HPSSC Staff Nurse - 2021
Pharmacology
Easy
The side effects of Tri-cyclic antidepressants (TCA) drugs are?
Appeared in: HPSSC Staff Nurse - 2021
Explanation
- Tricyclic antidepressants (TCAs) block muscarinic acetylcholine receptors, which leads to a cluster of symptoms known as anticholinergic side effects.
- The classic anticholinergic side effects include dry mouth (from decreased salivation), blurred vision (from pupillary dilation), and constipation (from reduced gut motility).
- A helpful mnemonic for these effects is "can't see, can't pee, can't spit, can't shit.".
- Since all the listed options—Dry mouth, Blurred Vision, and Constipation—are well-documented anticholinergic effects of TCAs, the most comprehensive and correct answer is 'All of these'.
Why Other Options Were Wrong
- Option A: This option is incomplete. While dry mouth is a very common side effect of TCAs, it is not the only one. The question asks for the 'side effects' (plural), and the other listed options are also correct.
- Option B: This option is incomplete. Blurred vision is a known anticholinergic side effect of TCAs, but it represents only a part of the overall side effect profile mentioned in the options.
- Option C: This option is incomplete. Constipation is a frequent side effect due to the anticholinergic action of TCAs on the gut, but it is not the sole side effect among the choices provided.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Side effects of Tricyclic Antidepressants (TCAs) as background academic context rather than a clinical decision trigger.
- Nurses must educate patients about these common anticholinergic side effects to improve medication adherence and help manage discomfort. Simple interventions like suggesting sugar-free candy for dry mouth or increasing fiber for constipation can make a significant difference.
- Recognizing the full spectrum of TCA side effects is crucial for patient safety, especially in older adults who are more susceptible to falls (from blurred vision and orthostatic hypotension), confusion, and complications like urinary retention.
- TCAs have a narrow therapeutic index and are highly lethal in overdose, primarily due to cardiac arrhythmias. Nurses play a key role in assessing suicide risk and educating patients and families on the secure storage of these medications.
How to Approach the Question
- First, identify the core of the question. It asks for the side effects of a specific drug class: Tricyclic Antidepressants (TCAs).
- Recall the key pharmacological properties of TCAs. Remember that they are known for affecting multiple receptor systems, not just serotonin and norepinephrine.
- Focus on the most prominent and frequently tested side effect profile, which is the anticholinergic effects. A useful mnemonic is "can't see, can't pee, can't spit, can't shit."
- Evaluate each option against this knowledge: 'Dry mouth' (can't spit), 'Blurred Vision' (can't see), and 'Constipation' (can't shit) are all classic anticholinergic effects.
- Observe that an 'All of these' option is available. Since options A, B, and C are all correct and common side effects, this collective option is the most complete and accurate answer.
- Confirm this by considering that if you chose any single option (A, B, or C), you would be ignoring the other correct options, making your answer incomplete.
Concept Tested & Keywords
- Concept Tested: Side effects of Tricyclic Antidepressants (TCAs)
- Stem keywords: Tri-cyclic antidepressants, TCA, side effects
- Lead-in keywords: BEST, MOST RELEVANT CLUE
- Negative lead-in flag: false
Question ID
QeGSkx-gy_365NYZn0ZhNs
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 2024-2026, 2025-2027
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 10251-10253
Practise the full HPSSC Staff Nurse - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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