TCAs

Question 1

All TCAs are indicated for what?

Answer 1

MDD

Question 2

TCA medications

Answer 2

Amitriptyline, desipramine, doxepin, imipramine, nortriptyline

Question 3

TCAs indicated in peds

Answer 3

amitriptyline, doxepin, nortriptyline are indicated for use in kids 12-17

Question 4

doxepin is also indicated for what?

Answer 4

insomnia

Question 5

TCAs all have what side effects?

Answer 5

CV effects, anticholinergic effects

Question 6

CV side effects of TCAs

Answer 6

cardiotoxicity, orthostatic hypotension, right bundle branch block, ventricular tachycardia and heart block are lethal in an OD

Question 7

Anticholinergic side effects

Answer 7

blurred vision, urinary retention, dry mouth, constipation, cognitive impairment, delirium

Question 8

When to give TCAs (what time of day)

Answer 8

Nighttime to decrease sedative properties

Question 9

Other side effects of TCAs

Answer 9

sexual dysfunction, weight gain, photosensitivity

Question 10

Amitriptyline can cause what side effect?

Answer 10

urine discoloration

Question 11

Abrupt D/C of a TCA can cause what?

Answer 11

TCA withdrawal syndrome

Question 12

TCA withdrawal syndrome symptoms

Answer 12

Insomnia, sweating, abdominal pain, diarrhea, myalgias, nausea

Question 13

Caution with using TCAs in what disease state

Answer 13

Thyroid disease

Question 14

Avoid TCAs in what patients?

Answer 14

Patients with hepatic impairment

Question 15

What should you avoid when taking a TCA?

Answer 15

alcohol

Question 16

TCA monitoring

Answer 16

Get a baseline EKG, monitor serum concentrations for verification of adherence or toxicity/OD