When teaching Mario with a typical depression about foods to avoid while taking phenelzine(Nardil), which of following would nurse in charge include?

Correct Answer: C. Salami

Foods high in tyramine, those that are fermented, pickled, aged, or smoked must be avoided because when they are ingested in combination with MAOIs a hypertensive crisis will occur. MAOIs prevent the breakdown of tyramine found in the body as well as certain foods, drinks, and other medications. Patients that take MAOIs and consume tyramine-containing foods or drinks will exhibit high serum tyramine level. A high level of tyramine can cause a sudden increase in blood pressure, called the tyramine pressor response. Even though it is rare, a high tyramine level can trigger a cerebral hemorrhage, which can even result in death.

• Option A: Eating foods with high tyramine can trigger a reaction that can have serious consequences. Patients should know that tyramine can increase with the aging of food; they should be encouraged to have foods that are fresh instead of leftovers or food prepared hours earlier.
• Option B: Examples of high levels of tyramine in food are types of fish, as well as types of meat, including sausage, turkey, liver, and salami. Also, certain fruits can contain tyramine like overripe fruits, avocados, bananas, raisins, or figs. Further examples are cheeses, alcohol, and fava beans; all of these should be avoided even after two weeks of stopping MAOIs. Anyone taking MAOIs is at risk for an adverse hypertensive reaction, with accompanying morbidity.
• Option D: Depending on the MAOI prescribed, some can cause patients to go into a coma, and others (e.g., overdosing on tranylcypromine) can result in death. The severity not only depends on the amount consumed but also on which type of MAOIs the patient took. For example, phenelzine and tranylcypromine being nonselective and nonreversible, increase the risk of a patient experiencing a hypertensive crisis when ingested with tyramine.