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MAO Inhibitors



- See:
      - Isocarboxazid/Marplan
      - Tranylcypromine/Parnate
      - Phenelzine/Nardil

- Discussion:
    - can potentiate the depressive effects of narcotics;
    - can cause fever and seizures when administered to a patient receiving MAOI;
    - the pressor effect of indirectly acting agents such as ephedrine may be greatly exagerated;
    - the traditional recommendations are that MAOI be discontinued 2 weeks before surgery;
    - anticholinergic agents be avoided whenever possible;
    - meperidine should definitely be avoided, whereas  fentanyl or morphine appear to be suitable during Hanesthesia;
    - enflurane or isoflurane are preferred over halothane because of reduced arrhythmogenic potential;
    - due to the possibility of hypotension associated with spinal and epidural anesthesia and the subsequent requirement for basopressors general anesthesia is preferred.