BT_PO 1.55 Outline clinically important drug interactions with the autonomic nervous system

I love nature (and hate pesticides which is why those little critters were all over my roses). Go Ladybird! Go!

Well nothing like a small topic for the middle of the week.

I have been marking some practice MCQs for a registrar today and one of them was on antidepressants and clinically important interactions. Many of the current versions of these drugs have some effect on noradrenaline handling, which can cause issues in the peri-operative period, so I am going to keep my focus there for today (scope for plenty more posts on this LO…)

Evers and Maze Anaesthetic Pharmacology Ch 60 has a section on this topic and Hemmings and Egan (which has a new edition!) also has a good section in the Drugs for Neuropyschiatric disorders chapter.

Clinically important is the key phrase here – you should know the answer to all of these (although I have only included 4…)

BT_PO1.55 Outline clinically important drug interactions with the autonomic nervous system

Tricyclic antidepressants (TCA) increase sensitivity to indirect acting sympathomimetics T/F

Tricyclic antidepressants increase sensitivty to direct acting sympathomimetics T/F

The risk of central anticholinergic syndrome is increased in patients, given atropine, who are on concurrent TCAs T/F

Noradrenaline can be safely used in patients on older monoamine oxidase inhibitors (eg phenelzine) T/F