Chapter 179: Monoamine Oxidase Inhibitors

Question 1

Transdermal monoamine oxidase inhibitor approved for use in majoy depression

Answer 1

Selegiline

Question 2

It contains many active ingredients, some of which have the ability to inhibit monoamine oxidase (MAO) and block serotonin reuptake

Answer 2

St. John’s wort (Hypericum perforatum)

Question 3

Primarily responsible for the breakdown of serotonin and norepinephrine

Answer 3

MAO-A

Question 4

Responsible for metabolizing phenylethylamine and treatment for Parkinson’s disease

Answer 4

MAO-B

Question 5

True or False

MAO-A and MAO-B have equal ability to metabolize dopamine or tyramine

Answer 5

True

MAO-A and MAO-B have equal ability to metabolize dopamine or tyramine

Question 6

Most abundant type of MAO in the gut

Answer 6

MAO-A

Question 7

Most abundant type of MAO in the brain

Answer 7

MAO-B

Question 8

A MAOI drug that is non selective but MAO-B selective in oral form

Answer 8

Selegiline

Question 9

A MAO-A selective inhibitor

Answer 9

Moclobemide

Question 10

True or False
Clinical toxicity is that it is usually delayed until well after most of the drug has already been metabolized. Hence, blood levels do not correlate with clinical toxicity

Answer 10

True
Clinical toxicity is that it is usually delayed until well after most of the drug has already been metabolized. Hence, blood levels do not correlate with clinical toxicity

Question 11

Example of drug that inhibits the metabolism of rasagiline?

Answer 11

Ciprofloxacin and Cimetidine

Question 12

What example drug to avoid in patient with serotonin syndrome?

Answer 12

• Meperidine,
• Dextromethorphan
• Tramadol
• Linezolid
• Propoxyphene

Question 13

In general, selective serotonin reuptake inhibitors and serotonin- norepinephrine reuptake inhibitors should be discontinued for 2 weeks prior to using an MAOI with the exception of ____, which should be stopped 4 weeks before using an MAOI

Answer 13

In general, selective serotonin reuptake inhibitors and serotonin- norepinephrine reuptake inhibitors should be discontinued for 2 weeks prior to using an MAOI with the exception of fluoxetine, which should be stopped 4 weeks before using an MAOI

Question 14

Refers to bilateral wandering horizontal eye movements.

Answer 14

Ping-pong gaze seen in MAOI overdose

Question 15

The most common ECG abnormality seen with MAOI toxicity

Answer 15

Sinus tachycardia

Question 16

Overdose of this MAOI drug may produce QT-interval prolongation but without associated dysrhythmias

Answer 16

Moclobemide

Question 17

Drug that has amphetamine metabolites

Answer 17

Selegiline and Tranylcypromine

Question 18

Recommended antihypertensive for MAOI toxicity

Answer 18

Phentolamin - 2.5-5mg IV

Nitroprusside - 1mcg/kg/min

Question 19

Management of hypotension in MAOI toxicity

Answer 19

Fluids then Norepinephrine do not give Dopamine

Question 20

The most effective antiarrhythmics for treating the ventricular dysrhythmias seen with MAOI toxicity

Answer 20

Lidocaine and Procainamide

Question 21

The hallmark symptom of the tyramine reaction is a what?

Answer 21

The hallmark symptom of the tyramine reaction is a severe occipital or temporal headache