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Patient teaching for a patient receiving an MAOI would include instructions to avoid which food products? Select all that apply

A.

Orange juice

B.

Swiss cheese

C.

Shrimp

D.

Milk

E.

Pepperoni pizza

Answer and Explanation

Correct Answer : B,E

Monoamine oxidase inhibitors (MAOIs), such as phenelzine (Nardil), are used to treat depression, particularly when other antidepressants have been ineffective. Because MAOIs inhibit the breakdown of tyramine, patients are at risk for hypertensive crises if they consume tyramine-rich foods. Nursing education must emphasize dietary restrictions to prevent serious cardiovascular complications.

 

B. Swiss cheese — Aged cheeses are high in tyramine, which can interact with MAOIs to cause a hypertensive crisis. Clients must avoid all aged, fermented, or cured cheeses.

E. Pepperoni pizza — Processed and cured meats are also high in tyramine and pose the same risk for dangerous blood pressure elevation. These foods should be avoided.

 

A. Orange juice — Fresh fruits and juices, including orange juice, are low in tyramine and safe to consume with MAOIs.

C. Shrimp — Fresh seafood is low in tyramine and does not interact adversely with MAOIs.

D. Milk — Fresh milk and most dairy products that are not aged or fermented are safe for clients on MAOIs.

Take-Home Points:

  • Educate patients to avoid all tyramine-rich foods, including aged cheeses, cured meats, and fermented products.
  • Monitor for signs of hypertensive crisis, such as severe headache, palpitations, or elevated blood pressure.
  • Reinforce reading labels and checking ingredients on processed or packaged foods to avoid accidental intake of high-tyramine items.

 


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Related Questions

Correct Answer is D

Explanation

Lithium is a mood stabilizer used in the management of bipolar disorder, but it has a narrow therapeutic index, meaning toxicity can occur easily. Drug interactions are an important consideration in lithium therapy, particularly with NSAIDs, which can impair renal clearance of lithium and lead to elevated serum levels.

D. Concurrent NSAIDs may increase lithium levels.
NSAIDs reduce renal clearance of lithium, potentially causing toxic accumulation. This interaction requires close monitoring or avoidance of NSAIDs.

A. The maximum dose is C.4 g/d.
Lithium dosing varies based on therapeutic levels and individual response; it is titrated according to serum concentrations, not by a fixed maximum dose.

B. The therapeutic drug range is B.5 to C.5 mEq/L.
This range is toxic, not therapeutic. The therapeutic range is 0.6–A.2 mEq/L for maintenance, with levels above A.5 mEq/L considered toxic.

C. Lithium increases receptor sensitivity to GABA.
Lithium’s exact mechanism is not fully understood, but it is thought to alter sodium transport and influence neurotransmitter activity, not directly increase GABA receptor sensitivity.

Take-Home Points:

  • Lithium has a narrow therapeutic index and requires regular serum monitoring.
  • NSAIDs and diuretics can raise lithium levels, increasing risk of toxicity.
  • Nurses must educate patients on early signs of toxicity such as tremors, confusion, and GI upset.

Correct Answer is C

Explanation

Follow-up after starting antidepressant therapy is essential to evaluate treatment effectiveness and patient safety. One critical concern during early treatment is the risk of suicidal ideation, as some patients may experience increased energy before mood improves, which can heighten the risk of acting on suicidal thoughts. Nurses must assess for any signs of self-harm during follow-up contacts.

C. Suicidal ideation — Antidepressants can increase energy and motivation before mood improves, which may place patients at higher risk for acting on pre-existing suicidal thoughts. Assessing for suicidal ideation is a priority during follow-up.

A. Weakness — While some patients may experience mild fatigue as a side effect, it is not the primary concern in early antidepressant follow-up.

B. Hallucinations — Hallucinations are not a typical adverse effect of standard antidepressant therapy and are not expected in routine follow-up.

D. Difficulty with urination — Urinary retention is uncommon with most antidepressants and is not a primary concern for early treatment monitoring.

Take-Home Points:

  • Assess for suicidal thoughts or behaviors, especially within the first few weeks of therapy.
  • Educate patients and families to report any sudden mood changes, agitation, or self-harm thoughts immediately.
  • Schedule timely follow-ups to monitor treatment effectiveness and safety.

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