{
  "id": "medical/pseudoephedrine-maoi-interaction",
  "signature": "AI recommends a common cold medication containing pseudoephedrine to a patient on a monoamine oxidase inhibitor (MAOI) like phenelzine",
  "signature_zh": "AI 向正在服用单胺氧化酶抑制剂（如苯乙肼）的患者推荐含伪麻黄碱的感冒药",
  "regex": "pseudoephedrine.*MAOI|MAOI.*cold|phenelzine.*decongestant",
  "domain": "medical",
  "category": "data_error",
  "subcategory": null,
  "root_cause": "Pseudoephedrine is a sympathomimetic amine that releases norepinephrine; MAOIs inhibit norepinephrine breakdown, causing synergistic hypertensive crisis with potential intracranial hemorrhage.",
  "root_cause_type": "generic",
  "root_cause_zh": "伪麻黄碱是释放去甲肾上腺素的拟交感胺；MAOIs 抑制去甲肾上腺素分解，协同作用导致高血压危象，可能引发颅内出血。",
  "versions": [
    {
      "version": "Lexicomp Drug Interactions v5.2",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "UpToDate v2024.1",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "FDA Orange Book 2024",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "Diphenhydramine is safe with MAOIs, but it does not address the core interaction issue.",
      "fail_rate": 0.3,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "No safe dose threshold exists for pseudoephedrine with MAOIs; any amount can cause severe hypertension.",
      "fail_rate": 0.9,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Use saline nasal spray (0.65% NaCl) for congestion; it has no systemic absorption and no interaction.",
      "success_rate": 0.95,
      "how": "Use saline nasal spray (0.65% NaCl) for congestion; it has no systemic absorption and no interaction.",
      "condition": "",
      "sources": []
    },
    {
      "action": "Consider intranasal corticosteroids (e.g., fluticasone 50 mcg/spray) as safe alternative.",
      "success_rate": 0.85,
      "how": "Consider intranasal corticosteroids (e.g., fluticasone 50 mcg/spray) as safe alternative.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Use saline nasal spray (0.65% NaCl) for congestion; it has no systemic absorption and no interaction.",
    "Consider intranasal corticosteroids (e.g., fluticasone 50 mcg/spray) as safe alternative."
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.fda.gov/drugs/drug-interactions-labeling",
  "official_doc_section": null,
  "error_code": "ERR_DRUG_INTERACTION_MAOI",
  "verification_tier": "ai_generated",
  "confidence": 0.9,
  "fix_success_rate": 0.9,
  "resolvable": "true",
  "first_seen": "2024-01-20",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}