The following is written by Sheldon S. Sones, RPh, FASCP, President, Sheldon S. Sones and Associates.
Monoamine oxidase inhibitors (MAO inhibitors or MAOIs) are drugs which, by virtue of their pharmacological mechanisms of action, may lead to an exaggerated level of monoamines which can cascade into a hypertensive crisis.
It is a classic drug-drug and drug-food interaction that we must all be focused on as the consequences of co-administration with certain drugs can be catastrophic.
While the use of newer classes of antidepressants such as Prozac and Lexapro have curtailed the common use of MAOIs, they remain with us and may well be presented on a patient's reconciliation drug list as a last line of treatment options. Further, some of the MAOIs fall into other drug categories.
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Suggested strategies:
- Keep the current list of MAOIs easily accessible to your admitting staff.
- Keep the list of potential interactions close at hand for review with the prescriber (i.e., anesthesia provider, surgeon, gastroenterologist who prescribes conscious sedation).
MAOI current list
|
Trade Name |
Generic |
Category |
|
Parnate |
Tranylcypromine Sulfate |
Antidepressant |
|
Marplan |
Isocarboxazid |
Antidepressant |
|
Nardil |
Phenelzine Sulfate |
Antidepressant |
|
Matulane |
Procarbazine |
Antineoplastic |
|
Eutonyl |
Pargyline |
Antihypertensive |
|
Eldepryl, Deprenyl |
Selegiline |
Antiparkinsonian |
|
Azilect |
Rasagiline |
Antiparkinsonian |
Common ambulatory surgery center drugs to avoid:
- Ephedrine
- All opiates but especially Demerol (meperidine)
- Pseudoephedrine
- Phenylephrine
- Tramadol (Ultram)
- Norepinephrine
Learn more about Sheldon S. Sones and Associates and www.sheldonsones.com.
More Articles Featuring Sheldon Sones:
4 Important Questions on Surgery Center Pharmacy and Safe Medication Practices
Perioperative Implications of Five Herbal Medications
6 Strategies for Surgery Centers to Address Drug Shortages