Tricyclic Antidepressants (TCAs) Lecture Notes

Introduction

• TCAs are used to treat depression and nerve pain.
• Visual mnemonic: Tricycles to remember "Tricyclic Antidepressants".

Identification of TCAs

• Mnemonic for drug endings:
  • Tryptaline: Think of the electrician "tripping" on a tricycle.
    • Examples: Amitryptaline, Nortryptaline.
  • Promine: Premier represents "promine".
    • Examples: Imipramine, Clomipramine, Desipramine.
  • Doxepin: Dock pin for doxepin.

Clinical Use

• Primary uses:
  • Treats depression by increasing serotonin and norepinephrine.
  • Not first-line due to side effects, but used if SSRIs fail.
  • Treats nerve pain, especially diabetic neuropathy and fibromyalgia.

Side Effects

• Orthostatic Hypotension:
  • Caused by TCAs; leads to dizziness when standing.
  • Important nursing education: Advise patients to stand up slowly.
• Anticholinergic Effects:
  • Causes urinary retention, blurry vision, dry mouth, tachycardia.
  • Remember with the image of a broken cola bottle ("acetylcholine").

Overdose Risk

• TCAs are lethal in overdose due to the risk of fatal cardiac arrhythmias.
• Remember: "Big tricycle is bad" to recall overdose risk.

Summary

• Drug Recognition:
  • Endings: Tryptaline, Pramine, and Doxepin.
• Uses:
  • Depression and nerve pain management.
• Side Effects:
  • Orthostatic hypotension and anticholinergic effects.
• Safety Warning:
  • Overdose can be fatal.

Conclusion

• TCAs are a significant class of antidepressants with specific indicators and risks.
• For further learning, refer to additional resources and interactive review images.

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