The patient has high blood pressure since blood pressure (BP) is at 230160 mm Hg and high blood pressure for adults occur at 140 mm Hg or greater systolic pressure or 90 mm Hg or higher diastolic pressure. Normal BP is less than 120 mm Hg systolic pressure and less than 80 mm Hg diastolic pressure. The breathing rate is normal since normal respiration rates for an adult range from 12 to 16 breaths per minute. The patient has a lower pulse rate at 56 beats per minute since the standard pulse for healthy adults ranges from 60 to 100 beats per minute. The use of Monoamine oxidase inhibitors (MAOIs) gets associated with side effects such as orthostatic hypotension Cheap Jamal Adams Jersey , nausea, dizziness, drowsiness and insomnia. Parnate (tranylcypromine sulfate) tablet which is an MAOI gets related to side effects such as drowsiness Cheap Nathan Shepherd Jersey , nausea and frequent headaches. The patient has a health care problem in which she has hypertension caused due to the toxicity of the medication. The patient took a nonselective MAOI ingestion of greater than 6 mg of tyramine that got contained in the aged cheese and resulted in a hyperadrenergic crisis. The MAOI ingestion of foods with high content of tyramine like aged cheese, some wines and beers, soy sauce and sauerkraut inhibits MAO-A that metabolizes the tyramine in the intestinal wall and liver. 1. What are monoamine oxidases (MAOs)? Monoamine oxidase (MAO) is the enzyme located in the outer membrane of mitochondria in body cells and is responsible for the metabolism of monoamine neurotransmitters. 2. Discuss the types Cheap Sam Darnold Jersey , locations and physiological functions of MAOs? Monoamine oxidases (MAO) exist in two types that are MAO-A, and MAO B. MAO-A commonly gets located in the intestines and liver and preferentially oxidizes serotonin in the central nervous system. MAO-B, on the other hand Cheap Le'Veon Bell Jersey , gets commonly located in the central nervous system and preferentially oxidizes phenylethylamine. The two flavoenzymes get bound to the mitochondrial outer membrane through transmembrane 伪-helices situated at their respective C-termini. MAO A and MAO B undertake significant physiological functions in the degradation as well as control of levels of amine neurotransmitters (Norepinephrine, Serotonin, Dopamine). It is because the enzymes contain covalent (8伪-S-Cysteinyl) FAD cofactors. MAO A and MAO B also degrade ingested amines such as tyramine that could serve as false neurotransmitters. 3. What is tyramine? (synthesis Cheap C.J. Mosley Jersey , functions, sources) Tyramine refers to the by-product of tyrosine metabolism. Tyrosine is a precursor of dopamine, epinephrine and norepinephrine. Tyramine commonly gets found in many drugs Cheap Curtis Martin Jersey , beverages and foods. 4. What are the effects of MAOIs on tyramine? The monoamine oxidase inhibitors (MAOIs) medications that include phenelzine (Nardil) and isocarboxazid (Marplan) interact with tyramine such as broad beans, cheese and chocolate. MAO breaks down tyramine, and MAO inhibitors stop the catabolism. If the tyramine catabolism does not occur Cheap Trevon Wesco Jersey , there is the occurrence of a potentially life-threatening elevation of blood pressure. 4. What is the mechanistic explanation for the MAOIs with aged cheese? Monoamine oxidase inhibitors (MAOIs) are drugs that block monoamine oxidase that is responsible for breaking down excess tyramine in the body. Tyramine is essential as it assists in regulating blood pressure. However, if a person takes MAOI medications and consumes high-tyramine foods such as aged cheese, there is a possibility of the tyramine quickly rising to dangerous levels resulting in a severe spike in Blood Pressure. This condition requires an emergency medical care. 6. Can a 尾-blocker be used in this situation to control blood pressure? If not Cheap Chuma Edoga Jersey , why? 尾-blockers should not get used in this circumstance. The patient in this case study requires an urgent Lowering of Blood Pressure basing on the high BP and presence of end-organ damage. A severe headache experienced by the patient represents a hypertensive emergency caused by cerebral edema or hemorrhage. The use of 尾-blocker尾-adrenergic receptor antagonist to normalize significant symptoms when the treatment for drug-induced sympathomimetic toxidrome gets needed is not appropriate. The 尾-blockers block 尾1- and 尾2- adrenergic receptors, the peripheral 尾- adrenergic receptors get unopposed hence enabling increased peripheral and coronary artery vasoconstriction.
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