ACTIVE LEARNING TEMPLATE
Medication
NAME Tricyclic antidepressants (TCAs)
CONTENT REVIEW MODULE CHAPTER _
TOPIC DESCRIPTOR
MEDICATION _Amitriptyline, imipramine, doxepin, nortriptyline, amoxapine, trimipramine, desipramine, clomipramine
EXPECTED These medications block reuptake of noreinephrine and serotonin in synaptic space, thereby
PHARMACOLOGICAL intesifying the effects of these neurotransmitters. It can take 10 to 14 days or longer before TCAs
ACTION: beging to work, and maximum effects might not be seen until 4 to 8 weeks.
Therapeutic Uses
Depressive disorders, Neuopathic pain, Fibormyalgia, Anxiety
disorders, Insomia, Bipolar disorder, OCD, ADHD.
Adverse Effects Nursing Interventions
Hypotension, dry mouth, blurred vision, photophbia, Take adverse effect usually diminishes over
time.
urinary hesitancy or retention, constipation, tachycardia. Give no more than 1 week supply of medication
Sendation, Toxicity, decreased seizure threshold, to prevent toxic dose.
excessive sweating, increased appetite Obtain baseline ECG.
Vital signs frequently.
monitor for toxicity
notify provider if become toxic.
monitor clients who have seziures disorders.
Contraindications assist clients with frequent linen changes.
weights
Amitriptyline is a pregnancy risk category C med
this med is contraindicated for clients who have seizure disorders.
use med cautiously in clients who have coronary artery disease, diabetes,
liver, kidney, and repiratory disorders. Urinary retention and obstruction; angle
clsosure glaucoma, benign prostatic hypertrophy, and hyperthyroidism. Client Education
TCAs can increse suicide risk
chewing sugarless gum
sipping on water
wearin sunglasses outdoors
Medication/Food Interactions eating foods high in fiber
exercising regulary
Concurrent use with MAOIs can cause severe hypertension. increase fluid intake
Use with antihistamines and other anticholinergic agents can result in additive
anticholinergic effects. voiding just before taking medication.
direct-acting sympathomimetics can result in increased effects of these medications Notifiy provider if effects persits.
because uptake is blocked by TCAs.
Alcohol, benzodiazepines, opioids, and antihistamines can result in CNS depression.
Medication Administration Evaluation of Medication
Effectiveness
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