The nurse is completing the medication reconciliation form for a patient admitted with chronic cancer pain. Which medication is of most concern to the nurse?
a. Amitriptyline (Elavil) 50 mg at bedtime
b. Ibuprofen (Advil) 800 mg 3 times daily
c. Oxycodone (OxyContin) 80 mg twice daily
d. Meperidine (Demerol) 25 mg every 4 hours
ANS: D
Meperidine is contraindicated for chronic pain because it forms a metabolite that is neurotoxic and can cause seizures when used for prolonged periods. The ibuprofen, amitriptyline, and oxycodone are all appropriate medications for long-term pain management.
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