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A patient on antidepressants presents to your OPD with a hypertensive crisis (SBP 220 mmHg). What's the first thing you suspect?
As this video explains, it's crucial to check the patient's medication history for MAO Inhibitors.
Here’s the quick breakdown:
🔹 The Cause: MAOIs are potent antidepressants but can cause a dangerous drug-food interaction.
🔹 The Trigger: Foods rich in tyramine (like aged cheese, cured meats, some wines) consumed by a patient on MAOIs.
🔹 The Mechanism: MAOIs block the breakdown of tyramine. This excess tyramine displaces large amounts of norepinephrine from nerve terminals, leading to a massive sympathetic surge and a severe hypertensive crisis.
This is a classic "Cheese Reaction," a medical emergency.
💡 The Question for You:
To manage this specific type of hypertensive crisis, what is the preferred drug of choice?
1️⃣ Phentolamine (a non-selective alpha-blocker)
2️⃣ Labetalol (a mixed alpha/beta-blocker)
Share your answer and, more importantly, your reasoning in the comments below! Let's discuss the pharmacology. 👇
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