Questions and Answers
What is the pharmacologic class of Imipramine?
What is the therapeutic class of Imipramine?
Antidepressant; treatment of nocturnal enuresis in children
What is an off-label use of Imipramine?
Intrac-table pain, anxiety disorders, withdrawal syndromes from alcohol and cocaine
Imipramine should be discontinued abruptly.
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Imipramine can cause paradoxical diaphoresis.
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What are the common side effects of Imipramine?
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Which condition is a contraindication for Imipramine?
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Match the following drugs with their association with Imipramine:
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What laboratory tests can be affected by Imipramine?
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Herbal supplements such as St. John's wort should not be used with Imipramine as they may cause serotonin syndrome (SES).
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What is the recommended action in case of Imipramine overdose?
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Which of the following is another drug in the same class as Imipramine?
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Study Notes
Pharmacologic and Therapeutic Class
- Imipramine is classified as a tricyclic antidepressant (TCA).
- Therapeutically used to treat major depression and nocturnal enuresis in children.
Actions and Uses
- Blocks reuptake of serotonin and norepinephrine in nerve terminals.
- Primary use for major depression; also occasionally for bed-wetting in children.
- Off-label applications include managing chronic pain, anxiety disorders, and substance withdrawal syndromes.
- Therapeutic effects may take 2 or more weeks to manifest.
Administration Alerts
- Paradoxical diaphoresis may mislead diagnosis of other conditions like hypoglycemia.
- Common anticholinergic side effects include dry mouth, dizziness, blurred vision, and weight changes.
- Abrupt discontinuation can lead to rebound effects like irritability and sleeplessness.
- Classified as pregnancy category C.
Pharmacokinetics
- Onset of action typically occurs in less than 1 hour.
- Peak plasma concentration reached in 1-2 hours when taken orally and 30 minutes via intramuscular injection.
- Duration of action is variable.
Adverse Effects
- Notable side effects include sedation, drowsiness, blurred vision, and cardiovascular events like dysrhythmias and hypertension.
- Black Box Warning indicates increased risk of suicidal thoughts and behavior in young populations with depressive disorders.
- Not recommended for pediatric use due to safety concerns.
Contraindications
- Should not be administered post-myocardial infarction, in patients with bundle-branch conduction defects, narrow-angle glaucoma, or severe kidney/liver impairment.
- Contraindicated within 14 days of MAOI discontinuation.
Drug Interactions
- Use with other CNS depressants can enhance sedation effects.
- Cimetidine may increase serum levels of imipramine; monitor for toxicity.
- Possible reversal of clonidine's antihypertensive effects when combined with imipramine.
- Concurrent use with St. John's wort may trigger serotonin syndrome.
Lab Tests
- Alters blood glucose test results.
- May lead to elevated levels of bilirubin and alkaline phosphatase in serum.
Herbal/Food Interactions
- Evening primrose oil or ginkgo may lower seizure threshold.
- St. John's wort used alongside can induce serotonin syndrome.
Treatment of Overdose
- No specific antidote for imipramine overdose; general supportive care is essential.
- Focus on ensuring airway, ventilation, and oxygenation with cardiac monitoring.
- Gastric lavage or administration of activated charcoal may be indicated.
Other Drugs in this Class
- Related drugs include:
- Amitriptyline (Elavil)
- Amoxapine
- Clomipramine (Anafranil)
- Desipramine (Norpramin)
- Doxepin (Silenor)
- Maprotiline
- Nortriptyline (Aventyl, Pamelor)
- Protriptyline (Vivactil)
- Trimipramine (Surmontil)
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Description
This quiz provides key information about Imipramine, its pharmacologic and therapeutic classes, as well as its actions and uses. Perfect for students studying pharmacology or preparing for exams on antidepressants.
