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2-pharm Exam > MAOI > Flashcards

MAOI Flashcards

1
Q

mao inhibitor is less commonly used due to what 3 side effects

A

hypotension
lethality of OD
lack of simplicity in dosing

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2
Q

what diet must be followed when taking an MAOI-causing what?

A

tyramine-free diet(causing systemic HTN)

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3
Q

if a patients do not respond to cyclic antidepressants - what can we give them

A

MAO inhibitors

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4
Q

how do we determine the dosing of MAO inhibitors

A

its not affected by age- young and old get the same amount- old have higher levels of MAO

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5
Q

what three maoi are approved in the US for depression or panic disorder

A

phenelzine
Tranylcypromine
Isocarboxazid

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6
Q

what MAOI is used for parkinson

A

Selegiline (MAO-B selective inhibitor). Formally known as deprenyl: has been shown to be effective in treatment of early Parkinson’s disease

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7
Q

where do you find MAO-A

A

platelets

60% found in the brain

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8
Q

where do you find MAO-B

A

placenta

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9
Q

MAO-B preferentially deaminates:

A

Phenylethylamine

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10
Q

MAO-A preferentially deaminates:

A

Serotonin
Norepinephrine
Epinephrine

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11
Q

what type of enzyme inhibition does MAO form- irreversible or reversible?

A

irreversible

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12
Q

where in the cell is MAO found

A

mitochondrial membrane

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13
Q

maoi moa

A

MAO in neurons are only capable of deaminating substrates that are free within the cytoplasm and are unable to gain access to substrates once they are bound in the storage vesicles.
Thus, cytoplasmic concentrations of MAO are maintained at low levels

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14
Q

what is the most common and serious side effect of MAOI- prominent in elderly

A

orthostatic hypotension

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15
Q

orthostatic hypotension may reflect accumulation of false neurotransmitters called?

A

octopamine- in the cytoplasm of postganglionic sympathetic nerve endings.

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16
Q

Phenelzine side effects

A

Phenelzine has anticholinergic like side effects and may produce sedation

17
Q

Tranylcypromine side effects

A

Tranylcypromine has no anticholinergic side effects but has mild stimulant effects, which may cause insomnia

18
Q

if patients complain of paresthesias during MAOI therapy what med can we give

A

pyridoxine therapy

19
Q

Administration of “this” drug in combination with maoi may result in excitatory type 1 or depressive type II response.

A

meperidine

20
Q

what three derivatives of meperidine has been associated with adverse reactions in patients treated with MAO inhibitors

A

fentanyl
sufentanyl
alfentanil

21
Q

If a sympathomimetic is needed and the patient is taking an MAOI - do they need an direct acting or indirect acting

A

directing acting (phenylephrine) is preferable to an indirect acting drug. regardless of the dose- decrease about 1/3 of normal

22
Q

what has been a suggested treatment for skeletal muscle rigidity and associated symptoms of hyper metabolism after an overdose with MAO inhibitors.

A

dantrolene

23
Q

what is the recommendation for MAO inhibitors and stopping them for anesthesia

A

there is a growing appreciation that aneshtesia can be safely administered in most patients being chronically treated with mao inhibitor.

24
Q

can patients on an MAOI have regional anesthesia?

if so can you use epi

A

it is acceptable but a cautious approach is not to add epinephrine.

25
Q

is weight gain or weight loss associated with MAOI

A

weight gain

26
Q

in contrast to tricyclic antidepressants- what does MAOI fail to produce

A

cardiac dysrhythmias

27
Q

what medication is given to treat HTN with MAOI

A

nitroprusside

28
Q

if cardiac dysrhythmias persist after control of systemic blood pressure what two meds can be administered

A

lidocaine and beta blockers

29
Q

what two drugs can be administered to patients treated with MAOI having electroconvulsive therapy

A

etomidate and thiopental

30
Q

what are the symptoms of serotonin syndrome

A

AMS, CLONUS, hyperthermia

31
Q

what should be administered for serotonin syndrome

A

5ht2a- antagonist

2-pharm Exam (10 decks)

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