Final answer:
Patients with renal impairment and the elderly have a higher risk of developing seizures from meperidine use due to the accumulation of its toxic metabolite, normeperidine, which is normally excreted through the kidneys.
Step-by-step explanation:
Patients with renal impairment and the elderly are at a higher risk of developing seizures when taking meperidine. Meperidine is metabolized in the liver, but its metabolite, normeperidine, is excreted via the kidneys. In individuals with compromised kidney function, like those with renal impairment or the elderly, normeperidine can accumulate to toxic levels, increasing the risk of seizures. This is particularly critical since meperidine's analgesic effect may be shorter than the half-life of its metabolite, possibly leading to drug accumulation and adverse side effects before the next dose is even considered.
It is essential for healthcare providers to be cautious when prescribing meperidine to patients with renal impairment or in the elderly population. Alternative pain management strategies should be considered in such patients to avoid the risk of seizures and other potential side effects associated with meperidine use.