CMN 548 TEST 4 QUESTIONS AND CORRECT
ANSWERS COMPLETE STUDY GUIDE
VERIFIED SOLUTIONS GRADED A+
⩥ A single dose of irreversible MAOIs may persist in its inhibition of
MAO for how long?
Answer: 2 weeks
⩥ What are the most frequent adverse effects of irreversible MAOIs?
Answer: MAOA&B: dizziness, drowsiness, fatigue, headache (without
increased BP), hyperreflexia, & sleep disturbances
⩥ Reversible MAOIs (RIMAs) Include what medication?
Answer: Maclobemide (Manerix)
⩥ How long will it take to recover MAO activity after a final dose of
RIMA?
Answer: 24-48 hours
⩥ What are the most frequent adverse effects of RIMAs?
Answer: orthostatic hypotension, insomnia, weight gain, edema &
sexual dysfunction, insomnia
tx by dividing doses, not giving after dinner, and using trazodone
,⩥ MAOIs are used to treat what conditions?
Answer: Depression, bipolar depression, panic disorder, social phobia,
bulimia, PTSD, angina pain, atypical face pain, migraine, ADHD,
idiopathic orthostatic HTN, & depression r/t brain injury
⩥ Reversible MAO-A (RIMA) used to treat:
Answer: MDD, dysthymic, chronic
⩥ Irreversible MAOA&B used to treat:
Answer: Depression, atypical
MDD, unresponsive to other antidepressants
⩥ Irreversible MAO-B used to treat:
Answer: MDD in adults
⩥ What is the treatment for MAOI induced orthostatic hypotension?
Answer: •Avoidance of caffeine, intake of 2L of fluid/day, addition of
dietary salt, adjustment of HTN meds, support stockings
•fludrocortisone 0.1-0.2mg/day for severe cases
•Advise pts to get out of bed slowly
,⩥ How long should the Psychiatric Nurse Practitioner wait to begin
another treatment for depression when stopping an MAOI to begin either
another MAOI or an SSRI?
Answer: When changing from one MAOI to another taper and stop use
of the first drug for 10-14 days before beginning the second drug
⩥ How long should the PNP wait to begin an MAOI after discontinuing
a patient from fluoxetine (Prozac)?
Answer: Don't use within 5 weeks of prozac
⩥ Describe potential complications for using MAOIs for patients who
have Bipolar I and Schizophrenia.
Answer: Induction of mania in persons in the depressed phase of BPI &
triggering psychotic decompensating in persons w/ schizophrenia
⩥ What are the symptoms of a tyramine-induced hypertensive crisis?
Answer: Results from inactive GI metabolism of dietary Tyramine due
to the MAOI's
Sxs: HA usually 1st sx, severe HTN, stiff neck, diaphoresis, nausea,
vomiting
Management: a-adrenergic antagonists such as phentolamine (regitine)
or chlorpromazine (thorazine) they will lower BP w/in 5 minutes. IV
furosemide (Lasix) to reduce fluid load, and B-adrenergic receptor
agonists for tachycardia. SL nifedipine (Procardia) can be given.
, ⩥ Tyramine containing foods should be avoided for how long after
discontinuing an
irreversible MAOI?
Answer: 2 weeks
⩥ Tyramine containing foods should be avoided for how long after
discontinuing an
reversible MAOI?
Answer: High concentrated tyramine foods should be avoided for 3 days
after last dose
⩥ List the symptoms of the discontinuation syndrome associated with
abrupt withdrawal of MAOIs. How would the PNP prevent this?
Answer: IRREVERSIBLE MAOI's: can occur 1-4 days after
discontinuation
•sxs: self limiting consisting of arousal, mood disturbances, & somatic
symptoms
•To aovid: D/c gradually tapered over several weeks
⩥ List the symptoms of the discontinuation syndrome associated with
abrupt withdrawal of MAOIs. How would the PNP prevent this?
