What is the best action when meperidine is prescribed to a patient taking amphetamine/dextroamphetamine?

• A. Hold the meperidine and contact the healthcare provider.
• B. Administer as prescribed.
• C. Administer and monitor closely.
• D. Switch to morphine.

Answer: (A)

The essential idea is to recognize a potential interaction between an opioid and a stimulant that can lead to serious adverse effects. Meperidine has serotonergic activity and, when given with amphetamine/dextroamphetamine, can increase monoamine effects enough to raise the risk of serotonin syndrome and other CNS overstimulation. Because amphetamine/dextroamphetamine already alters monoamine levels, adding meperidine could provoke dangerous symptoms such as agitation, tremor, rapid heart rate, high blood pressure, fever, and confusion. In addition, meperidine can accumulate neurotoxic metabolites (normeperidine), which raises seizure risk, especially in vulnerable patients. For these safety reasons, the prudent action is to withhold meperidine and consult the healthcare provider to choose an alternative analgesic or adjust the plan. If pain management is needed, a safer option such as morphine or another non-serotonergic analgesic may be considered under medical guidance.