A client has been prescribed isoniazid (INI) for tuberculosis. Which foods should the client avoid while taking this medication, as they are high in tyramine? (Select All that Apply.)

Chocolate

Aged cheese

Bananas

Red meat

White wine

Answer and Explanation

Correct Answer : A,B,C,E

A. Chocolate:

Chocolate contains tyramine, a substance that can interact with certain medications like monoamine oxidase inhibitors (MAOIs) to increase blood pressure. While isoniazid itself does not directly interact with tyramine, it is often recommended to avoid tyramine-rich foods to prevent potential interactions with other medications or to minimize potential risks. Therefore, clients taking isoniazid are advised to avoid consuming chocolate to reduce the risk of adverse effects.

B. Aged cheese:

Aged cheeses, such as cheddar, Swiss, and blue cheeses, are high in tyramine. Tyramine levels increase as cheeses age, and consuming aged cheeses can lead to tyramine buildup in the body, potentially causing hypertensive crisis when combined with certain medications like MAOIs. While isoniazid is not an MAOI, the cautionary advice to avoid tyramine-rich foods is often extended to individuals taking isoniazid to minimize potential risks.

C. Bananas:

Bananas contain tyramine, although in lower amounts compared to some other foods. However, it is still advisable for individuals taking isoniazid to avoid consuming bananas and other tyramine-rich foods to reduce the risk of potential interactions or adverse effects.

D. Red meat:

Red meat is not typically high in tyramine compared to other foods like aged cheeses, certain processed meats, and fermented foods. While some sources suggest limiting consumption of aged or fermented meats, fresh red meat is generally considered safe to consume while taking isoniazid.

E. White wine:

While red wine is more commonly associated with tyramine content, white wine can also contain tyramine and other biogenic amines. Like other tyramine-rich foods, white wine consumption should be limited or avoided by individuals taking isoniazid to minimize the risk of tyramine-related interactions or adverse effects.

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Correct Answer is C

Explanation

A. The herbal product must contain only one active ingredient:

This statement is not a legal requirement contained in DSHEA. Many dietary supplements contain multiple active ingredients, such as vitamins, minerals, herbs, amino acids, and other substances. DSHEA does not mandate that dietary supplements contain only one active ingredient.

B. Effectiveness must be demonstrated by the manufacturer:

DSHEA does not require manufacturers to demonstrate the effectiveness of dietary supplements before marketing. Unlike pharmaceutical drugs, which must undergo premarket approval by the Food and Drug Administration (FDA) to demonstrate safety and efficacy, dietary supplements do not need to prove effectiveness to be marketed. Instead, manufacturers are responsible for ensuring the safety of their products and making truthful claims on product labels.

C. Dietary supplements must state that the product is not intended to diagnose, treat, cure, or prevent any disease:

This statement accurately reflects a legal requirement contained in DSHEA. Under DSHEA, dietary supplement labels must include a disclaimer stating that the product is not intended to diagnose, treat, cure, or prevent any disease. This disclaimer helps to clarify that dietary supplements are intended to support general health and well-being rather than to treat specific diseases or medical conditions.

D. Dietary supplements must be tested for safety prior to marketing:

While DSHEA requires manufacturers to ensure the safety of their dietary supplements, it does not mandate standardized premarket testing for safety by regulatory authorities. Instead, manufacturers are responsible for conducting safety assessments and ensuring that their products are safe for consumers. The FDA may take action against manufacturers if a product is found to be unsafe or if it violates regulatory requirements, but premarket testing is not a specific legal requirement under DSHEA.

A. BP 98/62 B. Urticaria C. Wheezing D. Pulse rate 104/min

Correct Answer is C

Explanation

A. BP 98/62:

A blood pressure of 98/62 mmHg is within the normal range for an adult, although it's slightly lower than the average blood pressure. While monitoring blood pressure is important, this reading doesn't indicate a critical condition and doesn't require immediate intervention.

B. Urticaria:

Urticaria, also known as hives, is a skin rash characterized by raised, itchy welts. While it can be uncomfortable and may indicate an allergic reaction, it's not immediately life-threatening. However, it does warrant attention and further assessment.

C. Wheezing:

Wheezing is a high-pitched whistling sound that occurs during breathing and can indicate airway obstruction, such as in an allergic reaction or asthma exacerbation. Wheezing can be a sign of a severe allergic reaction or anaphylaxis, which requires immediate intervention to ensure the patient's airway remains open and to administer appropriate treatment.

D. Pulse rate 104/min:

A pulse rate of 104 beats per minute (bpm) is slightly elevated but within the normal range for an adult. While it's important to monitor heart rate, this finding alone doesn't indicate an immediate threat to the patient's life.

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A client has been prescribed isoniazid (INI) for tuberculosis. Which foods should the client avoid while taking this medication, as they are high in tyramine? (Select All that Apply.)

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