Meperidine is contraindicated in patients taking which Parkinson's disease medication?

Meperidine is contraindicated in patients taking which Parkinson's disease medication?

• A. Bromocriptine
• B. Levodopa
• C. Selegiline
• D. Amantadine

Answer: (C)

Meperidine must not be given with monoamine oxidase inhibitors, such as selegiline, which is used in Parkinson’s disease. Selegiline inhibits MAO-B (and at higher doses can affect MAO-A), and meperidine has serotonergic activity. When MAO is inhibited, breakdown of serotonin (and other monoamines) is reduced, so their levels rise. The combination can trigger serotonin syndrome, a dangerous state with agitation, autonomic instability, hyperthermia, and neuromuscular abnormalities. Because of this risk, selegiline is contraindicated with meperidine. The other Parkinson's meds listed—bromocriptine, levodopa, and amantadine—do not carry the same dangerous interaction with meperidine.

Meperidine must not be given with monoamine oxidase inhibitors, such as selegiline, which is used in Parkinson’s disease. Selegiline inhibits MAO-B (and at higher doses can affect MAO-A), and meperidine has serotonergic activity. When MAO is inhibited, breakdown of serotonin (and other monoamines) is reduced, so their levels rise. The combination can trigger serotonin syndrome, a dangerous state with agitation, autonomic instability, hyperthermia, and neuromuscular abnormalities. Because of this risk, selegiline is contraindicated with meperidine. The other Parkinson's meds listed—bromocriptine, levodopa, and amantadine—do not carry the same dangerous interaction with meperidine.