Transcript for:
Understanding Monoamine Oxidase Inhibitors

Monoamine oxidase inhibitors, commonly known as MAOIs, are a class of antidepressants known for having a lot of drug and food interactions. In this mnemonic video, I'll teach you an easy way to remember everything you need to know about MAOIs for test day. Here we go! For today's Pixerize video, we're eating at a delicious local restaurant on the island of Maui.

Maui is a super popular tourist destination because of its tropical climate and beautiful beaches. I mean, just take a look at the island below the restaurant. Maui is also our symbol for today's drug class, MAOIs.

After all, Maui and MAOI are almost spelled exactly the same. So when you see a question about MAOIs on test day, Just remember Maui to anchor yourself back to this scene. Let's get started by going through the most common drug names of MAOIs. This man here has just finished up eating at the local Maui restaurant. Nothing beats an ice-cold drink on a warm, tropical day like today.

All that's left in this man's glass are a couple of ice cubes, which is our symbol for the drug isocarboxazid. Ice cube for isocarboxazid? Or you can even think...

ice cube oxazid, if that helps. Isocarboxazide is one of the most common MAOIs, so just remember these ice cubes and you'll be good to go. So what's good at this local restaurant anyway?

Well, the customer here had some fennel and it did not disappoint. His plate of fennel is pretty empty, but there's more fennel in a crate in the back. See? This fennel here is our symbol for phenylzine, another MAOI drug. Fennel for phenylzine?

Got that? The waitress is here for her first day on the job. That's right, she's still in training.

This waitress in training is our symbol for tranylcypromine. Because training and tranylcypromine sound pretty similar, right? Tranylcypromine is the third and final MAOI drug name that you need to know for the NCLEX. Got that? Good.

Now let's move on to when MAOIs are used. The waitress in training has made a big mess. And upon realizing her mistake, she has started to cry.

This crying waitress is our symbol for depression. Crying for depression. Okay? I mean, this waitress definitely looks pretty depressed if you ask me.

MAOIs are a class of antidepressants, meaning they are used to treat depression. However, MAOIs are not a first-line treatment because they have many side effects, as well as several drug and food interactions that can cause some pretty severe reactions. Let's talk about what those reactions are next.

Like I said, this man has finished eating and is ready to go down to the beach. He doesn't want to waste a single second on the beautiful Maui island, so he is maximizing his time by inflating his beach ball right there in the restaurant. See how he is using that pump to increase the pressure inside the ball? That reminds me of how MAOIs can increase the pressure inside the arteries. In other words, MAOIs can cause high blood pressure.

as symbolized by the increasing pressure in the ball. With MAOIs, the blood pressure can get high enough to cause what's called a hypertensive crisis. We're talking severely high blood pressure here, higher than 180 over 120. A hypertensive crisis can lead to a stroke. So if the patient is complaining of headaches or neck stiffness, you want to check the blood pressure right away. Now, let's take a closer look at why the waitress-in-training is crying so much.

She was carrying a charcuterie board of wine, cheese, and meats and clumsily dropped it on the floor. Whoever ordered that is going to have to wait a while now. This falling charcuterie board of wine, cheese, and meat is our symbol to avoid foods containing tyramine. Let me explain. Eating food containing tyramine can trigger the hypertensive crisis we just talked about.

And the foods that contain tyramine include things like wine, aged cheeses, and processed meats. just like what's on this charcuterie board. There are more foods on this list, of course, like chocolate, yogurt, and pickled or fermented foods. That said, you should remember the classic wine, meats, and cheese board as the usual suspect in causing a hypertensive crisis. The NCLEX likes to ask about appropriate diets for patients on MAOIs, so just remember to avoid all foods with tyramine if possible.

This restaurant serves really big portions, and the man wasn't able to finish his meal. I'm sure you can relate. He asked the waitress in training to bag up his leftovers so that he can take it with him. Here she is now, dropping the bag onto his table.

Like many takeout bags, this one has a big happy face on it. Here at Pixerize, we use happy faces as our symbol for serotonin. After all, serotonin is the feel-good hormone that makes us happy, right?

MAOIs increase the amount of serotonin in the body, which is part of the reason why it works to treat depression. But too much serotonin can be dangerous and lead to serotonin syndrome. Serotonin syndrome is a medical emergency that results from an overload of serotonin signaling. typically manifesting as symptoms like agitation, restlessness, tachycardia, hypertension, and muscle rigidity.

Basically, a patient falling acutely ill with unstable vitals and overactivity should make you think of serotonin syndrome. Serotonin syndrome is best avoided by not taking MAOIs with any other serotonin-altering medications. This includes other antidepressants like SSRIs and TCAs. In fact, SSRIs and TCAs should never be taken within two weeks of taking an MAOI, due to the risk of serotonin syndrome. This means that if a patient is switching from an SSRI to a MAOI, or vice versa, the drug must be completely stopped for two weeks before starting the other medication.

In summary, use this happy face take-out bag to remember that MAOIs alter serotonin levels and can cause serotonin syndrome. I don't know about you, but... I'm ready to hit the beach. Let's wrap up what we've talked about. MAOIs are a class of antidepressants and include the drugs isocarboxazide, phenylzene, and tranylcypromine.

These drugs are used to treat depression, although they are not first-line treatments due to their side effects in dangerous food and drug interactions. Notably, MAOIs can cause a hypertensive crisis, especially if patients consume foods containing tyramine. like wine, cheese, and processed meats.

MAOIs can also cause serotonin syndrome, a life-threatening condition resulting from overload of serotonin signaling. As such, MAOIs should not be given within 14 days of taking any other serotonin-altering drug. That's it for MAOIs!

Now that you have a visual mnemonic to help you remember all the key facts, you'll be able to get all your MAOI questions right on test day.