What can cause a drug-induced hypertensive crisis?

The combination of MAOIs (monoamine oxidase inhibitors) with dietary tyramine is a classic example of a drug interaction that can lead to a hypertensive crisis. MAOIs are responsible for inhibiting the metabolism of monoamines, including norepinephrine. When a patient consuming MAOIs ingests tyramine-rich foods (such as aged cheeses, cured meats, or fermented products), the tyramine is not broken down effectively and can lead to a significant release of norepinephrine. This sudden increase in norepinephrine levels results in a drastic elevation of blood pressure, potentially leading to a hypertensive crisis.

This response highlights the importance of dietary restrictions in patients taking MAOIs to avoid foods high in tyramine, thereby preventing dangerous elevations in blood pressure. Understanding this mechanism is crucial for safe pharmacological management in patients treated with MAOIs.