Posted by Jennifer on June 13, 2000, at 20:40:03
In reply to Re: MAOIs and beer (Adam?), posted by Adam on June 13, 2000, at 17:21:22
It seems from this thread that we all need to get together and have a beer tasting party. Is Southern California good for everyone else? Actually, I hate beer, except in pancakes!
Here's the deal...it's all in the hops & yeast that are fermented to high heaven in imported (not USA) beer. The only beers that are possibly ok are Domestic (American), non-dark, cheap beers (ie: not aged long) and in glass is best, because glass absorbs tyramine.
Great info from Adam regarding BP measurement. He is 100% correct about Parnate being the worst offender. I think I'd try a Coors in the ER waiting room if at all! Further tips on the BP cuff...you can have inaccurate measurements if it is not the right size. If you are overweight, or overthin...double check it. The WIDTH of the cuff should be 1.5X the width of your upper arm. Length is not of concern as long as it will overlap sufficiently. If it's too narrow, you need to purchase a "thigh cuff". I have had good luck with an electronic one I got at the drug store on sale for $39. You do need to take it a few times when your BP is normal to see what your machine usually measures (since you can't calibrate it)
Adam- you were really lucky with the foods you ate not having a reaction. The number one thing we all need to remember is JUST BECAUSE A FOOD DID NOT GIVE YOU A RXN, DOES NOT MEAN IT WON'T THE NEXT TIME YOU EAT IT! Just as some meds work sometimes, and some don't, your body changes. Also, the tyramine levels in foods change almost hourly. A good rule of thumb is on day three, throw out the leftovers. I do eat avocado when I make guacamole, but I just make enough for 1 night and throw out the rest. (Not that I'm recommending this to anyone). I also enjoy a glass of white wine once in awhile...but not bottled wine coolers because they have hops.
As far as the med alert...MAO should be sufficient because everyone has in the back of their mind that it is something bad, and at least they'll probably double-check before giving meds. I always put "ALLERGIC TO DEMEROL, and NO EPI" (epinephrine) on med sheets. Demerol will send you into an immediate hypertensive crisis. All other narcotic injections should be started at 1/10th the dose, but that's just good to know for after a surgery or something. Epi would really be the only thing I can think of that someone would give you for cardiac or resp reasons after an accident or anaphylactic reaction. The problem is, you're dead without it. Many give it and treat the hypertension later. Always put MAO - no epi, so they know why you can't have it. Why am I always so darn lengthy? I guess I just get on a roll. Hope this helps, Jennifer> No problem.
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> One of the doctors who followed me in the transdermal selegiline study told me that of the Big Three (Marplan, Nardil, Parnate), Parnate may be the worst offender as far as hypertensive reactions go, and this almost got Parnate pulled off of the market permanently. It may have something to do with the fact that the parent compound, or one of its metabolites, is sufficiently amphetamine-like to cause (among other things) increased secretion of norepinepherine. I imagine this leaves the patient with an elevated level of NE in the blood and brain from the get-go (perhaps causing spontaneous hypertensive events in some). Couple that with the massive NE dump that occurs when tyramine dispaces NE in the secretory vessicles in neurons, and the risk for hypertensive crisis might be higher. Again, I'll stress this is just "what I was told", and appears to be based more on anecdotal clinical experience than controlled studies. Still, it's something to think about.
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> I would say, yes definitely pick up a sphigmomanometer and stethescope. Taking b.p. isn't hard, but if neither one of you is a medical professional, I would have one give you a thorough lesson. I'm lucky enough to have a nurse practitioner for a stepmom, so I got very good training. Also, you may, after learning how, want to try out a few with different variants of cuff before you buy one. I got mine as a present, and while it's quite usable, it's damn hard to take my own b.p. The problem is trying to properly secure the velcro on the cuff with one hand to get the right fit. I get around the problem with some creative use of table tops and a little dexterity, but I sometimes have to repeat measurements (waiting for my arm to return to normal is a pain) because I didn't get the right snugness/looseness ratio. Once I do get it on properly, though, it's easy to pump the bulb and control deflation of the bladder with my left hand while holding the diaphragm of the stethescope, with my right hand, against the brachial artery. Try using the bell of the stethescope to hear those funky sounds with the Russian name (I want to say Kartikov, but I know that's not right), just for kicks.
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> I guess there are these "portable" automatic units, but they're really expensive. I think I was able to be adequately outfitted for around $100.
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> Also, get that medic alert braclet or necklace. I like the necklace because A) there's nothing on my wrist to get in the way of my work, and B) nobody asks questions about the necklace, while I think the bracelet is kind of obvious and thus not a very good guard of privacy.
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> It took a long time to figure out what to put on there. I basically put instructions to call the service and give them my registry number before administering any medications. I just don't trust all the paramedics to know what "sympathomimetic" is (or all the physicians for that matter). Even if they do, I don't imagine all will know offhand which drugs are OK and which one's aren't. However, this does seem a bit too sweeping a precaution, and might cost valuable time.
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> Any alternative instructions out there? My doctors didn't have any better suggestions.
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> Thanks!
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> > Thank you all for the input. This is just the sort of information I was seeking (especially the list of beers).
> > It is actually my husband who is going to start Parnate soon (after many, many unsuccessful
> > trials of many other meds.) and I agreed to help with the background research. We will proceed very,
> > very, very cautiously. Sounds like we'll need a blood pressure cuff and to gather some baseline
> > blood pressure data.
> >
> > Thanks,
> > -Diane
poster:Jennifer
thread:37074
URL: http://www.dr-bob.org/babble/20000610/msgs/37216.html