What is the major reason that monoamine oxidase inhibitors (MAOIs) are rarely used in clinical practice today?
They are under a scheduled drug classification.
They are ineffective in treating depression or anxiety disorders.
They can cause gastrointestinal (GI) bleeding and esophageal varices.
They may cause dangerous interactions with some foods and drugs.
The Correct Answer is D
A. While MAOIs may have some regulatory considerations, they are not classified under a scheduled drug classification like controlled substances.
B. MAOIs are effective in treating depression and anxiety disorders, which is not the reason for their limited use.
C. Although MAOIs can have some side effects, they are more notably associated with dietary and drug interactions rather than causing GI bleeding or esophageal varices.
D. MAOIs can cause dangerous interactions with foods that contain tyramine (like aged cheeses and fermented products) and certain medications, leading to hypertensive crises, making their use cautious and limiting in clinical practice.
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Correct Answer is D
Explanation
A. Giving the drug with food may delay absorption but does not affect the extent of the first-pass effect.
B. Administering the drug in small, frequent doses may help maintain therapeutic levels but will not significantly alter the first-pass effect.
C. Limiting protein intake could reduce drug binding to proteins, but this is not a standard approach for managing first-pass metabolism.
D. Administering the drug intravenously bypasses the gastrointestinal tract and liver, avoiding the first-pass effect, thereby increasing the amount of free drug available to body cells.
Correct Answer is C
Explanation
A. An allergic reaction is a possible response to medication, but it is not directly related to doubling the dosage.
B. Anaphylactic reaction is a severe and rapid allergic response; while possible, it is not the most likely consequence of an overdose in this context.
C. Poisoning is a likely concern when a client takes double the prescribed dosage of analgesics, especially if the medication has a narrow therapeutic index or is known to cause toxicity at high doses.
D. Sedative effects could occur depending on the analgesic used, but poisoning is a more pressing concern following an overdose.