Final answer:
Meperidine (Demerol) and Propoxyphene (Darvocet) are unsafe choices for treating severe pain in older adults due to their side effects and related risks. While morphine and codeine are common painkillers, they must be used cautiously in the elderly. Methadone can be used but requires close monitoring.
Step-by-step explanation:
In treating an older patient who is experiencing severe pain, some medications may be unsafe choices. Meperidine (Demerol) is not recommended for older adults due to its side effects, including confusion and potential for toxicity with accumulation. Propoxyphene (Darvocet) has been withdrawn from the U.S. market due to safety concerns, including heart toxicity and adverse drug reactions. While morphine and codeine are opioids that are commonly used for pain management, caution is required as they can also present risks in the elderly due to the potential for respiratory depression and increased sensitivity to the sedative effects of opioids. Methadone (Dolophine) can be used but with great caution due to its long half-life and the risk of accumulation, especially in patients with underlying organ dysfunction. It is important to approach pain management in older adults with a careful evaluation of risks versus benefits for each medication.