Dosage/

Nursing Responsibilities
Name of Drug Frequency/ Mechanism of Action Indication Contraindication Adverse Effect
Timing/Route

Generic Name: Dosage: Relieves symptoms of To treat  Cardiovascular disease; CNS: • Monitor cardiovascular
phenelzine sulfate 15 mg unipolar depressive disorders depression  cerebrovascular disease; Agitation, dizziness, status closely for changes in
by inhibiting the enzyme after other  heart failure; drowsiness, headache, heart rate (especially if
Brand name: Frequency: monoamine oxidase (MAO). drug  hepatic disease; overstimulation, patient receives more than
Nardil TID Normally, MAO breaks down therapies have  history of headaches; restlessness, 30 mg daily) and signs of life-
monoamine failed.  hypersensitivity to phenelzine sedation, sleep threatening hypertensive
Classification: Route: neurotransmitters. or its components; disturbance, suicidal crisis. Question patient often
Antidepressant P.O. By inhibiting this enzyme,  hypertension; ideation, weakness about headaches and
phenelzine increases the  pheochromocytoma; palpitations. If either occurs,
Timing: concentration of serotonin in  severe renal impairment; CV: notify prescriber and expect
8AM, 1PM, 6PM the vesicles of monoamine  use of anesthetics, Bradycardia, edema, to discontinue drug.
nerve endings, allowing more  antihypertensives, hypertensive crisis, • Inform patient and family
serotonin to be released and  bupropion, orthostatic hypotension, members that therapeutic
engage with receptors on  buspirone, palpitations, effects of phenelzine may
postsynaptic cells. A  carbamazepine, tachycardia take several weeks to appear
serotonin deficiency may be  CNS depressants, and that she should continue
responsible in part for  cyclobenzaprine, EENT: taking drug as prescribed.
endogenous depression.  dextromethorphan, Blurred vision, dry • Caution patient to rise
 meperidine, mouth, photophobia slowly from a lying or sitting
 selective serotonin-reuptake position to minimize effects of
inhibitors, GI: orthostatic hypotension.
 sympathomimetics, or Abdominal pain, • Advise patient to inform all
tricyclic constipation, diarrhea, healthcare providers
 antidepressants; elevated liver enzymes, (including dentists) that she
 use within 14 days of other increased appetite, takes an MAO inhibitor
MAO inhibitor nausea because certain drugs are
contraindicated within 2
GU: weeks of drug therapy.
Impotence, priapism, • Encouraged family to be
sexual dysfunction, alert to the emergence of
urinary frequency, urine anxiety, agitation, panic
retention attacks, insomnia, irritability,
hostility, aggressiveness,
impulsivity, akathisia
MS: (psychomotor restlessness),
Muscle twitching hypomania, mania, other
unusual changes in behavior,
SKIN: worsening of depression, and
Diaphoresis, rash suicidal ideation, especially
early during antidepressant
Other: treatment and when the dose
Hypernatremia, weight is adjusted up or down.
gain • Urge patient to avoid
hazardous activities until
drug’s CNS effects are
known.
• Emphasize the importance
of reporting headaches and
other persistent, severe, or
unusual symptoms.
• Tell family or caregiver to
watch closely for suicidal
tendencies, especially when
therapy starts or dosage
changes.
• Instruct patient to avoid the
following beverages, drugs,
and foods during phenelzine
therapy and for 2 weeks
afterward:
 alcohol-free and
reduced alcohol
beer and wine;
appetite
suppressants;
beer; broad beans;
cheese (except
cottage and cream
cheese); caffeine
and chocolate in
large quantities; dry
sausage; hay fever
drugs; inhaled
asthma drugs; liver;
meat extract; OTC
cold and cough
preparations
(including those
containing
dextromethorphan),
nasal
decongestants
(drops, spray, or
tablets); pickled
herring; products
that contain
tryptophan;
proteinrich foods
that may have
undergone protein
changes by aging,
fermenting,
pickling, or
smoking;
sauerkraut; sinus
drugs; weight-loss
preparations; yeast
extracts (including
brewer’s yeast in
large quantities);
yogurt; and wine.