Antidepressants (TCAs) Flashcards Preview

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Flashcards in Antidepressants (TCAs) Deck (11)
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1
Q
Antidepressant drugs - 5 groups
A
Tricyclic antidepressants.
Selective seotonin reuptake inhibitors.
Serotonin and norepinephrine reuptake inhibitors.
Monoamine oxidase inhibitors.
Others.
2
Q
TCAs - 5 drugs
A
Clomipramine
Amitriptyline
Desipramine
Imipramine
Nortriptyline
3
Q
TCAs - MOA
A
Block reuptake of NE and SER. Immediate blockade and increase in synaptic concentration of SER and NE. Adaptive changes in NE and SER neurotransmission.
Over time: down-regulation of presynaptic autoreceptors for SER and increased firing rate of serotonergic neurons.
Blockade of muscarinic and 1-adrenoceptors: side effects
4
Q
TCAs - administration
A
At nighttime because of sedative effect
5
Q
TCAs - contraindications
A
Should not be given with SSRIs or MAOI
6
Q
TCAs - adverse effects
A
Autonomic side effect by blocking muscarinic and alpha1-adrenoceptors.
Some cause marked sedation.
Lower seizure threshold
7
Q
TCAs - symptoms of overdose
A
Life-threatening cardiac dysrhythmia (wide QRS tachycardia)
Marked autonomic effects (hypotension, sinus tachycardia)
Excessive sedation
Seizures
8
Q
Treatment of TCA overdose
A
Arrhythmia can be treated with IV sodium bicarbonate
9
Q
TCAs - interactions
A
TCA serum levels are increased by antipsychotic drugs, CCBs, cimetidine, SSRIs.
TCA serum levels are decreased by barbiturates, carbamazepine, phenytoin
10
Q
Which drugs are tertiary and secondary TCAs, and difference between them
A
Tertiary: Clomipramine, amitriptyline, imipramine.
Secondary: Desipramide, nortriptyline.
Tertiary cause more sedation and autonomic side effects, and they block NE reuptake more than SER reuptake.
11
Q
Clomipramine - indications
A
Depression.
OCD.