A nurse is modifying the diet of a client prescribed an MAOI. Which of the following foods should the nurse eliminate?
Cherries
Cheddar cheese
Chicken
Fresh fish
The Correct Answer is B
A. Cherries do not contain tyramine, which is the compound of concern for clients on MAOIs, so they can be included in the diet.
B. Cheddar cheese is high in tyramine, which can lead to hypertensive crises when consumed by clients taking MAOIs. Therefore, it should be eliminated from the diet.
C. Chicken is generally safe for clients on MAOIs as it does not contain significant amounts of tyramine.
D. Fresh fish is also safe to consume while on MAOIs as long as it is fresh and not aged, fermented, or spoiled, which could contain higher tyramine levels.
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Correct Answer is C
Explanation
A. Grapefruit juice does not have a known interaction with metronidazole and does not need to be avoided.
B. Dairy does not interfere with metronidazole's absorption or effectiveness, so it is not a contraindication.
C. Alcohol should be strictly avoided during and for at least 48 hours after metronidazole treatment, as it can cause a severe reaction, including nausea, vomiting, flushing, and rapid heart rate.
D. Tyramine-based foods do not interact with metronidazole, so they are not a contraindication for this medication.
Correct Answer is B
Explanation
A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.