This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Central Nervous system, Subject name: Pharmacology
Which of the following opioid should not be used with MAO inhibitors 
Select and explain. 
A. Pethidine, B. Pentazocine, C. Buprenorphine, D. Morphine
A: Pethidine
Answer: A: Pethidine 
Explanation: Pethidine (Meperidine) Toxicity/overdose:- Overdose of pethidine produces many excita tory effects--tremors, mydriasis, hyperreflexia, delirium, myoclonus and convulsions. This is due to accumulation of norpethidine which has excitant effects. Nonselective MAO inhibitors interfere with hydrolysis but not with demethylation of pethidine--norpethidine is produced in excess and excitement occurs. So, pethidine should not be used with MAO inhibitors. Ref:- kd tripathi; pg num:-475