Questions and Answers
What is the therapeutic class of Phenelzine?
Antidepressant
What is the pharmacologic class of Phenelzine?
Monoamine oxidase inhibitor (MAOI)
How does Phenelzine produce its effects?
By irreversible inhibition of MAO.
What is a significant risk associated with abrupt discontinuation of Phenelzine?
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The onset of Phenelzine's action is approximately ______.
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What are common adverse effects of Phenelzine?
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Which of the following conditions should contraindicate the use of Phenelzine? (Select all that apply)
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What might occur if Phenelzine is taken with tyramine-containing foods?
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Which of the following drugs should be avoided when taking Phenelzine? (Select all that apply)
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What should be monitored due to the effect of Phenelzine on platelet functioning?
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Name two other drugs that are in the same class as Phenelzine.
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Study Notes
Therapeutic and Pharmacologic Class
- Phenelzine is classified as an antidepressant and is part of the monoamine oxidase inhibitor (MAOI) class.
Mechanism of Action and Uses
- Irreversible inhibition of monoamine oxidase (MAO) enhances norepinephrine effects at adrenergic synapses.
- Indicated for treating depression unresponsive to other treatments and occasionally panic disorder.
- Drug effects may last 2 to 3 weeks post-therapy discontinuation.
Administration Alerts
- A 2 to 3-week washout period is necessary before starting other medications.
- Abrupt cessation may result in rebound hypertension.
- Classified as pregnancy category C.
Pharmacokinetics
- Onset of action: 2 weeks.
- Peaks vary among individuals.
- Duration of effect: 48 to 96 hours.
Adverse Effects
- Common side effects: constipation, dry mouth, orthostatic hypotension, insomnia, nausea, and loss of appetite.
- Increased heart rate and neural activity can lead to delirium, mania, anxiety, and convulsions.
- Severe hypertension risks when consuming tyramine-rich foods.
- Risk of seizures, respiratory depression, circulatory collapse, and coma in overdose situations.
- Black Box Warning issued due to increasing the risk of suicidal thoughts and behaviors in young patients.
Contraindications
- Not recommended for patients with cardiovascular or cerebrovascular diseases, hepatic impairment, chronic kidney disease (CKD), or pheochromocytoma.
Drug-Drug Interactions
- Avoid taking with tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) due to the risk of temperature elevation and seizures.
- Opioids can lead to respiratory failure or hypertensive crises.
- Sympathomimetics may induce hypertensive emergencies.
- Caffeine can cause cardiac dysrhythmias and hypertension.
Laboratory Tests
- May cause a slight false elevation in serum bilirubin levels.
- Platelet function may be affected; monitor complete blood count (CBC) results.
Herbal and Food Interactions
- Ginseng may cause headaches, tremors, mania, insomnia, irritability, and visual hallucinations.
- Ephedra and St. John's wort can trigger hypertensive crises.
Treatment of Overdose
- Requires intensive symptomatic and supportive care.
- Inducing emesis or utilizing gastric lavage can help.
- CNS stimulation symptoms, including seizures, should be treated with slow IV administration of diazepam.
- Address hypertension with calcium channel blockers.
- Manage hypotension and vascular collapse with IV fluids and possible vasopressors.
- Close monitoring of body temperature and respiratory support is critical.
Other Drugs in the MAOI Class
- Other MAOIs include isocarboxazid (Marplan), selegiline (Emsam), and tranylcypromine (Parnate).
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Description
Test your knowledge about Phenelzine, an antidepressant classified as a monoamine oxidase inhibitor (MAOI). These flashcards cover its therapeutic class, pharmacologic details, actions, and clinical uses, particularly in managing depression and panic disorders.
