You are treating a patient who has experienced a fracture of his right forearm while playing sports. The patient is alert, oriented, with normal vital signs. He reports pain is an "8" on a 10 -point system. The patient has a history of depression and has taken Nardil for many years with no problems. Which of the following is TRUE regarding the use of Demerol for this patient?

a. Because Nardil is used for depression, you should only administer half the initial dosage and have naloxone available for respiratory depression.
b. The patient will most likely have developed a tolerance for narcotics and may require larger than normal doses.
c. A standard dose of meperedine will be suitable for this patient.
d. Demerol should not be used for this patient.

d
Rationale: a. Nardil should not be used with Demerol
b. Nardil should not be used with Demerol
c. Nardil should not be used with Demerol
d. Correct. Nardil is a monoamine oxidase inhibitor (MAOI). The use of meperedine (Demerol) has occasionally caused severe and sometimes fatal reactions when an MAOI has recently been taken.