Tricyclic antidepressants, abbreviated TCAs, are a drug class that is commonly used to treat depression and nerve pain. In this video, I'll teach you an easy visual mnemonic so that you'll be set for any questions about TCAs on test day. For today's video, we're joining the Premier and his son on the docks while they are waiting for the electrician to open up the dock gate. The premier is a busy man, so you know that he's going to take advantage of a full day with his son. Instead of waiting around for the electrician, the premier and his son are out riding tricycles.
The son looks about the right age for a tricycle, but the premier? Well, we'll talk about that in a minute. But for now, use the tricycle to remember the drug class tricyclic antidepressants. Get it?
Tricycle for tricyclic antidepressants. Sounds pretty similar. Tricyclic antidepressants are often abbreviated TCA's. Next, let's talk about how to recognize tricyclic antidepressants.
The electrician has finally arrived, and the little boy was so excited that he started riding circles around the electrician. The electrician got distracted by the boy, and he wasn't watching where he was going carefully enough, and he tripped on the big adult-sized tricycle. When you think of the electrician tripping, Think of this as the symbol for the drugs ending in tryptaline. Tripping for tryptaline.
Some TCAs end in tryptaline, like amitryptaline and nortryptaline. Now, when you see these drugs on test day, notice the tryptaline ending and remember the man tripping on this tricycle. And you'll remember tricyclic antidepressants. Got all that?
Let's move on to the next drug ending that you should know for test day. Even on a day off with his son, the premier is still dressed in full premier attire. He even has a name tag that says premier on it.
He obviously does not want you to forget that he is a premier, because the premier is also our symbol for the drug ending promine. Premier for promine, get it? Three common TCAs that end in promine are amipromine, clomipromine, and dicipromine.
I mean, dicipromine. Next, this dock pin has been acting up lately. The Premier has a pin pad here to keep security for his private dock, but it is malfunctioning so the Premier can't get through the gate.
Hopefully, the electrician can fix it. By the way, the dock pin here is our symbol for our last tricyclic antidepressant, Doxepin. Get it?
Dock pin for Doxepin? Okay, great. Now that we know how to recognize a TCA from its drug names, Let's move on to what TCAs are used for in the clinical setting.
When the electrician tripped on the tricycle, the premier tumbled off and fell into the water. That really scared the boy, seeing his dad fall into the water like that. This crying, sad boy is our symbol for depression, because that boy looks pretty depressed if you ask me.
TCAs are used to treat depression, and they do so by increasing the serotonin and norepinephrine levels in the brain. It's important to remember, that with most antidepressants, and TCAs especially, that it can take a few weeks for them to reach a therapeutic level and actually make a difference in the mood of the patient. TCAs are not the first-line treatment for depression because of their many side effects, which we'll get to in a minute.
But if SSRIs and other antidepressants aren't effective, TCAs may be the drugs that do the trick. Next, take a look at the wires coming out of the doc pen pad. They look pretty complex, so it's good the premier called an electrician to do the job.
Here at Pixerize, we use wires to symbolize the nerves. Because both wires and nerves are used to transmit electrical signals, right? And these broken wires can help you remember damaged nerves, right?
Well, the electrician's job is to fix the broken wires, just like tricyclic antidepressants are used to treat nerve pain. TCAs are especially helpful in treating diabetic neuropathy. and fibromyalgia.
The reason the electrician tripped in the first place is because the boy was riding in circles around him, making him dizzy. You know what else makes you dizzy? TCAs can, because they can cause orthostatic hypotension.
Orthostatic hypotension, also called postural hypotension, is when the blood pressure suddenly drops as you sit or stand up too quickly. People with orthostatic hypotension will feel dizzy as they stand. and this can lead to a fall if the patient isn't careful.
As the nurse, it's important that you educate the patient to stand up slowly to avoid this sudden drop in blood pressure. Falling is a safety concern, so remember this dizzy falling electrician to help you remember the risk of orthostatic hypotension with TCAs. As the electrician is falling, he is dropping his empty bottle of cola, and it is shattering on the ground.
Here at Pixerize, cola is our recurring symbol for acetylcholine. Get it? Cola for acetylcholine?
You can even call it acetylchola if you want. Well, this cola bottle is empty, falling, and broken. To emphasize that in this video, we are talking about anticholinergic effects. That is, things that result.
from reducing levels of acetylcholine. TCAs can block the actions of acetylcholine, leading to anticholinergic effects like urinary retention, blurry vision, dry mouth, tachycardia, and so on. I think it's safe to say that this big oversized tricycle was a pretty bad idea.
Better to just stick to the regular kid's one. Just like a tricycle that is too big is bad, taking a dose of tricyclic antidepressants that is too big is also bad. Like lethal bad.
In other words, tricyclic antidepressants are lethal in overdose. They can cause fatal cardiac arrhythmias. Like I mentioned earlier, for this reason, tricyclic antidepressants are not the preferred choice of antidepressants. If you can remember that this big tricycle is bad, you'll be sure to remember that overdosing on TCAs is also really bad.
Now that we've covered everything about tricyclic antidepressants, let's quickly review what we've learned here. Tricyclic antidepressants are a class of mental health drugs recognizable by their endings of tryptaline, like amitryptaline and nortryptaline, as well as pramine, like clomipramine, imipramine, and desipramine. The only exception to these two endings is doxepin.
As a class, all TCAs are used to treat depression. as well as nerve pain from causes like diabetic neuropathy or fibromyalgia. Important side effects include orthostatic hypotension, which can result in dizziness and falls, as well as anticholinergic effects like dry mouth, urinary retention, tachycardia, and so on. Finally, tricyclic antidepressants are lethal in overdose.
I better go pull the premiere out of the water. Yep, adult-sized tricycles are definitely not the way to go. I'll see you in the next one. For more videos like this one, subscribe to our channel and check out our newest lessons. For more resources on this topic, including fact lists and interactive review images, click the image next to the More Here arrow.
I'll see you next time.