Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

What is a relevant concern when prescribing MAO inhibitors?

1. Interaction with anticoagulants

2. Interaction with aged cheeses

3. Interaction with beta blockers

4. Interaction with antihistamines

The correct answer is: Interaction with aged cheeses

When prescribing monoamine oxidase (MAO) inhibitors, a relevant concern is the interaction with aged cheeses. MAO inhibitors work by inhibiting the enzyme monoamine oxidase, which breaks down neurotransmitters such as serotonin, norepinephrine, and dopamine. This inhibition can lead to an accumulation of these neurotransmitters, but it also affects the metabolism of tyramine, a naturally occurring substance found in many aged and fermented foods, including aged cheeses. When a patient on MAO inhibitors consumes aged cheeses, the high levels of tyramine can lead to possibly dangerous increases in blood pressure, resulting in a hypertensive crisis. Symptoms of a hypertensive crisis include severe headache, palpitations, sweating, nausea, and, in extreme cases, can lead to stroke or death. Therefore, educating patients about dietary restrictions, particularly regarding the consumption of aged cheeses, is essential when they are prescribed MAO inhibitors. Other options listed, while they may involve interactions with various medications, do not pose the same immediate and severe risk as the tyramine-tyramine interaction with aged cheeses does.