MAOIs

Question 1

MOA od MAOIs

Answer 1

Prevent inactivation of biogenic amines like NE, serotonin, DA, and tyramine

Question 2

What does MAO-A inactivate?

Answer 2

Serotonin

Question 3

What does MAO-B inactivate

Answer 3

NE and Epi

Question 4

When are MAOIs indicated

Answer 4

For refractory depression and refractory depression/panic disorder

Question 5

3 MAOIs

Answer 5

1. Phenelzine
2. Transcypromine
3. Isocarboxazid

Question 6

What are two main AE of MAOI?

Answer 6

1. Serotonin syndrome
2. Hypertensive crisis - when mixed with foods rich in tyramine or sympathomimetics
   * also get HA, sweating, nausea, vomiting, photophobia, autonomic instability, chest pain, arrhythmias, death

Question 7

What two other drugs other than serotonergic drugs must be avoided with MAOIs?

Answer 7

1. Decongestants

2. Opiates, such as demerol

Question 8

Treatment of serotonin syndrome according to First Aid

Answer 8

1. stop offending drugs
2. CCB (oral nifedipine)
3. If carefully monitored: chlorpromazine or phentolamine (a non-selective alpha antagonist)

Question 9

what are 5 foods that contain tyramine?

Answer 9

1. red wine
2. cheese
3. chicken liver
4. fava beans
5. cured meats

Question 10

What is most common side effect of MAOI?

Answer 10

orthostatic hypotension

*also drowsiness, weight gain, sexual side effects, dry mouth, sleep issues

Question 11

What is a unique side effect of MAOIs and how treated

Answer 11

Can cause parethesias in people with pyridoxine deficiency, treat with B6

*rarely: liver failure, seizures, edema