Treatment of choice for cheese reaction
?
a) Prazocin
b) Pentazocin
c) Phentolamine
d) Phenoxybenzamine
Correct Answer - C
Ans. is ‘c’ i.e., Phentolamine
Cheese reaction
Certain varieties of cheese, beer, wines, picked meat and fish, yeast
extract contain large quantities of tyramine, dopa.
In MAO inhibited patients these indirectly acting sympathomimetic
amines escape degradation in the intestinal wall and liver →
reaching into systemic circulation they displace large amount of NA
from adrenergic nerve endings Hypertensive crisis, cerebrovascular
accidents.
This can be treated by i.v. injection of a rapidly acting phentolamine.
Prazosin and chlorpromazine are alternative.