Proconvulsant
Proconvulsant (lowers the seizure threshold)
- ↓ seizure threshold
- Myoclonus and tremor precede seizures
- Normeperidine, meperidine’s N-demethylated metabolite, accumulates in renal impairment and with repeated dosing
- Naloxone does not reverse it and may worsen it — the excitation is not opioid-receptor mediated
Drugs with this mechanism (1)
- Normeperidine — Neurotoxic meperidine metabolite; accumulation, especially with renal impairment, can cause tremor and seizures.
Self-check
- Which meperidine metabolite accumulates with renal impairment or repeated dosing?
Normeperidine. - Does naloxone reverse this proconvulsant excitation?
No; it may worsen it.
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