A patient on MAO inhibitors is consuming cheese, which could cause a reaction due to the presence of:

Question

Question

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AIIMS NORCET 7 Prelims Memory Based Paper 2024

Answer 1

Correct Answer: Tyramine

Rationale:

Monoamine oxidase inhibitors (MAOIs) are a class of medications used to treat depression by inhibiting the action of monoamine oxidase, an enzyme that breaks down neurotransmitters such as serotonin, norepinephrine, and dopamine.
Tyramine is a naturally occurring monoamine compound found in various foods, including aged cheese, and it is normally metabolized by monoamine oxidase. When a patient on MAOIs consumes tyramine-rich foods, the lack of monoamine oxidase leads to an excessive accumulation of tyramine.
High levels of tyramine can cause a hypertensive crisis, which is characterized by a sudden and dangerous increase in blood pressure. Symptoms may include severe headache, palpitations, chest pain, and nausea.

Explanation of Other Options:

Caffeine

Rationale: Caffeine is a stimulant that affects the central nervous system by blocking adenosine receptors, leading to increased alertness and wakefulness. It is not metabolized by monoamine oxidase and does not typically cause hypertensive crises when consumed by patients on MAOIs.

Serotonin

Rationale: Serotonin is a neurotransmitter involved in mood regulation. While MAOIs do increase serotonin levels by inhibiting its breakdown, serotonin is not found in food and does not directly cause hypertensive crises when consumed. The concern with serotonin and MAOIs is more related to the risk of serotonin syndrome, not hypertensive crisis.

Acetylcholine

Rationale: Acetylcholine is a neurotransmitter involved in the activation of muscle action, learning, and memory. It is not metabolized by monoamine oxidase and does not have a direct link to hypertensive crises in patients on MAOIs.

Conclusion:

Among the given options, tyramine is the correct answer because its consumption by patients on MAOIs can lead to a hypertensive crisis due to its accumulation in the body. This emphasizes the importance of dietary restrictions for individuals on MAOI therapy to prevent such severe reactions.