Antidepressant Meds: Tricyclics

Question 1

Examples

Answer 1

Amitriptyline, Imipramine

Question 2

Actions

Answer 2

Inhibits presynaptic reuptake of neurotransmitters norepinephrine and serotonin; anticholinergic action at CNS and peripheral receptors

Question 3

Indications

Answer 3

Depression, Obstructive sleep apnea

Question 4

Adverse effects

Answer 4

Sedation, Anticholinergic effects ( dry mouth, blurred vision). Confusion ( especially in the elderly), photosensitivity, disturbed concentration, orthostatic hypotension, bone marrow depression, urinary retention.

Question 5

Nursing Consideration

Answer 5

Therapeutic effect in 1-3 weeks, maximum response in 6-9 weeks. May be administered in daily dose at night to promote sleep and decrease adverse effects during the day. Orthostatic hypotension precautions. INstruct client that adverse effects will decrease over time. Sugarless lozenges for dry mouth. Do not abruptly stop taking medication (headache, vertigo, nightmares, malaise, weight change). Avoid alcohol, sleep-inducing drugs, OTC drugs. Avoid exposure to sunlight, wear sunscreen. Older adults; strong anticholinergic and sedation effects.