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Year 3 Drugs - Mental Health > TCAs > Flashcards

Flashcards in TCAs Deck (16):
1

Name a common TCAs?

Amitriptyline

2

How do TCAs work?

Inhibit neuronal reuptake of serotonin (5-HT) and noradrenaline from the synaptic cleft, thereby increasing their availability for neurotransmission.
TCAs also block other receptors such as muscarinic, histamine (H1), α-adrenergic (α1 and α2) and dopamine (D2) receptors

3

What pain relief medication works on a similar basis to TCAS?

Tramadol also blocks NA and serotonin receptor whilst also working on the opioid mu receptor

4

What are the common uses for TCAs?

1. Moderate to severe depression - when SSRIs do not work
2. Neuropathic pain - although not licenced

5

What are the contraindications of using TCAs?

Do not use with monoamine oxidase inhibitors as they both work to increase the levels of serotonin and NA so can cause hypertension, hyperthermia and serotonin syndrome

6

When should TCAs be used with caution?

Elderly
CV disease
Epilepsy
= More at risk of adverse effects
Constipation
Prostatic hypertrophy
Raised intraocular pressure/ Acute angle glaucoma
= can be worsened by antimuscarininc effects

7

What are the common interactions with TCAs?

Monoamine oxidase inhibitors
TCAs can enhance antimuscarinic, sedative or hypotensive adverse effects of other drugs.

8

What are the antimuscarinic side effects of TCAs?

Dry mouth
Constipation
Urinary retention
Blurred vision

9

What are the CV side effects of TCAs?

Arrhythmias
ECG changes (prolonges QT and QRS complexes)

10

What are the histamine and alpha blocker side effects of TCAs?

Sedation
Hypotension

11

What are the CNS side effects of TCAs?

Convulsions
Hallucinations
Mania

12

Why can TCAs worsen psychosis and bipolar?

they can cause convulsions hallucinations and mania

13

What are the overdose side effects of TCAs?

Hypotension
Arrhythmias
Convulsions
Coma
Respiratory failure

14

What are the with-drawl side effects of TCAs?

Sleep disturbance
Influenza like symptoms
GI upset

15

How are TCAs excreted?

Metabolised by liver
Excreted by kidneys

16

What are the differences in doses when TCAs are used for depression and pain?

Depression 75 mg daily
Pain 10 mg at night