NCLEX Saunders: Pharmacology: Psychotherapeutics: Monoamine Oxidase Inhibitors (MAOIs)

A client is prescribed tranylcypromine. The nurse educating a client about tranylcypromine should instruct the client to avoid which activity? 1.Drinking any amount of wine 2.Consuming any fresh dairy products 3.Exposing the skin of the face to sunlight 4.Eating either fresh or frozen green leafy vegetables

1.Drinking any amount of wine Rationale:Tranylcypromine is a monoamine oxidase inhibitor (MAOI) that is used to treat depression. Food and fluids containing tyramine, such as aged cheese, smoked or pickled meats or poultry, fermented meat, beer, wine, and liqueurs, should not be used concurrently with MAOIs because they can cause sudden and severe hypertensive reactions. The remaining options are not contraindicated with the use of this medication.

The nurse is providing dietary instructions to a client who is prescribed tranylcypromine sulfate. The nurse emphasizes that it is important to avoid eating which food? 1.Salami 2.Scallops 3.Pineapple 4.Mashed potatoes

1.Salami Rationale:Tranylcypromine sulfate is a monoamine oxidase inhibitor (MAOI) that is used to treat depression. A tyramine-restricted diet is required during therapy to avoid hypertensive crisis, a life-threatening effect of the medication. Foods to be avoided are meats prepared with tenderizer, smoked or pickled fish, beef liver, chicken liver, and dry sausage (salami, pepperoni, and bologna). In addition, figs; bananas; aged cheese; yogurt and sour cream; beer, red wine, alcoholic beverages; soy sauce; yeast extract; chocolate; caffeine; and foods that are aged, pickled, fermented, or smoked need to be avoided. Many over-the-counter medications also include tyramine and must be avoided as well.

The nurse developing a teaching plan for a client being prescribed phenelzine sulfate should instruct the client to avoid which item? 1.Vasodilators 2.Aged cheeses 3.Digitalis preparations 4.Cherries and blueberries

2.Aged cheeses Rationale:Phenelzine sulfate is in the monoamine oxidase inhibitor (MAOI) class of antidepressant medications. A client taking an MAOI must avoid foods that contain tyramine such as aged cheeses, alcoholic beverages, avocados, bananas, and caffeine drinks. Other food items to avoid include chocolate, meat tenderizers, pickled herring, raisins, sour cream, yogurt, and soy sauce. Medications that should be avoided include amphetamines, antiasthmatics, and certain antidepressants. Clients taking MAOI medications also should avoid levodopa and meperidine. The items identified in the other options need not be avoided.

A hospitalized client is started on a monoamine oxidase inhibitor (MAOI) for the treatment of depression. The nurse should instruct the client that which foods are acceptable to consume while taking this medication? Select all that apply. 1. Figs 2. Yogurt 3. Crackers 4. Aged cheese 5. Tossed salad 6. Oatmeal raisin cookies

3. Crackers 5. Tossed salad Rationale:With MAOIs, the client should avoid ingesting foods that are high in tyramine. Ingestion of these foods could trigger a potentially fatal hypertensive crisis. Foods to avoid include yogurt; aged cheeses; smoked or processed meats; red wines; and fruits such as avocados, raisins, or figs.

A client is prescribed a monoamine oxidase inhibitor. What is the primary reason the nurse needs to assess this client closely 1.Risk of liver damage may be increased. 2.Bradycardia and hypotension may indicate toxicity. 3.Headache, hypertension, and nausea and vomiting may indicate toxicity. 4.Hypotensive crisis may be precipitated by foods rich in tyramine and tryptophan.

3.Headache, hypertension, and nausea and vomiting may indicate toxicity. Rationale:Headache, hypertension, tachycardia, nausea, and vomiting are precursors to hypertensive crisis brought about by the ingestion of foods rich in tyramine and tryptophan while the client is taking monoamine oxidase inhibitors (MAOIs). These medications act by decreasing the amount of monoamine oxidase in the liver, which is necessary for the breakdown and use of tyramine and tryptophan. Hypertensive crisis may lead to circulatory collapse, intracranial hemorrhage, and death.

A monoamine oxidase inhibitor is prescribed for a client. Which sign or symptom is indicative of toxicity? 1.Lethargy 2.Depression 3.Restlessness 4.Constipation

3.Restlessness Rationale:Acute toxicity of monoamine oxidase inhibitors (MAOIs) is manifested by restlessness, anxiety, and insomnia. Dizziness and hypertension also can occur in acute toxicity. The remaining options are not signs of toxicity related to MAOIs. note: monoamine oxidase inhibitor (MAOI) is used to treat depression

A client has begun taking phenelzine. At the initiation of therapy, the client is taught which foods are acceptable to consume? Select all that apply. 1.Avocados 2.Figs and raisins 3.Bologna or salami 4.Carrots or radishes 5.Sweet potatoes and squash 6.Red wine, such as Chianti or sherry

4.Carrots or radishes 5.Sweet potatoes and squash Rationale:Phenelzine is a monoamine oxidase inhibitor (MAOI). The client should avoid foods that are high in tyramine because they could trigger a potentially fatal hypertensive crisis. Foods to avoid include aged cheeses, smoked or processed meats, red wines, avocados, raisins, and figs. Vegetables are generally acceptable, with the exception of broad beans, including fava beans.

A client diagnosed with depression and prescribed tranylcypromine sulfate has been instructed on the appropriate diet. The nurse determines that the client understands the diet if which foods are selected from the dietary menu? 1.Pickled herring, french fries, and milk 2.Pepperoni pizza, salad, and a cola drink 3.Roasted chicken, roasted potatoes, and beer 4.Fried haddock, baked potato, and a cola drink

4.Fried haddock, baked potato, and a cola drink Rationale:Tranylcypromine sulfate is a monoamine oxidase inhibitor (MAOI) that is used to treat depression. A tyramine-restricted diet is required while on this medication to avoid hypertensive crisis, a life-threatening effect of the medication. Foods to be avoided are meats prepared with tenderizer, smoked or pickled fish, beef or chicken liver, and dry sausage (salami, pepperoni, bologna). In addition, figs; bananas; aged cheese; yogurt and sour cream; beer, red wine, and other alcoholic beverages; soy sauce; yeast extract; chocolate; caffeine; and aged, pickled, fermented, or smoked foods need to be avoided.