MAO inhibitors

Question 1

name the MAO enzymes and their actions !

Answer 1

-MAO-A (“albino mouse”) breaks down Serotonin , Norepinephrine , Dopamine
(“white mouse eating smiley cheese , compass cheese and dopa rope”)

-MAO B (“ black mouse”) breaks down dopamine exclusively (“black mouse eating rope”)

Question 2

name non-selective MAOis

Answer 2

Tranylcypromine
(“Try a sip of wine !” sign on table)

Phenelzine
(“Funnel in wine bottle on table”)

Isocarboxazid
(“Boxed wine on table”)

Question 3

what are MAOis used for?

Answer 3

-MAOis are irreversible
(“mouse skeleton trapped in mouse trap)

-useful in treatment of Atypical depression
(“Chateu Tyramine …not your typical winery”)

-useful in treatment of depression (not 1st line)
(“happy/sad mask on chateu tyramine sign”)

-useful in treatment of resistant depression
(“guy trying to open resistant wine bottle with happy/sad mask label”)

Question 4

-name selective MAOis inhibitor

Answer 4

Selegiline - selective MAO B inhibitor
(“guy on ladder with sledge hammer trying to hit black mouse”)

Moclobemide - selective MAO A inhibitor

Question 5

what are selective MAOis used for ?

Answer 5

-useful for treatment of Cogwheel rigidity seen in Parkinson’s disease since they increase Dopamine levels in the CNS

(“watch runing by cogwheels above sledge hammer”)

Question 6

what are the side effects of MAOis ?

Answer 6

-since non selective MAOis inhibit serotonin breakdown they have similar side effects to SSRIs including:

• highest rate of sexual dysfunction among anti depressant
• ​orthostatic hypotension
• ​weight gain

-should be avoided with tyramine containing foods such as aged meats , wine and cheese
(“wine and cheese on table”)

-tyramine is usually broken down in the GI by MAO enzymes
(“albino mouse eating GI meat”)

-when MAOis are adminestered tyramine is not broken down and act as sympathomimetic
(“albino trapped in mouse trap and NE compass cheese released”)

-Tyramine Toxicity can percipitate a hypertensive
crisis
(“blonde lady is hypertensive and sweaty having steam come out of her ears “)

-may cause Serotonin Syndrome
(“pile of smiley cheese next to tricycle”)

-should be avoided with other drugs such as TCAs and SSRIs
(“yellow tricycle in front”)

Question 7

what drug could be adminesterd for management of hypertensive crisis resulting from Tyramine toxicity ?

Answer 7

Phentolamine-reversible α1 and α2 antagonist (“phantom of the alpha behind blonde lady”)