Monoamine Oxidase Inhibitors (MAOIs) Flashcards
Give an example of a reversible MAOI?
Moclobemide
Give 3 examples of irreversible MAOIs?
- Phenelzine
- Isocarboxazid
- Tranylcypromine
Why are reversible MAOIs preferred over irreversible?
Thought to cause fewer food and drug interactions than irreversible
What is the mechanism of action of MAOIs?
Inhibit monoamine oxidase, resulting in an increase in amine neurotransmitters
What is the route of delivery of MAOIs?
PO
When are MAOIs contraindicated?
- Cerebrovascular disease
- Phaeochromocytoma
- Manic phases
When should you avoid the use of MAOIs?
- Concomitant use of other antidepressants
- Pregnancy
- Agitated patients
Why should the use of MAOIs be avoided with other antidepressants?
Can cause severe CNS toxicity
Why should the use of MAOIs be avoided in pregnancy?
Increased risk of neonatal malformations
When should MAOIs be used with caution?
- Elderly population
- Patients who experience severe hypertensive reactions to certain drugs and food
- Acute porphyria
- Cardiovascular disease
- Diabetes mellitus
- Concurrent ECT and surgery
What monitoring should be done with MAOIS?
- Ask about symptoms
- Check blood pressure
What might MAOIs interact with?
- Food and drinks with a high tyramine content
- Other antidepressants
- Carbamazepine
What foods/drinks have a high tyramine content?
- Mature cheese
- Hydrolysed meats or yeast extracts
- Wine, beer, or other alcoholic drinks
- Picked foods
- Banana skins (why would u eat the skin anyway)
- Broad bean pots
What are the common/very common side effects of MAOIs?
- Dizziness
- Postural hypotension
What are the uncommon side effects of MAOIs?
- Behavioural changes including agitation
- Blurred vision
- Convulsions
- GI disturbance
- Deranged LFTs