MAOIs

Question 1

isocarboxazid

Answer 1

marplan

Question 2

phenelzine

Answer 2

nardil

Question 3

selegiline

Answer 3

eldepryl

Question 4

tranycypromine

Answer 4

parnate

Question 5

side effect

Answer 5

can cause lethal hypotension, ortho static hypotension, drowsiness, weight gain, sexual dysfunction, dry mouth, sleep dysfunction

Question 6

indication

Answer 6

Refractory depression and refractory anxiety disorders (panic)

Question 7

are there diet restrictions for MAOIs?

Answer 7

YES avoid tyramine in diet (cheeses, cured meats, alcohol, fruits)

Question 8

what happens if the patient on MAOIs has tyramine?

Answer 8

hypertensive crisis, HA, sweating, n/v, photophobia, autonomic instability, chest pain, arrhythmias, coma and death

Question 9

are there drug restrictions with TCAs?

Answer 9

YES cold meds, asthma meds, pain meds, antihistamines, demerol and fentanyl

Question 10

surgical restrictions with TCAs?

Answer 10

YES, must be stopped for 14 days prior to prevent hypertensive crisis

Question 11

MOA of MAOIs

Answer 11

Prevent the inactivation of biogenic amines such as norepinephrine, serotonin, dopamine and tyramine by irreversibly inhibiting MAOA (inactivates serotonin) and MOAB (inactivates norepinephrine and epinephrine)

Question 12

Serious side effects of MAOIs

Answer 12

Serotonin syndrome: usually from SSRI+MAOI, lethargy, restlessness, confusion, flushing, diaphoresis, tremor and myoclonic jerks, may progress to hyperthermia, hypertonicity, rhabdo, renal failure, convulsions, coma and death
Hypertensive crisis: usually from eating tyramine rich foods or sympathomimetics