TCA Flashcards

1
Q

TCA - mechanism of action

A

Presynaptic blockade of both noradrenaline and serotonin uptake.

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2
Q

As well as blocking noradrenaline and serotonin re-uptake, what other receptors do tricyclic antidepressants block?

A

Muscarinic
Histaminergic
α-adrenergic

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3
Q

What are the side effects of tricyclic antidepressants as a result of its anti-muscarinic properties?

A

Dry mouth
Constipation
Urinary retention
Blurred vision

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4
Q

What are the side effects of tricyclic antidepressants as a result of its anti-histaminergic properties?

A

Weight gain

Sedation

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5
Q

What are the side effects of tricyclic antidepressants as a result of its anti-α-adrenergic properties?

A

Postural hypotension

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6
Q

What are the cardiotoxic side effects of tricyclic antidepressants?

A

QT interval prolongation
ST segment elevation
Heart block arrhythmias

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7
Q

Name some tricyclic antidepressants.

A

Amitriptyline

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8
Q

Why are SSRIs preferred over tricylics in the treatment of depression?

A

SSRIs are not sedating and have fewer anti-muscarinic properties

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9
Q

Which patients with depression might we choose to give tricyclic antidepressants to instead of SSRIs?

A

Those in whom sedation would be beneficial, eg those experiencing insomnia or psychotic depression patients. SSRIs can make insomnia worse.

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10
Q

Main use of TCA

A

Treatment of neuropathic pain

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11
Q

Name two uses of Amitriptyline?

A
  1. management of neuropathic pain

2. prophylaxis of headache

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12
Q

What are the non-neurotransmitter and non-cardiac complications and side effects of tricyclic antidepressants?

A

Peripheral neuropathy

Gynaecomastia

SIADH

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