Monoamine Oxidase Inhibitors (MAOIs) Flashcards

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1
Q

Give an example of a reversible MAOI?

A

Moclobemide

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2
Q

Give 3 examples of irreversible MAOIs?

A
  • Phenelzine
  • Isocarboxazid
  • Tranylcypromine
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3
Q

Why are reversible MAOIs preferred over irreversible?

A

Thought to cause fewer food and drug interactions than irreversible

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4
Q

What is the mechanism of action of MAOIs?

A

Inhibit monoamine oxidase, resulting in an increase in amine neurotransmitters

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5
Q

What is the route of delivery of MAOIs?

A

PO

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6
Q

When are MAOIs contraindicated?

A
  • Cerebrovascular disease
  • Phaeochromocytoma
  • Manic phases
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7
Q

When should you avoid the use of MAOIs?

A
  • Concomitant use of other antidepressants
  • Pregnancy
  • Agitated patients
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8
Q

Why should the use of MAOIs be avoided with other antidepressants?

A

Can cause severe CNS toxicity

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9
Q

Why should the use of MAOIs be avoided in pregnancy?

A

Increased risk of neonatal malformations

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10
Q

When should MAOIs be used with caution?

A
  • Elderly population
  • Patients who experience severe hypertensive reactions to certain drugs and food
  • Acute porphyria
  • Cardiovascular disease
  • Diabetes mellitus
  • Concurrent ECT and surgery
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11
Q

What monitoring should be done with MAOIS?

A
  • Ask about symptoms

- Check blood pressure

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12
Q

What might MAOIs interact with?

A
  • Food and drinks with a high tyramine content
  • Other antidepressants
  • Carbamazepine
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13
Q

What foods/drinks have a high tyramine content?

A
  • 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
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14
Q

What are the common/very common side effects of MAOIs?

A
  • Dizziness

- Postural hypotension

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15
Q

What are the uncommon side effects of MAOIs?

A
  • Behavioural changes including agitation
  • Blurred vision
  • Convulsions
  • GI disturbance
  • Deranged LFTs
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16
Q

What are the rare side effects of MAOIs?

A

Progressive hepatocellular necrosis that can be fatal

17
Q

What might happen on cessation of MAOIs?

A

Withdrawal symptoms ranging in severity and nature

18
Q

What patient counselling is required with MAOIs?

A
  • Dangerous reaction to food and drink

- Do not take other antidepressants at the same time

19
Q

What might happen if MAOIs are taken with foods high in tyramine?

A

Hypertensive reactions

20
Q

How can foods high in tyramine be avoided?

A

Patients should only eat fresh food and avoid food that is suspected of going stale or ‘going off’. This is especially important wiht meat, fish, poultry, or offal.

21
Q

How long does the danger of interaction of high tyramine foods last?

A

Up to 2 weeks post-treatment