MAOIs
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Study Tools For MAOIs
MAO Inhibitors (Mnemonic)
Antidepressant Cheat Sheet (Cheatsheet)
140 Must Know Meds (Book)
Monoamine Oxidase Inhibitors (MAO-Is) (Picmonic)
Monoamine Oxidase Inhibitor (MAOI) Contraindications (Picmonic)
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Outline
Overview
- MAOI = monoamine oxidase inhibitors
- Indication
- [Depression- usually a last resort due to side effects
- Patho background
- Monoamine oxidase enzymes breakdown neurotransmitters like dopamine, norepinephrine, epinephrine, and serotonin
- Neurotransmitters = mood stabilizers
- Lack of neurotransmitters may contribute to depression
- Monoamine oxidase enzymes breakdown neurotransmitters like dopamine, norepinephrine, epinephrine, and serotonin
- Mechanism of action
- Block monoamine oxidase enzymes results in increased levels of ALL neurotransmitters
- Causing low safety margin and a lot of side effects!
- Indication
Nursing Care
General
- MAOI’s are an important drug to be aware of because of side effects and toxicities.
Assessment
- Assess for side effects
- Orthostatic hypotension
- Headache
- Insomnia
- Diarrhea
- Hypertensive Crisis when taken with foods that contain tyramine
- Stiff neck
- Headache
- Flushing
- Palpitations
- Nausea
- Can ultimately cause
- Myocardial infarction
- Cerebral bleeding
- Stroke
Therapeutic Management
- Administration
- When given with anti-hypertensive medications increased risk of hypotension
- Can increase effectiveness of insulin causing hypoglycemia
- Patients may need lower doses of insulin
- Inform patient it will take 2-3 weeks for med to show its effect.
- If stopping one antidepressant wait 2-3 weeks to start a new one to prevent toxicity.
Nursing Concepts
- Mood Affect
- MAOI’s may be given to treat depression.
- Pharmacology
- MAOI’s are an important drug to be aware of because of side effects and toxicities.
Patient Education
- Patients should be informed to contact their provider if they experience any symptoms of hypertensive crisis.
- Patients should be instructed to avoid foods high in tyramine, such as wine beer and aged cheese.
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Transcript
Okay. In this video, we gonna talk about another class of antidepression. It’s monoamine oxidase inhibitors. And as we know, there are like 4 classes of antidepressant. So, let’s talk about the monoamine oxidase inhibitors in this video.
What’s their mechanism of action? So, monoamine oxidase enzymes is responsible for the breakdown of neurotransmitters such as dopamine, norepinephrine, epinephrine, and serotonin in the brain, let me mention that one. When, well, actually, these neurotransmitters are thought to be of mood stabilizer. So, there is a change in concentration or level of this neurotransmitter in the brain, if their level goes down, then it causes the depression, that’s the theory is, because they don’t really know what causes the depression for sure. They think, serotonin is the main one. However, there maybe another ones are responsible, so just, dopamine, norepinephrine and epinephrine as well. So, let’s get back to the monoamine oxidase. So, monoamine oxidase enzymes break downs these neurotransmitters in the brain. So, the level goes down that possibly causes the depression. However, these drugs will work by inhibiting this enzyme, so, it will inhibit this enzyme in the brain. When it will inhibit the enzyme in the brain, this enzyme will not be able to break down these good neurotransmitters which is dopamine, serotonin, epinephrine and norepinephrine. And the level will go up and that will relieve to depression. That’s how it works. Now, these drugs actually increase more than one neurotransmitter level, so, they have a really low safety margin. Because, it actually increase the level in the brain. However, when you take a medicine, it’s gonna increase, it’s gonna work everywhere, it’s gonna work in every part of the body, any organ of the body. It’s gonna increase the level of norepinephrine and epinephrine in the rest of the body as well. Well, norepinephrine and epinephrine is sympathetic nervous system neurotransmitters, so, it will cause a sympathetic nervous like effect in the rest of the body as well. So, that is the main reason this medication has a low safety margin and will cause more side effects than any other class of medications. And this medication is usually last resort. Like they try, first of all, serotonin, selective serotonin reuptake inhibitors, and after, they will try tricyclic antidepression, and if it still doesn’t, not relieve the depression in the patient, then they’ll try the monoamine oxidase inhibitors which is the last resort.
