Page 23 - pharma 1 theoretical updated MNU_Neat

Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)

COMT MAO inhibitors (MAOIs):

inhibitors

 pyrogallol - Non-selective MAOIs as Iproniazid, tranylcypromine,
 dopacetamide pargyline (Antidepressant)
- Selective MAO-A inhibitors → clorgiline.

- Selective MAO-B inhibitors →selegiline.
Cheese reaction
➢ hypertensive crisis occur in patients, receive non-selective MAOIs,

ingest large amount of tyramine found in certain food.
 concentrations of tyramine→ reach adrenergic neurons→ release
NE in large amount→ hypertensive crisis.

 Patients under MAOIs therapy → avoid food rich in tyramine
(cheese, yeast extract, pickles green, figs and wine)

Pharmacological effects of Epinephrine

to mucous
Vasoconstriction (α).
membrane or
if it used with local anesthetic, it will prolong its action
injected S.C.
If applied
locally Vasoconstriction 
mydriasis and  in intraocular pressure
on the eye
as a result of aqueous humor formation and  aqueous

humor outflow
 Increased cardiac output, Increased automaticity

on  +ve Dromotropic effect ( Conductivity)
cardiovascular  +ve Bathmotropic effect ( Excitability of the heart)
system  +ve chronotropic effect (heart rate)

“ effect”  +ve inotropic effect. ( force of contraction)
 Facilitate conduction in the atrio-ventricular (AV) node

➢ E →  systolic blood pressure and  diastolic blood pressure.
➢ The increase in systolic pressure → due to the  in cardiac output
Blood

pressure: ( effect) and vasoconstriction ( effect).
➢ Mean blood pressure is not changed or increased minimally.
Peripheral resistance (PR) decreases.

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