MMD DRUGS- TCA

Question 1

name this class of drug?

2nd or 3rd line agents if SSRI or SNRI didn’t work

Multiple sites of action (5-HT, NE, alpha1, H1, M1) à many potential adverse effects]

Overdose may be lethal

Answer 1

TCA (Tricyclic Antidepressants)

Question 2

name the tertiary TCAs?

*these bind to the non serotonin receptors with higher affinity

Answer 2

Amitriptyline, Imipramine, Clomipramine, Doxepin

-More specific for Seratonin reuptake inhibition

Question 3

Secondary TCAs?

Answer 3

Nortriptyline, Desipramine

More specific for NE reuptake inhibition

Question 4

what are the uses?

Answer 4

Neuropathic pain, fibromyalgia, migraine prophylaxis

-1st line for these 3, depression

Question 5

what receptors are affected by adverse effects?

Answer 5

muscarinic (M1)

histaminergic (H1)

alpha 1

sodium channel blockade

Question 6

dosage when pain is indicated?

Answer 6

lower doses

Question 7

black box warning?

Answer 7

suicidiality