So, let’s talk about the side effects. One of the main side effects for this medication is orthostatic hypotension, headache, insomnia, and diarrhea. However, the main thing to look for is hypertensive crisis. This is really really really important for the NCLEX and as a nurse, you need to remember. There’s particular side effects, side effect for this medication is it can cause the hypertensive crisis. Whenever you give this medication, monoamine oxidase inhibitors with tyramine containing food. It will cause hypertensive crisis, maybe, like within hours or maybe even faster than that. And the reason that it causes the hypertensive crisis. So, we all know that the liver is responsible for the metabolism of most of the drugs and it will make them inactive. Now, when you take a tyramine containing food, this tyramine will suppress the liver, like our, most specifically it will suppress the enzymes in the liver that are responsible for the breakdown of monoamine oxidase inhibitor medications. So, liver will not be able to metabolize these drugs effectively and they will stay in our body for longer time at a high concentration because it was supposed to get metabolize by liver and converting to inactive form. But, due to the tyramine, it will not, and it will stay in the body for longer period at a high concentration. And that will cause the hypertensive crisis. Now, the signs and symptoms of hypertensive crisis will be a stiff neck, headache, flushing, palpitation and nausea. And if it is not treated on time, it can go into the myocardial infarction and can cause cerebral bleeding. It can cause the stroke, hemorrhagic stroke. If this medications are given with the hypertensive medication, like any anti-hypertensive medication, like calcium channel blocker, the alpha blocker, those medication, it will cause even more hypotension. And this one can increase the hypoglycemic effect of insulin. So, patient on this medication may require a low dose of insulin in order to produce the desired effect because it will increase the effect of insulin in the body. So, we have to keep an eye on that one.
And also, the thing to remember is like whenever you give medication to patient, this anti-depression medication will take 2 – 3 weeks to show its effect. And another thing to remember, so, like, if you stop one class of antidepressant, wait 2 – 3 weeks to start another one. Otherwise, it will cause toxicity and/or severe side effects. So, like, if a patient was on tricyclic antidepression for example, and he wasn’t working and he was not relieving the depression signs and symptoms. Then what they will do, to stop the tricyclic antidepression, wait for 2 – 3 weeks, and then they will start on monoamine oxidase inhibitors. They cannot start right after they stop the tricyclic antidepression or any other types of antidepression medication. So, those are the two main things to remember, is to, it will take 2-3 weeks before it shows it effects and wait 2-3 weeks before you start another class of medication and stop one, okay?
This is the main information about the monoamine oxidase inhibitors. The main thing remember is tyramine containing food can cause the hypertensive crisis, really really important.
But if you have any questions regarding this medications, feel free to ask us. Thank you.
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Global Symptoms for Brain Tumors Nursing Mnemonic (HAS)
Gluten Free Diet Nursing Mnemonic (BROW)
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)
Hemodynamics
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Hemorrhagic Stroke Risk Factors Nursing Mnemonic (HATS)
Hiatal Hernia Symptoms Nursing Mnemonic (Her Belly Really Hurts Following Dinner)
High Pressure Vent Alarms Nursing Mnemonic (Kings Eat Big Cakes)
High Risk Behavior Nursing Mnemonic (HEADSS)
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)
Hyperkalemia – Causes Nursing Mnemonic (MACHINE)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypernatremia – Causes Nursing Mnemonic (MODEL)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypoxia – Signs and Symptoms (in Pediatrics) Nursing Mnemonic (FINES)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
IADLS (Instrumental Activities of Daily Living) Nursing Mnemonic (SCUM)
Increase MAP Nursing Mnemonic (VAK)
Inflammation- Signs and Symptoms Nursing Mnemonic (HIPER)
Insulin Mnemonic (Ready, Set, Inject, Love)
Interventions for Aphasia Nursing Mnemonic (PROP)
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)
Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Low Pressure Vent Alarms Nursing Mnemonic (Cake Everyday)
Lymphoma – Signs and Symptoms Nursing Mnemonic (NURSE For Pete’s Sake)
Management of Glomerulonephritis Nursing Mnemonic (Please Help Deliver Diuretics)
Management of Lyme Disease Nursing Mnemonic (BAR)
Management of Pressure Ulcers (Pressure Injuries) Nursing Mnemonic (SKIN)
Manic Attack – Signs and Symptoms Nursing Mnemonic (DIG FAST)
MAO Inhibitors Nursing Mnemonic (TIPS)
Medication Classess for IBD Nursing Mnemonic (Sometimes I Can’t Answer)
Medications for Pancreatitis Nursing Mnemonic (Please Make Tummy Better)
Medications to Prevent Seizures Nursing Mnemonic (Pretty Little Liars Forever)
Meningitis Assessment Findings Nursing Mnemonic (FAN LIPS)
Mnemonic for Organ Systems (MR DICE RUNS)
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Myocardial Infarction Nursing Mnemonic (MONATAS)
OB Non-Stress Test Results Nursing Mnemonic (NNN)
OLD CARTS Mnemonic (OLD CARTS)
Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)
Pain Assessment Questions Nursing Mnemonic (OPQRST)
Nursing Care and Pathophysiology for Parkinsons
Asthma
Pediatric Gastrointestinal Dysfunction – Diarrhea
Pharmacokinetics Nursing Mnemonic (ADME)
Planning Community Health Interventions Nursing Mnemonic (PRECEDE-PROCEED)
Pneumonia Risk Factors Nursing Mnemonic (VENTS)
Pneumothorax Signs and Symptoms Nursing Mnemonic (P-THORAX)
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Postpartum Hemorrhage (PPH)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Pregnancy Outcomes Nursing Mnemonic (GTPAL)
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Process of Labor – Baby Nursing Mnemonic (ALPPPS)
Promotion and Evaluation of Normal Elimination Nursing Mnemonic (POOPER SCOOP)
Prostate Nursing Mnemonic (FUN)
Proton Pump Inhibitors
Pulmonary edema treatment Nursing Mnemonic (MAD DOG)
Pupil Reactions Nursing Mnemonic (PERRLA)
Reactivation of Herpes Zoster Nursing Mnemonic (FICA)
Reasons for a Bronchoscopy Nursing Mnemonic (Please Assess His Weird Bronchoscopy Results)
Reasons for Chest Tube Nursing Mnemonic (Don’t Ever Fail)
Restrictive Lung Disease Causes Nursing Mnemonic (PAINT)
Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)
Risk Factors for Cholelithiasis Nursing Mnemonic (5-F’s)
Risk Factors for Osteoporosis Nursing Mnemonic (ACCESS)
Safety Check Nursing Mnemonic (MADLE)
SBAR Communication Nursing Mnemonic (SBAR)
Schizophrenia
Scleroderma Symptoms Nursing Mnemonic (CREST)
Seizure Causes Nursing Mnemonic (VITAMIN)
Seizure Documentation Nursing Mnemonic (TDOC)
Senile Dementia – Assess for Changes Nursing Mnemonic (JAMCO)
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Sprains and Strains – Nursing Care Nursing Mnemonic (RICE)
SSRI’s Nursing Mnemonic (Effective For Sadness, Panic, and Compulsions)
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Stages of Hepatitis Nursing Mnemonic (PIP)
Steps in the Nursing Process 1 Nursing Mnemonic (ADPIE)
Steps in the Nursing Process 2 Nursing Mnemonic (AAPIE)
Steps In The Nursing Process 3 Nursing Mnemonic (SOAPIE)
Steroids – Side Effects Nursing Mnemonic (6 S’s)
Stoke Assessments Nursing Mnemonic (FAST)
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
Symptoms of Wernicke’s Encephalopathy Nursing Mnemonic (COAT)
TB Drugs Nursing Mnemonic (RIPE)
Toxicity Sepsis- Signs and Symptoms Nursing Mnemonic (The 6 T’s)
Tracheal Esophageal Fistula – Sign and Symptoms Nursing Mnemonic (The 3 C’s)
Traction – Nursing Care Nursing Mnemonic (TRACTION)
Transient Incontinence – Common Causes Nursing Mnemonic (P-DIAPERS)
Trauma – Assessment (Emergency) Nursing Mnemonic (ABCDEFGHI)
Trauma – Complications Nursing Mnemonic (TRAUMATIC)
Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)
Treatment of Sickle Cell Nursing Mnemonic (HOP to the hospital)
Triage Nursing Mnemonic (START)
Two pathways of the peripheral nervous system Nursing Mnemonic (SAME)
Types of Anemia Nursing Mnemonic (Always Introduce Special Patients)
Types of Hemorrhoids Nursing Mnemonic (Pie)
Ulcerative Colitis – Assessment Nursing Mnemonic (MADE 10)
Umbilical Cord Vasculature Nursing Mnemonic (2A1V)
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Vasospasm Therapy Nursing Mnemonic (Triple H Therapy)
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)
Vitamins – Fat Soluble Nursing Mnemonic (All Dogs Eat Kibble)
Vitamins – Water Soluble Nursing Mnemonic (Birth Control)
Walkers Nursing Mnemonic (Wandering Wilma Always Late)
Who Needs Dialysis Nursing Mnemonic (AEIOU)