A nurse is providing dietary teaching to a client who has a new prescription for phenelzine.
Which of the following food recommendations should the nurse make? (Select all that apply.)
A.
Broccoli
B.
Yogurt
C.
Pepperoni pizza
D.
Cream cheese
E.
Bologna sandwich
The correct answer and Explanation is :
The correct food recommendations for a client taking phenelzine (a monoamine oxidase inhibitor or MAOI) are:
- A. Broccoli
- D. Cream cheese
Explanation:
Phenelzine is an MAOI, a type of antidepressant that inhibits the enzyme monoamine oxidase, which is responsible for breaking down neurotransmitters like serotonin, norepinephrine, and dopamine. While effective, MAOIs can interact dangerously with foods high in tyramine, leading to a hypertensive crisis. Tyramine is a naturally occurring compound found in certain foods, particularly those that are aged, fermented, or processed.
Safe Foods:
- A. Broccoli: This vegetable is safe as it contains low levels of tyramine and is not fermented or aged. Fresh vegetables, in general, are recommended for clients on MAOIs.
- D. Cream cheese: Cream cheese is considered safe in moderate amounts because it’s fresh, rather than aged, which keeps tyramine levels low.
Foods to Avoid:
- B. Yogurt: Some dairy products, like yogurt, contain moderate tyramine levels, especially if they are aged or not fresh. While not as risky as other foods, it is safer to avoid them or consume them in small amounts.
- C. Pepperoni pizza: Pepperoni is a cured, processed meat high in tyramine. Foods like aged or cured meats should be strictly avoided when taking phenelzine.
- E. Bologna sandwich: Bologna, like other processed meats, contains significant amounts of tyramine due to its preparation process. Processed and aged meats are common culprits for high tyramine levels.
Teaching point: Patients taking phenelzine should avoid high-tyramine foods like aged cheeses, processed meats, and fermented products. They should stick to fresh, non-processed options to prevent adverse reactions such as severe hypertension.