S15C173 - MAOI OD

Question 1

MAOI examples

Answer 1

• antidepressants: phenelzine, isocarboxazid

- parkinsons med: rasagiline, selegiline

Question 2

MAOI: tyramine rxn

Answer 2

• MAOI increase the absorption of tyramine
• tyr. acts as a sympathomimetic, rxn occurs w/in 15-90mins after consumption, severe occipital/temporal h/a, HTN, diaphoresis, ydriasis, stiff neck, palpitaitons, c/p
• HTN: give phentolamine or nitroprusside

Question 3

MAOI interactions

Answer 3

• MANY, don’t Rx a new med if you can help it

- dextromethorphan, tramadol, propoxyphene, cyclobenzaprine

Question 4

MAOI toxicity

Answer 4

• symptoms can be delayed by 6-12h and up to 24h
• hyperadrenergic state with excess serotonin followed by sympatholytic state with HoTN and depressed CNS
• h/a, agitation, irritablity, nausea, palpitations, tremor

Question 5

MAOI OD dx and tx

Answer 5

• dx relies on hx and known ingestion
• HTN: phentolamine, nitroprusside
• HoTN: bluid, NE
• Dysrhythmias: lidocaine, procainamide
• Sz: benzos (dilantin not useful)
• Hyperthermia: benzos