A 19-year-old college student presents with severe occipital headache, profuse diaphoresis, and substernal chest pain after consuming tyramine-rich aged cheese while taking an antidepressant. Vital signs show BP 210/140 mmHg, HR 118 bpm, RR 22/min, temperature 37.8°C, and SpO2 98% on room air. Serum troponin is normal. He denies recent medication changes besides antidepressant initiation two weeks ago. Which antidepressant class most likely caused this hypertensive crisis?
- A)Selective serotonin reuptake inhibitor
- B)Tricyclic antidepressant
- C)Serotonin-norepinephrine reuptake inhibitor
- D)Monoamine oxidase inhibitorGABARITO
- E)Atypical antipsychotic
Explicação
MAOIs inhibit monoamine oxidase, the enzyme that breaks down tyramine and other monoamines. Dietary tyramine normally is metabolized by gut and hepatic MAO, but with MAOI use, it accumulates and causes massive sympathomimetic release, leading to hypertensive c... Ver explicação completa e trilha adaptativa →