Posted by Ken Blades on February 25, 2007, at 3:06:17
In reply to Re: Master list of drugs to avoid while on MAOIs? » UgottaHaveHope, posted by laima on February 23, 2007, at 14:42:09
>>>>>In addition, in conversation, he told me novocane, ie at the dentist, can be a problem. Weird, huh?<<<<
Novocaine[the common term for local anesthetic but
this one is not used much nowadays], and its
more commonly used younger brother lidocaine[brand name Xylocaine] can be of concern used on MAO inhibitor-dosed people. The dental forms of lidocaine[as well as others used in medicine]
contain epinephrine as a vasoconstrictor, keeping
the lidocaine 'in place' longer. Epinephrine is also a normal substance in the body, one that the
monoamine oxidase enzyme metabolizes. Without
that process, the epinephrine can precipitate
a hypertensive crisis.So you're supposed to tell the dentist that
you're on a MAO inhibitor[and hope to hell he
knows what that is!] before you get any local
anesthetic. You should probably mention the
epinephrine/MAO danger just to be safe.>>>>Phenelzyn- is that parnate? That one sure seems to have to most potential for interactions!<<<<
Phenelzine is NARDIL. Actually, from what I've
read, Parnate is more likely to precipitate
interactions. But I wouldn't be complacent
with either drug.Recently I had an upper GI endoscopy...I
had written my MAOI status on everything,
and even told it to one of the nurses.
When the M.D doing the endoscopy started
injecting something in the I.V., I asked
what it was...he said 'Demerol'..I yelled
'I'm on a MAOI!'...he pulled on the
syringe and removed what he had started
to inject...Next time...I'm writing 'TAKING PARNATE
-NO DEMEROL!' on my forehead
with a marker!Moral of the story...keep telling them you're on a MAOI. Better safe than sorry.
Most non-psychiatrists and non-anesthesiologists
these days don't seem to be too aware of MAOIs.
poster:Ken Blades
thread:735398
URL: http://www.dr-bob.org/babble/20070224/msgs/735952.html