Normeperidine accumulation can cause tremors, seizures, and myoclonus, especially in which patient population?

Normeperidine accumulation can cause tremors, seizures, and myoclonus, especially in which patient population?

• A. Tremors
• B. Seizures
• C. Myoclonus
• D. Tremors, Seizures, and Myoclonus

Answer: (D)

Normeperidine is an active CNS stimulant metabolite of meperidine. It tends to accumulate when renal function is impaired, and this accumulation is especially problematic in elderly patients, whose clearance is often reduced. The neurotoxic effects of normeperidine include tremors, myoclonus, and seizures, reflecting its excitatory action on the CNS. Because these symptoms can all occur together as a consequence of accumulation, the statement that encompasses tremors, seizures, and myoclonus best captures the spectrum of neurotoxicity you’d see in at‑risk populations. Clinically, this is why meperidine is avoided in elderly or renally impaired patients, favoring other analgesics with a more favorable CNS toxicity profile.

Normeperidine is an active CNS stimulant metabolite of meperidine. It tends to accumulate when renal function is impaired, and this accumulation is especially problematic in elderly patients, whose clearance is often reduced. The neurotoxic effects of normeperidine include tremors, myoclonus, and seizures, reflecting its excitatory action on the CNS. Because these symptoms can all occur together as a consequence of accumulation, the statement that encompasses tremors, seizures, and myoclonus best captures the spectrum of neurotoxicity you’d see in at‑risk populations. Clinically, this is why meperidine is avoided in elderly or renally impaired patients, favoring other analgesics with a more favorable CNS toxicity profile.