annemergmed.2007.09.033moderateconsumed2 sections
2007Meperidine and skin surface warming additively reduce the shivering threshold: a volunteer study.Kimberger O, Ali SZ, Markstaller M, Zmoos S, Lauber R, Hunkeler C, Kurz A · Critical Caredoi:10.1186/cc5709strongconsumed4 sections
2002The panorama of opioid-related cognitive dysfunction in patients with cancerLawlor PG · Cancerdoi:10.1002/cncr.10389moderateconsumed1 section
1999Opioid rotation for cancer painMercadante S · Cancerdoi:10.1002/(sici)1097-0142(19991101)86:9<1856::aid-cncr30>3.0.co;2-gmoderateconsumed3 sections
1998Adverse effects of opioid agonists and agonist-antagonists in anaesthesia.Bowdle TA · Drug Safetypmid:9747665moderateconsumed6 sections
1995The Serotonin SyndromeSporer KA · Drug Safetydoi:10.2165/00002018-199513020-00004moderateconsumed2 sections
1992Toxicity of norpethidine in sickle cell crisis.Pryle BJ, Grech H, Stoddart PA, Carson R, O'Mahoney T, Reynolds F · BMJ (Clinical research ed.)pmid:1611370weakconsumed4 sections
1989Norpethidine induced myoclonus in a patient with renal failure.Reutens DC, Stewart-Wynne EG · Journal of Neurology, Neurosurgery & Psychiatrydoi:10.1136/jnnp.52.12.1450weakconsumed5 sections
1983Meperidine and central neurotoxicity.Hershey LA · Annals of Internal Medicinepmid:6838077moderateconsumed5 sections
—Searched PubMed for "pethidine meperidine pharmacology receptor binding opioid" — no resultsabsenceno results—

4Docket

one filing per activity — decisions, correspondence, reports

  1. 0012026-05-10revisionRevision 1

    Initial LLM generation (v5 pipeline, wiki, prose phase)

    psx:substance/pethidine/version/1
  2. 0022026-06-04proposal32 value proposals approved together

    one review action inferred from a shared reviewer and instant — the graph records one activity per proposal

    32 items in this filing

    • contraindication · renal
    • contraindication · other
    • contraindication · age
    • contraindication · hepatic
    • contraindication · neurological
    • contraindication · other
    • contraindication · psychiatric
    • contraindication · metabolic
    • contraindication · other
    • contraindication · respiratory
    • contraindication · pregnancy_breastfeeding
    • dose_tier · threshold
    • dose_tier · light
    • dose_tier · common
    • dose_tier · strong
    • dose_tier · heavy
    • timeline · oral · onset
    • timeline · oral · peak
    • timeline · oral · plateau
    • timeline · oral · resolution
    • timeline · oral · afterglow
    • toxicity
    • dependence · full
    • withdrawal
    • tolerance
    • dosage · oral
    • duration · oral · onset
    • duration · oral · peak
    • duration · oral · offset
    • duration · oral · total
    • duration · oral · aftereffects
    psx:substance/pethidine/proposal/contraindication/99199194-d83c-4f63-8c09-5ca9ee96e52d
  3. 0032026-06-04publicationPublication — backfill
    psx:substance/pethidine/pub/b6918789-e0c8-47e1-96b1-c48aa2917dab

5Issued documents

what the notice, info card and emergency page said, by hash

Issued documents
documentcontent hashissuedfrom versionsuperseded
info_cardb1ea9c80087d2a5893317bf4…2026-10-19 20:33Revision 1current
emergencyf85b2d2362c98030e2585598…2026-09-04 04:31Revision 1current
info_cardcbd246c2f5faf865808e7e68…2026-09-04 04:31Revision 1superseded2026-10-19
notice605e29df7ada7b4e996f1616…2026-09-04 04:31Revision 1current