QUESTIONS WITH CORRECT ANSWERS
PRACTICE SOLUTION GRADED A+
⩥ Anticholinergic effects of TCAs at plasma levels > 300mg/ml can
cause what?.
Answer: Confusion
disorientation
delirium
delusion
hallucinations (more commonly in elderly)
⩥ What s/s would a pt present with who was experiencing
anticholinergic SE?.
Answer: Dry mouth
constipation
blurred vision
delirium
urinary retention
aggravation of narrow angle glaucoma
CNS effects-confusion + delirium
,⩥ What is one of the most common SE in young persons that causes
discontinuation of TCAs?.
Answer: Tachycardia
⩥ The most common cardiac autonomic AE of TCAs that causes
discontinuation is?.
Answer: Tachycardia
⩥ Nicotine as well as oral contraceptives, may have what effect on TCA
plasma concentrations?.
Answer: Nicotine may reduce TCA concentrations
⩥ List THREE benefits of using TCAs over SSRIs?.
Answer: less prone to:
1. cause sexual dysfunction
2. cause significant long term weight gain
3. cause sleep disturbances
⩥ What are the s/s of OD for TCAs?.
Answer: -Arrhythomgenic (R ventricular cardiomyopathy)
-Agitation
-Delirium
-Convulsions
, -Hyperactive deep tendon reflexes
-Bowel/bladder paralysis
-Dysregulation of BP + Temp
-Mydriasis (dilated pupils)
-Coma
-Respiratory depression
⩥ What is the recommendation for prescribing a TCA for a pt who is at
risk for suicide?.
Answer: -Make RX non-refillable, and for no longer than 1 week at a
time
-avoid AMOXAPINE as this is more likely than other TCAs to result in
death when taken in OD
-monitor for at least 3-4 days after OD in an intensive care medical
setting
⩥ How long after an OD on TCAs can the risk remain for cardiac
arrhythmias?.
Answer: 3-4 DAYS after OD
⩥ Why are SSRIs first choice among antidepressants?.
Answer: -greater safety
-eliminating cardiovascular + anticholingergic effects