TITLE: WOULD WE RECOGNIZE AN MAO INHIBITOR IF WE SAW ONE?

AUTHORS: Suanne Daves, MD, M. F. O'Connor, MD, J. Klafta, MD, P. A. Klock, MD, J. F. Foss, MD
AFFILIATION: University of Chicago, Chicago, IL.

INTRODUCTION: One of the tenets of problem-based learning is that learning is best accomplished when the material is cast in the most relevant context possible. This process allows the learners to integrate the theories of medicine with their application in practice. Although anesthesiologists are generally well informed about the interactions of MAO inhibitors and agents commonly used in anesthesiology, classic MAO inhibitors are only rarely prescribed. Further, the specifics of the MAO inhibitors presently available in the USA are only rarely included in discussions of their interactions in anesthesia. We conducted this survey to assess the ability of anesthesia personnel at various levels of training and practice to recognize the most commonly prescribed MAO inhibitors.
METHODS: After obtaining IRB approval, we distributed a 3 part questionnaire to 20 anesthesia faculty, residents, and students at our institution. Basic demographic information was solicited, as well as background information about where practitioners looked for information about drugs and how often they did so. The test itself was divided into 3 sections. The first required practitioners to match 42 generic and trade names, the second required them to match generic or trade name (or both) with class of drug. The third section required them to match paired generic and trade names with adverse reactions and important drug-drug interactions.
RESULTS: 10 of 20 (50%) (95% CI: 28% to 72%) respondents were able to match the generic and trade names of phenelzine, one of the most commonly prescribed MAO inhibitors in the USA and world. Only 14 of 20 (70%) (95% CI: 50% to 90%) matched either the trade or the generic names with the class of drug, and only 13 (65%) (95% CI: 44% to 85%) were able to match the paired names with one of the important drug-drug interactions in anesthesiology.
DISCUSSION: The results of our survey strongly suggest that the names of actual MAO inhibitors that practitioners might encounter in practice need to be incorporated more prominently in educational programs, and that this information may need to be intermitttently reinforced as well.