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Re: Nardil and asthma meds.? zero

Posted by ed_uk on July 29, 2005, at 15:32:42

In reply to Re: Nardil and asthma meds.? ed_uk, posted by zero on July 29, 2005, at 12:35:19

Hi Zero,

>Would you happen to have a link to further explanation of that last paragraph (below)?

I don't have a link because I got my info from a texbook - Stockley's Drug Interactions.

Sympathomimetics can be divided into two main groups: directly-acting and indirectly-acting.

A directly-acting sympathomimetic is a drug which directly stimulates adrenergic receptors itself. An indirectly-acting sympathomimetic is a drug which releases NE from nerve endings.

Most directly-acting sympathomimetics do not interact with MAOIs. The selective beta-2 agonists are an example of directly-acting sympathomimetics which do not appear to interact with MAOIs.

Most indirectly-acting sympathomimetics (eg. amphetamine, ephedrine, phenylpropanolamine etc) *do* interact with MAOIs. MAOIs cause NE to accumulate inside the nerve endings of the sympathetic nervous system. NE is therefore released in abnormally large quantites if a patient on an MAOI takes an indirectly-acting sympathomimetic: hence the drug interacion. Directly-acting sympathomimetics do not release NE, hence the absense of a clinically significant interaction.

Btw, some sympathomimetic drugs are metabolised by MAO, these drugs will interact with MAOIs. I don't know how albuterol and salmeterol are metabolised, I'd have to look it up.

If you decide to combine Serevent with an MAOI, start at low doses and increase gradually.





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