Home Drug Guide Pargyline Hydrochloride

Drug Guide

Generic Name

Pargyline Hydrochloride

Brand Names Eutonyl

Classification

Therapeutic: Antihypertensive, Monoamine Oxidase Inhibitor (MAOI)

Pharmacological: Non-selective Monoamine Oxidase Inhibitor

FDA Approved Indications

  • Management of hypertension unresponsive to other therapy

Mechanism of Action

Pargyline inhibits monoamine oxidase (MAO), leading to increased levels of norepinephrine, dopamine, and serotonin in the central nervous system and peripheral tissues, resulting in vasodilation and decreased blood pressure.

Dosage and Administration

Adult: Initially 20 mg 2-3 times daily, titrated as needed up to 40-50 mg 2-3 times daily.

Pediatric: Use not well established; generally not recommended.

Geriatric: Start at lower doses due to increased sensitivity and potential for adverse effects.

Renal Impairment: Adjust dose cautiously; renal function should be monitored.

Hepatic Impairment: Use with caution; hepatic function should be assessed.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Wide distribution; crosses the blood-brain barrier.

Metabolism: Metabolized in the liver.

Excretion: Excreted primarily in the urine.

Half Life: Approximately 2-4 hours, but effects may last longer due to enzyme inhibition.

Contraindications

  • History of hypersensitivity to pargyline or other MAO inhibitors.
  • Concurrent use with other MAO inhibitors, SSRIs, or tyramine-rich foods.

Precautions

  • Use with caution in patients with hepatic impairment, cardiovascular disease, or psychiatric disorders. Avoid foods high in tyramine to prevent hypertensive crises. Monitor blood pressure regularly.

Adverse Reactions - Common

  • Orthostatic hypotension (Common)
  • Dizziness (Common)
  • Insomnia (Common)

Adverse Reactions - Serious

  • Hypertensive crisis due to tyramine interactions (Rare)
  • Serotonin syndrome (when combined with serotonergic drugs) (Rare)
  • Liver toxicity (Rare)

Drug-Drug Interactions

  • Other MAO inhibitors, SSRIs, SNRIs, TCAs, sympathomimetics, vasoconstrictors.

Drug-Food Interactions

  • Foods high in tyramine (aged cheese, smoked meats, fermented foods)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure regularly; assess for symptoms of hypertensive crisis.

Diagnoses:

  • Risk for hypertensive crisis
  • Altered blood pressure regulation

Implementation: Educate patient on dietary restrictions; avoid tyramine-rich foods; monitor for adverse reactions.

Evaluation: Effectiveness in blood pressure control; absence of hypertensive episodes.

Patient/Family Teaching

  • Instruct about the importance of dietary restrictions to prevent hypertensive crises.
  • Advise to report symptoms such as severe headache, neck stiffness, or palpitations immediately.

Special Considerations

Black Box Warnings:

  • Hypertensive crisis risk with tyramine-rich foods.
  • Potential for serotonin syndrome when combined with serotonergic agents.

Genetic Factors: Genetic variations affecting MAO enzyme may influence drug response.

Lab Test Interference: May interfere with laboratory tests for monoamine oxidase activity.

Overdose Management

Signs/Symptoms: Severe hypertension, hyperthermia, chest pain, seizures.

Treatment: Supportive care; quick removal of drug; antihypertensive medications as needed; Manage seizures accordingly.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.