Comprehensive Nursing Pharmacology Q 277
Nurse Celine is caring for a client with clinical depression who is receiving an MAO inhibitor. When providing instructions about precautions with this medication, the nurse should instruct the client to:
A. Avoid chocolate and cheese.
B. Take frequent naps.
C. Take the medication with milk.
D. Avoid walking without assistance.
Correct Answer: A. Avoid chocolate and cheese.
Foods high in tryptophan, tyramine, and caffeine, such as chocolate and cheese may precipitate hypertensive crises. Tyramine is an amino acid that helps regulate blood pressure. It occurs naturally in the body, and it’s found in certain foods. Medications called monoamine oxidase inhibitors (MAOIs) block monoamine oxidase, which is an enzyme that breaks down excess tyramine in the body. Blocking this enzyme helps relieve depression.
Option B: Naps do not have an effect on MAO inhibitors. MAOIs, although effective, generally have been replaced by newer antidepressants that are safer and cause fewer side effects. Still, an MAOI is a good option for some people. In certain cases, an MAOI relieves depression when other treatments have failed.
Option C: Aged, mature, or hard cheeses (aged cheddar, Swiss, Parmesan, blue cheese, Camembert) and milk should be avoided. Beverages with caffeine also may contain tyramine, so your doctor may recommend limits.
Option D: Perform a thorough physical assessment to establish baseline data before drug therapy begins, to determine the effectiveness of therapy, and to evaluate for the occurrence of any adverse effects associated with drug therapy.