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Pediatric Monoamine Oxidase Inhibitor Toxicity Treatment & Management

  • Author: Soumya Ganapathy, MD; Chief Editor: Timothy E Corden, MD  more...
 
Updated: Jan 15, 2015
 

Medical Care

As with most toxic ingestions, the cornerstone of management is continuous monitoring, decontamination when clinically indicated, and meticulous supportive care.

  • Give careful attention to airway management.
  • Maintain euvolemia because patients with monoamine oxidase inhibitor (MAOI) poisoning can become dehydrated secondary to their hypermetabolic state.
  • Maintain euthermia, especially in patients with suspected serotonin syndrome. Water mist sprays with fanning are effective. The removal of clothing and the use of cooling blankets may also be effective.
  • Treat seizures and agitation with intravenous benzodiazepines.
  • Decontamination with activated charcoal should be performed with caution and with attention to the possibility of airway compromise.
  • Treat hypertension only if it is sustained and clinically significant.
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Consultations

See the list below:

  • Close consultation with a medical toxicologist or personnel from a regional poison center is recommended.
  • Consult a pediatric intensivist.
  • Consult a psychiatrist in cases of suspected intentional ingestion.
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Contributor Information and Disclosures
Author

Soumya Ganapathy, MD Department of Emergency Medicine, Beverly Hospital

Soumya Ganapathy, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Frank A Maffei, MD, FAAP Associate Professor of Pediatrics, Temple University School of Medicine; Medical Director, Pediatric Intensive Care Unit, Janet Weis Children's Hospital at Geisinger Health System

Frank A Maffei, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Jeffrey R Tucker, MD Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center

Disclosure: Received salary from Merck for employment.

Chief Editor

Timothy E Corden, MD Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, Wisconsin Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

Michael E Mullins, MD Assistant Professor, Division of Emergency Medicine, Washington University in St Louis School of Medicine; Attending Physician, Emergency Department, Barnes-Jewish Hospital

Michael E Mullins, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians

Disclosure: Received stock ownership from Johnson & Johnson for none; Received stock ownership from Savient Pharmaceuticals for none.

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