21 Monoamine Oxidase Inhibitors

Question 1

Onset of clinical toxicity of MAOis

Answer 1

6-24 hours after ingestion

Question 2

True or False:
Blood levels of MAOi correlate with clinical toxicity

Answer 2

FALSE

Answer:
Clinical toxicity is usually delayed UNTIL WELL after MOST OF THE DRUG HAS BEEN METABOLIZED

Question 3

Drugs that cannot be given if the patient is currently taking MAOis

Answer 3

Meperidine
Dextrometorphan
Tramadol
Linezolid
Propoxyphene
SSRIs
SNRIs

Question 4

True or False:

Delayed gastric lavage for MAOi is generally not recommended

Answer 4

True

MAOis are absorbed rapidly; if presentation is WITHIN 1 HOUR, SDAC can be given. but MDAC is not recommended

Question 5

Recommended antihypertensive agents for MAOi overdose

Answer 5

Phentolamine 2.5-5mg IV q10-15 mins
Nitroprusside 1mcg/kg/min as IV infusion

Question 6

Recommended anticonvulsants of choice for MAOi overdose

Answer 6

Benzodiazepines (Loraz and Diaz)

Question 7

Hallmark symptom of tyramine reaction

Answer 7

Severe occipital or temporal headache

Question 8

There should be at least a ____-week abstinence period between the ime a MAOi is discontinued and when any contraindicated drug is started

Answer 8

2 weeks

Question 9

Most common ECG finding for MAOi overdose

Answer 9

Sinus tachycardia