# A client on selegiline 10 mg/day for Parkinson disease asks the nurse which foods to avoid. Which response is most accurate for selegiline at this dose?

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391765&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A client on selegiline 10 mg/day for Parkinson disease asks the nurse which foods to avoid. Which response is most accurate for selegiline at this dose?

## Option

1. Eat a high-protein diet for optimal selegiline effect
2. Avoid all green vegetables to prevent interactions
3. Strict tyramine-free diet is mandatory at all doses
4. At doses up to 10 mg/day, selegiline is MAO-B selective and routine tyramine restriction is not required, but limit intake of high-tyramine foods at higher doses or with the transdermal patch >6 mg/24 hr **✔ Correct answer**

**Correct answer: 4**

## Explanation

Correct (2): Selegiline is selective for MAO-B at low doses (≤10 mg PO daily or 6 mg/24-hr patch) — peripheral MAO-A is preserved so tyramine breakdown is largely intact and dietary restriction is generally not required. At higher doses or higher-strength patches, MAO-B selectivity is lost, and strict tyramine restriction applies as with nonselective MAOIs. (1) Overly restrictive. (3) Unrelated. (4) Levodopa absorption is hindered by protein.

## In-depth explanation

Memory Tip MAO-B selective (selegiline, rasagiline) at low dose = no strict tyramine diet. NONselective MAOI (phenelzine, tranylcypromine) = strict tyramine restriction always.

## Clinical scenario

Scenario 64-year-old female on selegiline 10 mg/day (an MAO-B selective inhibitor) for Parkinson disease, asking dietary teaching at outpatient follow-up.

## Key concepts

- **MAO-B selective inhibitor** — Selegiline or rasagiline at therapeutic PD doses; preserves peripheral MAO-A function.
- **Tyramine-induced hypertensive crisis** — Severe BP elevation from tyramine accumulation when MAO-A is blocked; not typical with low-dose selegiline.
- **Selegiline transdermal patch** — Higher-dose patches (>6 mg/24 hr) lose MAO-B selectivity and require tyramine restriction.

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