Flashcards in Antidepressants (TCAs) Deck (11)
Antidepressant drugs - 5 groups
Selective seotonin reuptake inhibitors.
Serotonin and norepinephrine reuptake inhibitors.
Monoamine oxidase inhibitors.
TCAs - 5 drugs
TCAs - MOA
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
TCAs - administration
At nighttime because of sedative effect
TCAs - contraindications
Should not be given with SSRIs or MAOI
TCAs - adverse effects
Autonomic side effect by blocking muscarinic and alpha1-adrenoceptors.
Some cause marked sedation.
Lower seizure threshold
TCAs - symptoms of overdose
Life-threatening cardiac dysrhythmia (wide QRS tachycardia)
Marked autonomic effects (hypotension, sinus tachycardia)
Treatment of TCA overdose
Arrhythmia can be treated with IV sodium bicarbonate
TCAs - interactions
TCA serum levels are increased by antipsychotic drugs, CCBs, cimetidine, SSRIs.
TCA serum levels are decreased by barbiturates, carbamazepine, phenytoin
Which drugs are tertiary and secondary TCAs, and difference between them
Tertiary: Clomipramine, amitriptyline, imipramine.
Secondary: Desipramide, nortriptyline.
Tertiary cause more sedation and autonomic side effects, and they block NE reuptake more than SER reuptake.