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Toxicity, Monoamine Oxidase Inhibitor: Follow-up

Author: Steven Marcus, MD, Professor, Department of Preventive Medicine and Community Health, Associate Professor, Department of Pediatrics, New Jersey Medical School, University of Medicine and Dentistry of New Jersey; Executive and Medical Director, New Jersey Poison Information and Education System; Consulting Staff, Departments of Pediatrics and Internal Medicine, University Hospital, University of Medicine and Dentistry of New Jersey; Consulting Staff, Department of Pediatrics, Newark Beth Israel Medical Center
Contributor Information and Disclosures

Updated: Sep 22, 2009

Follow-up

Further Inpatient Care

  • Maintain vigilance regarding recrudescence of fever and fluid requirements.
  • Because toxicity may be delayed in onset of overdose, admit the patient and observe in a monitored setting.

Prognosis

  • Patients should recover without sequelae if no adverse reactions occur, such as renal failure, stroke, or refractory hypotension.

Patient Education

  • All patients medicated with MAOIs should receive extensive education regarding drug and food interaction problems. Encourage them to have all of their prescriptive and nonprescriptive drugs dispensed from one pharmacy so that an accurate medication profile can be maintained.

Miscellaneous

Medicolegal Pitfalls

  • Failure to recognize toxicity, particularly the potential for drug/drug interaction
  • Failure to early and aggressively decontaminate the patient with monoamine oxidase inhibitor (MAOI) exposure
  • Failure to admit and observe patients with MAOI overdose
  • Administering contraindicated drugs, especially meperidine, to patients taking MAOIs
 


More on Toxicity, Monoamine Oxidase Inhibitor

Overview: Toxicity, Monoamine Oxidase Inhibitor
Differential Diagnoses & Workup: Toxicity, Monoamine Oxidase Inhibitor
Treatment & Medication: Toxicity, Monoamine Oxidase Inhibitor
Follow-up: Toxicity, Monoamine Oxidase Inhibitor
References
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References

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Further Reading

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Keywords

monoamine oxidase inhibitor toxicity, monoamine oxidase inhibitor poisoning, antidepressant overdose, MAOI, MAO, MAO-A, MAO-B, MAOI poisoning, phenelzine sulfate, Nardil, tranylcypromine sulfate, Parnate, isocarboxazid, Marplan, selegiline, serotonin reuptake inhibitors, analgesics, tyramine-containing foods, catecholamines, excessive catecholamine neurotransmitters, MAOI overdose

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Contributor Information and Disclosures

Author

Steven Marcus, MD, Professor, Department of Preventive Medicine and Community Health, Associate Professor, Department of Pediatrics, New Jersey Medical School, University of Medicine and Dentistry of New Jersey; Executive and Medical Director, New Jersey Poison Information and Education System; Consulting Staff, Departments of Pediatrics and Internal Medicine, University Hospital, University of Medicine and Dentistry of New Jersey; Consulting Staff, Department of Pediatrics, Newark Beth Israel Medical Center
Steven Marcus, MD is a member of the following medical societies: Academy of Medicine of New Jersey, American Academy of Clinical Toxicology, American Academy of Pediatrics, American College of Emergency Physicians, American College of Medical Toxicology, American Medical Association, and Medical Society of New Jersey
Disclosure: Nothing to disclose.

Medical Editor

Richard Lavely, MD, JD, MS, MPH, Lecturer in Health Policy and Administration, Department of Public Health, Yale University School of Medicine
Richard Lavely, MD, JD, MS, MPH is a member of the following medical societies: American College of Emergency Physicians, American College of Legal Medicine, and American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

John T VanDeVoort, PharmD, Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals
John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists
Disclosure: Nothing to disclose.

Managing Editor

Fred Harchelroad, MD, FACMT, FAAEM, FACEP, Chair, Department of Emergency Medicine, Director of Medical Toxicology - Allegheny General Hospital, Associate Professor, Department of Emergency Medicine, Drexel University College of Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD, Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital
Disclosure: Nothing to disclose.

 
 
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