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22 Cards in this Set
- Front
- Back
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What is the amine hypothesis of mood?
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A functional decrease in amines-particularly norepinephrine and serotonin-results in depression
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What are tricyclic antidepressants related to?
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phenothiazones
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What do TCAs do?
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Block monoamine pumps
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What transporters are blocked by TCAs?
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NE and 5HT--some block DA
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Are TCAs 1st line therapy?
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No
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What other receptor actions to TCAs have?
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antimuscarinic, anti-alpha-adrenergic, and antihistaminic
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What are the side effects of TCA?
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sedation, dry mouth, urinary retention, etc.
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what causes TCA sedative effects?
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H1 blockade, which is additive with other sedatives like EtOH
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What about TCA and seizures?
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TCAs lower seizure threshold
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Is there interaction between TCA and MAOI?
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Yes, don't give TCAs within 3 weeks of cessation of MAOI because of exaggerated monoamine effect
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What has limited TCA use?
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can be fatal upon overdose
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What are effects of TCA overdose?
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agitation, delirium, coma, respiratory distress, high fever, seizures, cardiovascular abnormalities
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What are the MAOI isoforms?
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MAO A and MAO B--both are found in the human brain
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What are the substrates for MAOIs?
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Tyramine and DA for both; MAO A also metabolizes 5HT and NE
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Where are MAOIs found?
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mitochondria
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What does inhibition of MAOIs lead to?
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accumulation of 5HT, NE, and DA in synaptic vesicles and cytoplasm of synaptic ending--this exarggerates monoamine response
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When do MAOIs begin working?
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several weeks after initiation
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What are the MAOIs available?
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phenylzene and tranycypromine
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What indications are there for MAOIs?
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Tyramine-free diet. (Tyramine can cause a hypertensive crisis) Also, can't take ephedrine or pseudoephedrine
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How else can MAOIs cause a hypertensive crisis?
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Cause the release of NE
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Which isoforms are inhibited by MAOIs?
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Both A and B
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What side effects to MAOIs have
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Hypotension due to ganglionic blockade caused by exaggerated release of monoamines from inhibitory ganglionic interneurons
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