Case Study

WD is an 86 yo F who is seen by the internal medicine physician because she has been feeling very depressed. The physician takes a full history from WD, which reveals that several medications have been prescribed to her by a variety of specialists. It seems that each specialist neglected to pay attention to the meds that WD was prescribed by her other doctors and the potential drug-nutrient interactions.

The physician’s notes are as follows:

Current Medication Reason for Prescribing

St. John’s wort WD read in a magazine that this helps with depression

Slow Fe (iron supplement) prior anemia

Warfarin history of embolic stroke

Omeprazole history of embolic stroke

Tums upset stomach

Amoxicillin recent respiratory infection

Doxazosin incontinence

Allegra seasonal allergies

Lipitor high cholesterol

Vitamin E she heard it was “good for heart disease”

Diet hx

B- eggs D- cooked spinach

bacon chicken breast

orange juice mashed potatoes

fruit cocktail

L- Italian hoagie (salami, ham, cheddar cheese, lettuce, and tomato) iced tea

-Given the above, the physician decides to put WD on Nardil Which of the following from WD's diet history will you counsel WD on changing?

Question

Case Study

WD is an 86 yo F who is seen by the internal medicine physician because she has been feeling very depressed. The physician takes a full history from WD, which reveals that several medications have been prescribed to her by a variety of specialists. It seems that each specialist neglected to pay attention to the meds that WD was prescribed by her other doctors and the potential drug-nutrient interactions.
The physician’s notes are as follows:
Current Medication	Reason for Prescribing
St. John’s wort	WD read in a magazine that this helps with depression
Slow Fe (iron supplement)	prior anemia
Warfarin	history of embolic stroke
Omeprazole	history of embolic stroke
Tums	upset stomach
Amoxicillin	recent respiratory infection
Doxazosin	incontinence
Allegra	seasonal allergies
Lipitor	high cholesterol
Vitamin E	she heard it was “good for heart disease”
Diet hx
B- eggs	D- cooked spinach
bacon	chicken breast
orange juice	mashed potatoes
fruit cocktail
L- Italian hoagie (salami, ham, cheddar cheese, lettuce, and tomato) iced tea

-Given the above, the physician decides to put WD on Nardil Which of the following from WD's diet history will you counsel WD on changing?

Quizplus · Accepted Answer

Nardil is a monoamine oxidase inhibitor (MAOI) drug used to treat depression. MAOIs interact with various foods and drinks that contain high levels of tyramine, which can cause a sudden and dangerous increase in blood pressure. Salami, ham, and cheese are all high in tyramine and should be avoided while taking MAOIs. Oranges, bacon, and vitamin E supplements do not contain high levels of tyramine and do not need to be avoided. Nardil is a monoamine oxidase inhibitor (MAOI) used to treat depression. MAOIs can interact with foods containing high levels of tyramine, which can lead to a hypertensive crisis. Salami, ham, and cheese all have high levels of tyramine and thus should be avoided by those taking MAOIs. Orange juice and bacon do not have high levels of tyramine and can be consumed in moderation with the medication. Vitamin E supplements should be discussed with the physician as they can also interact with MAOIs.