Which medication can have adverse effects such as seizures and delirium?

Meperidine is associated with adverse effects such as seizures and delirium primarily due to its metabolite, normeperidine. Unlike other opioids, meperidine's active metabolite can accumulate, especially in patients with renal impairment, leading to neurotoxicity. The accumulation of normeperidine can decrease seizure thresholds and may contribute to symptoms of delirium, making this medication particularly risky in certain populations.

In contrast, hydromorphone, fentanyl, and methadone have different safety profiles. Though they can cause various side effects, they are not typically associated with seizures or delirium to the same extent as meperidine. Therefore, it is essential for healthcare practitioners to be aware of the unique risks that meperidine poses concerning central nervous system effects, especially in patients with compromised renal function or those who are elderly.