Adverse Effects of Tricyclic Antidepressants
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Questions and Answers

Match the adverse effects with the corresponding description:

Postural “Orthostatic” hypotension = Due to α- blockade Anticholinergic ‘Atropine-like’ effects = Due to muscarinic R blockade (blurred vision, dry mouth, tachycardia, constipation, and urinary retention) CNS depression = Excessive sedation (histaminic H1 blockade), lassitude, fatigue, and occasionally, confusion Sympathomimetic effects = Including tachycardia, sweating, and insomnia

Match the type of MAO inhibitor with its description:

Non-selective MAO inhibitors = Phenelzine Selective MAO-A inhibitors = Moclebemide Selective MAO-B inhibitors = Selegiline (transdermal patch)

Match the monoamine oxidase (MAO) type with its main metabolized neurotransmitters:

MAO-A = Predominantly metabolizes NA, 5-HT, and DA MAO-B = Preferentially metabolizes DA

Match the type of MAOI with its mechanism of action:

<p>Most MAOIs (except moclebemide) = Form stable complexes with the enzyme (irreversible inhibition)</p> Signup and view all the answers

Match the following with their correct statements:

<p>Prevention of MAO inhibitor adverse effects = SSRIs should be started at least 14 days after discontinuation of MAO inhibitors. Mechanism of SSRIs = SSRIs allosterically inhibit SERT, binding at a site other than that of serotonin. Advantages of SSRIs over TCAs = Low cardiovascular side effects SSRIs Side effects &amp; interactions = Insomnia, headache, restlessness, anxiety</p> Signup and view all the answers

Match the following with their correct descriptions:

<p>MAO inhibitors regeneration time = At least 14 days after discontinuation for sufficient time for MAO enzyme regeneration. SSRIs minimal inhibitory effects = Minimal inhibitory effects on the NE transporter or blocking actions on adrenergic and cholinergic receptors. Preferred in elderly = SSRIs are preferred in elderly due to lower anticholinergic effects. Platelet function inhibition = Inhibition of platelet function resulting in ecchymosis is a side effect of SSRIs.</p> Signup and view all the answers

Match the adverse effect with the type of food that should be avoided in patients on long term non-selective MAO inhibitor therapy:

<p>Cheese reaction = aged cheeses and meats, liver, pickled or smoked fish, beer and red wines Serotonin syndrome = foods rich in tyramine</p> Signup and view all the answers

Match the manifestation with the condition that can result from giving SSRIs along with or just after stopping MAO inhibitors:

<p>Hyperthermia, restlessness, sweating, muscle rigidity, aggressive behavior, tremors, seizures, and coma = Serotonin syndrome</p> Signup and view all the answers

Match the type of MAO inhibitor that may produce less inhibition of gut and hepatic MAO at low doses due to avoiding first-pass metabolism:

<p>Selegiline administered as transdermal patch = Non-selective MAO inhibitors</p> Signup and view all the answers

Match the treatment with the adverse effect it is used for in patients experiencing the cheese reaction:

<p>Phentolamine (α-blocker) = Cheese reaction</p> Signup and view all the answers

Match the etiology with the reason for significant increase in serotonin levels in synapses when SSRIs are given along with or just after stopping MAO inhibitors:

<p>Reduced reuptake and inhibition of metabolism = Serotonin syndrome</p> Signup and view all the answers

Match the primary site of action with the location where these drugs inhibit MAO which metabolizes potentially toxic substances like tyramine:

<p>Liver and gut = Monoamine oxidase (MAO) inhibitors</p> Signup and view all the answers

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