53.Arrhythmia的病人最應避免使用何種antidepressant?
(A)sertraline
(B)amitriptyline
(C)bupropion
(D)mirtazapine
答案:登入後查看
統計: A(152), B(1696), C(400), D(199), E(0) #3133820
統計: A(152), B(1696), C(400), D(199), E(0) #3133820
詳解 (共 6 筆)
#5996854
副作用—抗憂鬱藥
心血管
心律不整—TCA
高血壓—SNRI、bupropion
姿勢性低血壓—TCA、trazodone
膽固醇升高—mirtazapine
抗膽鹼 口乾、便秘、尿滯留、視力模糊—TCA
神經學
癲癇—bupropion
性功能障礙—TCA、SSRI、SNRI
失眠—SSRI、SNRI、DNRI
鎮靜—TCA、mirtazapine、trazodone
體重增加—TCA(amitriptyline)、paroxetine、mirtazapine
口訣:從am到pm
91
0
#6118709
覺得 amitriptyline(包含所有TCA)可能造成心律不整的兩個機轉
ㅤㅤ
1、阻止NE再回收,導致過多NE作用在心臟的β1受體導致心跳加速。
2、M2阻斷造成在心臟達到類似atropine的心跳過速。
19
1
#6016254
uptodate:
blocks reuptake of both serotonin and norepinephrine, but more potently blocks reuptake of serotonin. It also has a high affinity for histamine H1 and muscarinic M1 receptors; compared with other cyclic antidepressants, amitriptyline is highly sedating, associated with weight gain, and anticholinergic side effects
1
1