Which drug is contraindicated with Monoamine Oxidase Inhibitors (MAOI)?

• A. Barbiturates
• B. Pethidine
• C. Local Anaesthesia with felypressin
• D. Narcotic analgesics

Answer: (B)

Pethidine, also known as meperidine, is contraindicated in patients taking Monoamine Oxidase Inhibitors (MAOIs) due to the risk of severe adverse reactions. When pethidine is administered in conjunction with MAOIs, it can lead to life-threatening side effects like serotonin syndrome or hypertensive crises. This occurs because pethidine can lead to increased serotonin levels, and MAOIs inhibit the breakdown of neurotransmitters, including serotonin, resulting in excessive accumulation.

In contrast, barbiturates, local anaesthesia with felypressin, and many narcotic analgesics do not interact with MAOIs in the same dangerous manner. While caution is always advised when using any medication in conjunction with MAOIs, the specific interactions that pethidine presents make it a high-risk choice in these patients. This highlights the importance of understanding drug interactions, especially with medications that influence neurotransmitter levels.