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Proconvulsant

• Lowers the seizure threshold — a CNS-excitatory effect that is the reason the entity is on the board at all
• Normeperidine, meperidine’s N-demethylated metabolite, accumulates in renal impairment and with repeated dosing; myoclonus and tremor precede seizures
• 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.

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