Answer: REVERSABLE MAOI's: No discontinuation syndrome evident
ANSWERS COMPLETE STUDY GUIDE
VERIFIED SOLUTIONS GRADED A+
⩥ A single dose of irreversible MAOIs may persist in its inhibition of
MAO for how long?
Answer: 2 weeks
⩥ What are the most frequent adverse effects of irreversible MAOIs?
Answer: MAOA&B: dizziness, drowsiness, fatigue, headache (without
increased BP), hyperreflexia, & sleep disturbances
⩥ Reversible MAOIs (RIMAs) Include what medication?
Answer: Maclobemide (Manerix)
⩥ How long will it take to recover MAO activity after a final dose of
RIMA?
Answer: 24-48 hours
⩥ What are the most frequent adverse effects of RIMAs?
Answer: orthostatic hypotension, insomnia, weight gain, edema &
sexual dysfunction, insomnia
tx by dividing doses, not giving after dinner, and using trazodone
,⩥ MAOIs are used to treat what conditions?
Answer: Depression, bipolar depression, panic disorder, social phobia,
bulimia, PTSD, angina pain, atypical face pain, migraine, ADHD,
idiopathic orthostatic HTN, & depression r/t brain injury
⩥ Reversible MAO-A (RIMA) used to treat:
Answer: MDD, dysthymic, chronic
⩥ Irreversible MAOA&B used to treat:
Answer: Depression, atypical
MDD, unresponsive to other antidepressants
⩥ Irreversible MAO-B used to treat:
Answer: MDD in adults
⩥ What is the treatment for MAOI induced orthostatic hypotension?
Answer: •Avoidance of caffeine, intake of 2L of fluid/day, addition of
dietary salt, adjustment of HTN meds, support stockings
•fludrocortisone 0.1-0.2mg/day for severe cases
•Advise pts to get out of bed slowly
,⩥ How long should the Psychiatric Nurse Practitioner wait to begin
another treatment for depression when stopping an MAOI to begin either
another MAOI or an SSRI?
Answer: When changing from one MAOI to another taper and stop use
of the first drug for 10-14 days before beginning the second drug
⩥ How long should the PNP wait to begin an MAOI after discontinuing
a patient from fluoxetine (Prozac)?
Answer: Don't use within 5 weeks of prozac
⩥ Describe potential complications for using MAOIs for patients who
have Bipolar I and Schizophrenia.
Answer: Induction of mania in persons in the depressed phase of BPI &
triggering psychotic decompensating in persons w/ schizophrenia
⩥ What are the symptoms of a tyramine-induced hypertensive crisis?
Answer: Results from inactive GI metabolism of dietary Tyramine due
to the MAOI's
Sxs: HA usually 1st sx, severe HTN, stiff neck, diaphoresis, nausea,
vomiting
Management: a-adrenergic antagonists such as phentolamine (regitine)
or chlorpromazine (thorazine) they will lower BP w/in 5 minutes. IV
furosemide (Lasix) to reduce fluid load, and B-adrenergic receptor
agonists for tachycardia. SL nifedipine (Procardia) can be given.
, ⩥ Tyramine containing foods should be avoided for how long after
discontinuing an
irreversible MAOI?
Answer: 2 weeks
⩥ Tyramine containing foods should be avoided for how long after
discontinuing an
reversible MAOI?
Answer: High concentrated tyramine foods should be avoided for 3 days
after last dose
⩥ List the symptoms of the discontinuation syndrome associated with
abrupt withdrawal of MAOIs. How would the PNP prevent this?
Answer: IRREVERSIBLE MAOI's: can occur 1-4 days after
discontinuation
•sxs: self limiting consisting of arousal, mood disturbances, & somatic
symptoms
•To aovid: D/c gradually tapered over several weeks
⩥ List the symptoms of the discontinuation syndrome associated with
abrupt withdrawal of MAOIs. How would the PNP prevent this?
Answer: REVERSABLE MAOI's: No discontinuation syndrome evident
