Some foodstuffs contain tyramine which is usually broken down by MAO in the body. This substance, if it persists in the body, causes hypertensive effects due to the release of noradrenaline and consequent elevation of blood pressure, which may be great enough to cause a subarachnoid haemorrhage.
Foodstuffs high in tyramine include meat and yeast extracts, pickled herrings, cheeses especially stilton, camembert, gorgonzola and brie. Drinks that may cause adverse hypertensive reactions include red wines. Others include broad beans, game.
If the patient has a hypertensive crisis because of non- breakdown of tyramine they are treated by blocking alpha adrenoreceptors by parenteral administration of phentolamine (alternatively by i.m. chlorpromazine). The patient's blood pressure must be carefully monitored.
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