Which drug can cause seizures due to its toxic metabolites in older adults?

The drug associated with seizures due to its toxic metabolites in older adults is meperidine. Meperidine is an opioid that is known to be less favorable for use in the elderly because it can lead to the accumulation of its active metabolite, normeperidine. This metabolite has a lower seizure threshold and can cause neurotoxic effects, including seizures, particularly in patients with renal impairment or in those taking the medication over extended periods.

Elderly patients often have altered pharmacokinetics and pharmacodynamics due to age-related changes in metabolism and excretion, which increase the risk of adverse effects from medications like meperidine. In addition to its potential for causing seizures, meperidine has other concerning side effects compared to other opioids, which makes its use less common in geriatric populations.

Understanding the importance of avoiding certain medications in older adults helps guide safe prescribing practices to prevent harmful reactions such as seizures.