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.