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MAO inhibitors
Question | Answer |
---|---|
MAO inhibitors | Isocarboxazid, Phenelzine, Tranylcypromine, Selegiline |
Isocarboxazid | Marplan |
Phenelzine | Nardil |
Tranylcypromine | Parnate |
Selegiline | Emsam |
Tyramine | Amino Acid that helps regulate blood pressure by triggering cells to release norepinephrine, thus acting as an indirect sympathomimetic. It is also a substrate for MAO, an enzyme that breaks down excess tyramine. |
Which MAO inhibitors have a contraindication with severe renal disease? | Isocarboxazid, Phenelzine |
Warnings | Hypertensive Crisis; Serotonin Syndrome |
Which MAO inhibitor is used for Parkinson Disease? | Zelapar ODT (Selegiline) |
Tyramine rich foods | Aged cheese, pickled foods, fermented food, aged food, smoked food |
Monoamine oxidase (MAO) | Enzyme that binds to tyramine substrate and breaks down excess tyramine, thus decreasing levels of norepinephrine, dopamine, and serotonin |
Drug interactions | Drugs that increase serotonin and epinephrine |
What drugs require 2 week washout period? | SSRIs, Bupropion, SNRIs, TCAs |
Which SSRI requires a 5 week washout? | Fluoxetine |
Counseling | Avoid tyramine rich foods |
MAO inhibitor toxicity symptoms | severe hypothermia, hypertension |
How long does MAO inhibitor toxicity take to develop? | Patients may initially be asymptomatic, but symptoms should generally appear within the first several hours, sometimes delayed up to 24 hours. |
Which MAO inhibitor comes in a patch? | Selegiline (Emsam) |
MAO inhibitor onset of action | Initial effects observed within 1-2 weeks with continuing to 4-6 weeks |
MAO inhibitor half life (PO Meds) | 10 hours |
MAO inhibitor half life (Transdermal Patch) | 20 hours |