Antidepressants (TCAs) Flashcards Preview

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Flashcards in Antidepressants (TCAs) Deck (11)
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1

Antidepressant drugs - 5 groups

Tricyclic antidepressants.
Selective seotonin reuptake inhibitors.
Serotonin and norepinephrine reuptake inhibitors.
Monoamine oxidase inhibitors.
Others.

2

TCAs - 5 drugs

Clomipramine
Amitriptyline
Desipramine
Imipramine
Nortriptyline

3

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

4

TCAs - administration

At nighttime because of sedative effect

5

TCAs - contraindications

Should not be given with SSRIs or MAOI

6

TCAs - adverse effects

Autonomic side effect by blocking muscarinic and alpha1-adrenoceptors.
Some cause marked sedation.
Lower seizure threshold

7

TCAs - symptoms of overdose

Life-threatening cardiac dysrhythmia (wide QRS tachycardia)
Marked autonomic effects (hypotension, sinus tachycardia)
Excessive sedation
Seizures

8

Treatment of TCA overdose

Arrhythmia can be treated with IV sodium bicarbonate

9

TCAs - interactions

TCA serum levels are increased by antipsychotic drugs, CCBs, cimetidine, SSRIs.
TCA serum levels are decreased by barbiturates, carbamazepine, phenytoin

10

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.

11

Clomipramine - indications

Depression.
OCD.