What post operative medication could be the cause of the hypertensive crisis?

The correct answer is Demerol (meperidine) at a dosage of 40mg, as it is known to potentially lead to a hypertensive crisis, particularly in certain patient populations. Demerol can influence blood pressure due to its metabolite, normeperidine, which may cause central nervous system stimulation and lead to increased blood pressure. Additionally, if not used cautiously with other medications, particularly monoamine oxidase inhibitors (MAOIs), it can trigger significant hypertensive responses, making it crucial to monitor patients receiving this opioid closely.

In contrast, the other medications listed—Dilaudid (hydromorphone), Morphine, and Fentanyl—do not typically share the same high risk of inducing hypertensive crises. While they can cause various side effects including respiratory depression and hypotension, their usual effects do not primarily involve significant changes in blood pressure in the same manner as Demerol. Therefore, understanding the distinct pharmacological profiles of these medications is key in post-operative settings to avoid complications like hypertensive crises.