Tricyclic antidepressants Flashcards
What are the neurotransmitters increased by the action of TCAs ?
Serotonin and Norepinephrine.
What are the secondary TCAs (Selective) ?
Desipramine and Nortryptyline: Inhibit only Norepenephrine transporters.
What are the Tertiary TCAs ( Non-selective) ?
Amytriptyline, Imipramine, and Clomipramine. Inhibits norepinephrine and serotonin transporters.
TCAs are slow or fast acting ?
Slow (2 to 4 weeks)
What are the indications for TCAs ?
- Third line agent in MDD.
- Migraine prophylaxis
- Phobic disorders
- Chronic neuropathic pain.
What is the specific use of Clomepramine ?
OCD management.
What is the specific indication for Imipramine ?
Nocturnal enuresis.
What is the effect of TCAs action on Histamine 01 receptor ?
Sedation
What is the effect of TCAs action on Alpha 01 receptors ?
Orthostatic hypotension.
What is the effect of TCAs action on Muscaranic receptors ?
Atropine like side effects such as sympathetic signs.
What are the cardiac side effects of TCAs ?
Arrhythmia and QT prolongation.
What is the Tx of TCAs cardio toxicity ?
Sodium bicarbonate to prevent arrhythmia.
What are the most common causes of TCAs induced death ( 3Cs )
Convulsion, Coma and Cardio toxicity.
TCAs can cause severe respiratory depression and death if taken along with _______.
Ethanol and sedative hypnotics.
