Dextromethorphan should not be given with which drug?
ANSWER: (B) MAO inhibitorsREF: Katzung 12th edition page 559, KDT 6th ed page 213, 215The antitussive dextromethorphan should also be avoided by patients taking one of the monoamine oxidase B inhibitors; indeed, it is wise to advise patients to avoid all over-the- counter cold preparationsNon Opioid analgesic most commonly used as a antitussives are Noscapine, Dextromethorphan, Chlophedianol.They should be used with caution in patients taking monoamine oxidase inhibitorsDextromethorphan:A synthetic compoundD isomer has selective antitussive action (raises threshold of cough centre)Antitussive action lasts for 6 hoursL isomer is analgesic (i.e. Antitussive does not have analgesic property)Dextromethorphan is as effective as codeine,does not depress mucociliary function of the airway mucosa and is practically devoid of constipating and addicting actions.However Dextromethorphan has been increasingly abused in high doses (> 2 mg/kg , > 5-10 times the recommended antitussive dose) by adolescents as a hallucinogen.Action does not exert through opioid receptor, hence is not blocked by NaloxoneContraindicated with MAO inhibitorsContraindicated in children less than 6 years of age due to increasing deathContraindicated with MAO Is such as isocarboxiod, phenelzine, rasagiline, selegiline or transcypromaine
SSRIs
MAO inhibitors
Atropine
Paracetamol
Opioids