Sketchy Pharm: Tricyclic Antidepressants Flashcards

1
Q

What drugs are tricyclic antidepressants?

A

The -pramines: imipramine (the “IMPRInt” on Amy’s cheek), desipramine, and clomipramine

The -triptylines: amitriptyline and nortriptyline (Amy tripping on the tricycle)

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2
Q

By what mechanism do TCAs work?

A

They block the norepinephrine and serotonin reuptake channels

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3
Q

When are TCAs used?

A

When SSRIs and SNRIs fails

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4
Q

Other than resistant depression, for what disorders are TCAs used?

A

Diabetic neuropathy, OCD, and migraine (the bell, Dwayne and the marbles, and the guy with his hand stuck in the diasweeties machine)

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5
Q

TCAs are not used frequently due to their adverse effects. What are they?

A

Sexual dysfunction (gym teacher getting rejected)
Anticholinergic effects (atropine Alice’s tea party)
H1 histamine antagonism (guy swatting a bee-ball away)
Alpha-1 antagonism (vasodilation -> girl falling over by Alice)
Cardiac arrhythmia (the broken peaNAT cookies representing the blocking of fast sodium channels, with widening of QRS)
Convulsions – due to antagonist effect on GABA A (guy shaking on court)

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6
Q

Which TCAs have the fewest side effects?

A

Nortriptyline and desipramine (the ball bouncing off of NORThside PRep academy)

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7
Q

How would you treat the cardiac complications of TCA overdose?

A

Bicarb. This promotes the unionized version of TCAs to predominate, which is less able to block the sodium channels.

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