Posted by ed_uk on January 14, 2006, at 13:34:14
In reply to Redirect Please: Parnate and asthma meds zero, posted by peridown on January 14, 2006, at 8:29:52
Hi G :)
You will not find any studies demonstrating that MAOIs interact with albuterol: no such studies exist.
Theoretically, albuterol would not be expected to interact with Nardil. It's mechanism of action is considerably different from that of other sympathomimetics which do interact with Nardil eg. ephedrine. Nevertheless, the possibility of an interaction remains, it simply hasn't received any study. I cannot say what form the interaction would take, although hypertension seems distinctly unlikely. Alone, albuterol tends to dilate blood vessels (decreasing peripheral vascular resistance) and increase the heart rate. These effects are most marked at high doses eg. when albuterol is taken orally (as tablets or syrup) or via a nebuliser. One or two puffs of the standard 100mcg Ventolin inhaler doesn't generally cause problematic side effects.
The standard warnings that albuterol should not be combined with an MAOI are not evidence based. They are a reflection of the continuing tendency to assume the worst with respect to MAOIs. The drug companies who manufacture bronchodilators will put these warnings on the 'package inserts' for their products to protect themselves from litigation if a patient alleged that a serious interaction occured. Such warnings are also a reflection of the lack of research into the potential of albuterol to interact with MAOIs. The fact that certain sympathomimetic drugs can be dangerous in combination with MAOIs means that doctors are likely to be very cautions when combining any sympathomimetic drug with an MAOI, even those such as albuterol which are markedly different from the sympathomimetics (ephedrine etc) which do interact with MAOIs. Monitoring blood pressure and heart rate would be sensible when adding an MAOI to ongoing treatment with beta agonists such as salmeterol (present in Serevent and Advair).
If you do suffer an exacerbation of asthma while taking an MAOI, a steroid inhaler + an oral steroid (eg. prednisone) might be necessary. Inhaled steroids do not interact with MAOIs. Oral steroids can cause psychiatric side effects and so caution is warranted.
A variety of bronchodilators can provide relief of asthma symptoms. Beta agonist such as albuterol work very rapidly and tend to be the most effective. Antimuscarinic bronchodilators such as ipratropium (present in the Atrovent inhaler) are more effective in the treatment of chronic bronchitis than in asthma. Nevertheless, they do relieve the symptoms of asthma in some cases, albeit more slowly than albuterol. Atrovent does not interact with MAOIs.
Take care
Ed
poster:ed_uk
thread:534537
URL: http://www.dr-bob.org/babble/20060108/msgs/599052.html