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Pethidine
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==Pharmacokinetics== [[File:Pethidine DOJ.jpg|frame|right]] Pethidine is quickly hydrolysed in the liver to [[Pethidinic Acid|pethidinic acid]] and is also demethylated to norpethidine, which has half the analgesic activity of pethidine but a longer elimination half-life (8β12 hours);<ref>{{cite journal|title=Does pethidine still have a place in therapy?|journal=Australian Prescriber|year=2002|volume=25|issue=1|pages=12β13| vauthors = Molloy A |doi=10.18773/austprescr.2002.008|doi-access=free}}</ref> accumulating with regular administration, or in [[kidney failure]]. Norpethidine is toxic and has convulsant and hallucinogenic effects. The toxic effects mediated by the metabolites cannot be countered with opioid receptor antagonists such as naloxone or naltrexone, and are probably primarily due to norpethidine's anticholinergic activity probably due to its structural similarity to atropine, though its pharmacology has not been thoroughly explored. The neurotoxicity of pethidine's metabolites is a unique feature of pethidine compared to other opioids. Pethidine's metabolites are further conjugated with [[glucuronic acid]] and excreted into the urine. [[File:Metabolism of pethidine.png|class=skin-invert-image|600px]]
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