Tricyclic antidepressants – This book covers the entire syllabus of “Psychiatric Nursing” prescribed by the Universities of Bangladesh- for Basic and diploma nursing students. We tried to accommodate the latest information and topics. This book is an examination-friendly setup according to the teachers’ lectures and examination questions.
At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourish. The unique way of presentation may make your reading of the book a pleasurable experience.
Tricyclic antidepressants
Mechanism of action of TCA:
Tricyclic antidepressants
⇓
Inhibit the reuptake pump of biogenic amines (norepinephrine. serotonin, dopamine)
⇓
Increase concentration of amines in the brain.
⇓
Longer duration of action of amines at the receptor site
⇓
Antidepressant action
Indications of TCA:
1. As antidepressant
2. Nocturnal enuresis (bed wet), in children over 6 years
3. Chronic pain.
4. Multiple sclerosis
5. Phobic anxiety syndrome (school phobia)
6. Hyperkinesis in children
8. Minimal brain damage
7. Peptic ulcer.
9. Alcoholism
10. Neurosis, Neuralgia, Migraine.
Contraindications of TCA:
1. Ischaemic heart disease
2. Cardiac arrhythmia
3. Pregnancy & lactation
4. Severe liver damage.
5. Following MAO-I within last two weeks.
Adverse effects of TCA:
1. Anti-cholinergic effect:
➤ Dryness of mouth
➤ Blurred vision
➤ Constipation
➤ Urinary retention.
2. CNS effects:
➤ Sedation
➤ Tremor
➤ Agitation
➤ Confusion
➤ Parkinsonism
3. CVS effects:
➤ Tachycardia
➤ Hypertension > Arrhythmia
4. Agranulocytosis
5. Cholestatic jaundice.
Role of a nurse towards a patient who is on TCA:
1. Cyclic compounds should be consumed at night in a single daily dose
2. Clients should exercise caution when driving or performing activities requiring sharp, alert reflex until sedative effects can be determined
3. Certain foods, e.g. cheese, pizza, meat, bean curd, over ripe fruit, peanuts, etc. have to be avoided by the clients who are consuming TCA or MAO inhibitors.
[Ref: KP Neeraja/I/Vol-1/280]
| Effects on Libido | Less | More |
| Wt. gain | Problem with wt. gain | No problem with wt. gain |
| Side effects | More | Less |
| CVS effect | More CVS effect | Less CVS effect |
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