Neurotoxic metabolite
- Direct CNS excitation: myoclonus, tremor, agitation
- Marks a metabolite, significant for this excitation rather than anything it binds
- Normeperidine wears this alongside the proconvulsant peg; these signs precede the seizures
- Not reversed by naloxone
- Accumulates in renal impairment and with repeated dosing
Drugs with this mechanism (1)
- Normeperidine — Neurotoxic meperidine metabolite; accumulation, especially with renal impairment, can cause tremor and seizures.
Self-check
- Does naloxone reverse the described normeperidine CNS excitation?
No. - What promotes accumulation of the neurotoxic metabolite?
Renal impairment and repeated dosing.
All mechanisms · Open Neurotoxic metabolite in the interactive console ↗