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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Roslynn on October 17, 2012, at 14:58:01
Hi, I will be starting Parnate in a few weeks. My doctor does not dispense an emergency med to take if you get a hypertensive crisis. He told me to call 911. My question is, will the emergency squad and staff at ER know what to do? (I will me wearing a medical ID).
But what DO they do once you get to the ER? How do they treat the hypertensive crisis?
Thank you for any answers.
Roslynn
Posted by test_subject_99 on October 17, 2012, at 16:26:47
In reply to For those of you on MAOIs--question, posted by Roslynn on October 17, 2012, at 14:58:01
Personally, I would make sure I 'somehow' obtained some sublingual nifedipine. Your pdoc is wrong to not give u a few samples to carry around with u, just like my pdoc was when I used to take phenelzine.
I was rushed to the A&E, explained to them as clearly as i could (whilst my head bagan to crack & lava bubbled away in my stomach), what was wrong, what I was taking and what I believe caused the reaction (lamb's liver). I was placed in a cubical on a bed with the curtain drawn round me and left unsupervised most of the time. Later as the effect wore off I discharged myself.
So I didn't die, but how were they to know that?
Yep! ER/A&E staff are simply not made aware of the danger- that or they are completely ignorant!
Parnate, from what I've heard, seems to have more chances of HC than other MAOIs. Even known to rarely give a spontaneous HC withought apparent cause.
If I ever go on tranylcypromine I'll make sure I get hold of some nifedipine somehow. In fact I should do NOW- I currently take an MAOI myself
Posted by zazenducke on October 17, 2012, at 18:54:54
In reply to For those of you on MAOIs--question, posted by Roslynn on October 17, 2012, at 14:58:01
Sublingual nifedipine has previously been used in hypertensive emergencies. This was found to be dangerous, and has been abandoned. Sublingual nifedipine causes blood-pressure lowering through peripheral vasodilation. It can cause an uncontrollable decrease in blood pressure, reflex tachycardia, and a steal phenomenon in certain vascular beds. There have been multiple reports in the medical literature of serious adverse effects with sublingual nifedipine, including cerebral ischemia/infarction, myocardial infarction, complete heart block, and death. As a result of this, the FDA reviewed all data regarding the safety and efficacy of sublingual nifedipine for hypertensive emergencies in 1995, and concluded that the practice should be abandoned because it was neither safe nor efficacious.[5][6]
http://en.wikipedia.org/wiki/Nifedipine
This explains why sublingual nifedipine is not used.
Posted by ChicagoKat on October 17, 2012, at 22:12:39
In reply to Re: For those of you on MAOIs--question » Roslynn, posted by zazenducke on October 17, 2012, at 18:54:54
Thank you zazenducke for posting this. I was aware sublingual nifedipine had been banned and fallen out of practice b/c it was found to be dangerous, but your post gives all the specific reasons why plus the proof of this.
For those on MAOIs who want to carry something with them to help if they should experience a hypertensive crisis, regular immediate release nifedipine does have a fairly quick onset of action at about 20mins. But really, the danger of foods with MAOIs has been overhyped. What's far more dangerous is over the counter cold preparations and the like. These should definitely be avoided.
Kat> Sublingual nifedipine has previously been used in hypertensive emergencies. This was found to be dangerous, and has been abandoned. Sublingual nifedipine causes blood-pressure lowering through peripheral vasodilation. It can cause an uncontrollable decrease in blood pressure, reflex tachycardia, and a steal phenomenon in certain vascular beds. There have been multiple reports in the medical literature of serious adverse effects with sublingual nifedipine, including cerebral ischemia/infarction, myocardial infarction, complete heart block, and death. As a result of this, the FDA reviewed all data regarding the safety and efficacy of sublingual nifedipine for hypertensive emergencies in 1995, and concluded that the practice should be abandoned because it was neither safe nor efficacious.[5][6]
>
> http://en.wikipedia.org/wiki/Nifedipine
>
> This explains why sublingual nifedipine is not used.
Posted by phillipa on October 17, 2012, at 23:17:27
In reply to Re: For those of you on MAOIs--question » zazenducke, posted by ChicagoKat on October 17, 2012, at 22:12:39
Be careful follow docs instruction to a T and the best of luck to you. Phillipa
Posted by Erewhonian on October 21, 2012, at 1:10:47
In reply to For those of you on MAOIs--question, posted by Roslynn on October 17, 2012, at 14:58:01
I've read of Thorazine being prescribed to lower blood pressure during an MAOI hypertensive crisis.
I wasn't able to get my pdoc to prescribe me anything for an emergency with my Nardil, even though I'm 22 miles from the nearest hospital. He prescribes Nardil to several of his patients, but doesn't seem very knowledgeable about it.
This is the end of the thread.
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