A client has been prescribed isoniazid (INI) for tuberculosis. Which foods should the client avoid while taking this medication, as they are high in tyramine? (Select All that Apply.)

1. Abdominal surgery requires starting antibiotic therapy 4 days before surgery:

This statement is not accurate. While antibiotic prophylaxis is commonly administered before certain types of surgery to prevent surgical site infections, the timing and duration of antibiotic therapy vary depending on factors such as the type of surgery, the patient’s medical history, and institutional guidelines. However, starting antibiotic therapy four days before surgery would not be standard practice for most abdominal surgeries.

B. A reduction of intestinal bacteria lessens the possibility of postoperative infection:

This statement is correct. Neomycin, as well as other antibiotics used in bowel preparation regimens, help reduce the population of intestinal bacteria. By decreasing the bacterial load in the bowel before surgery, the risk of contaminating the surgical site with harmful bacteria during the procedure is reduced, thus lowering the likelihood of postoperative infections.

C. The bacteria found in the bowel cannot be destroyed after surgery:

This statement is incorrect. While it is true that the bowel contains a complex ecosystem of bacteria that play important roles in digestion and other physiological functions, the population of intestinal bacteria can be temporarily reduced through the use of antibiotics, such as neomycin, as part of a bowel preparation regimen before surgery.

D. Anesthesia makes the bowel resistant to an antibiotic after surgery:

This statement is not accurate. Anesthesia does not render the bowel resistant to antibiotics after surgery. However, the administration of antibiotics during surgery and postoperatively may be indicated in certain cases to prevent or treat infections, particularly if the surgical procedure involves contamination of the abdominal cavity or if the patient is at increased risk of infection.

A. Chocolate:

Chocolate contains tyramine, a substance that can interact with certain medications like monoamine oxidase inhibitors (MAOIs) to increase blood pressure. While isoniazid itself does not directly interact with tyramine, it is often recommended to avoid tyramine-rich foods to prevent potential interactions with other medications or to minimize potential risks. Therefore, clients taking isoniazid are advised to avoid consuming chocolate to reduce the risk of adverse effects.

B. Aged cheese:

Aged cheeses, such as cheddar, Swiss, and blue cheeses, are high in tyramine. Tyramine levels increase as cheeses age, and consuming aged cheeses can lead to tyramine buildup in the body, potentially causing hypertensive crisis when combined with certain medications like MAOIs. While isoniazid is not an MAOI, the cautionary advice to avoid tyramine-rich foods is often extended to individuals taking isoniazid to minimize potential risks.

C. Bananas:

Bananas contain tyramine, although in lower amounts compared to some other foods. However, it is still advisable for individuals taking isoniazid to avoid consuming bananas and other tyramine-rich foods to reduce the risk of potential interactions or adverse effects.

D. Red meat:

Red meat is not typically high in tyramine compared to other foods like aged cheeses, certain processed meats, and fermented foods. While some sources suggest limiting consumption of aged or fermented meats, fresh red meat is generally considered safe to consume while taking isoniazid.

E. White wine:

While red wine is more commonly associated with tyramine content, white wine can also contain tyramine and other biogenic amines. Like other tyramine-rich foods, white wine consumption should be limited or avoided by individuals taking isoniazid to minimize the risk of tyramine-related interactions or adverse effects.