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01-08-2020

Posted by karel.roden on August 1, 2020 at 1:30 AM Comments comments (0)

A hypotensive effect, respiratory depression, a depressing effect on the nervous system is observed with the joint prescription of medicines that depress the central nervous system: general anesthetics, benzodiazepines, barbiturates, antidepressants and others.

There is a decrease in the effectiveness of alpha-blockers, phenytoin. Fluvoxamine, fluoxetine increase the concentration of the drug in the blood. The risk of developing epileptic seizures increases, and the central anticholinergic and sedative effects of combined therapy with benzodiazepines, phenothiazines, and anticholinergic drugs increase..

The simultaneous administration of methyldopa, reserpine, betanidine, guanethidine, clonidine reduces the severity of their hypotensive effect. When taking cocaine, arrhythmia develops. Delirium develops when taking acetaldehydrogenase inhibitors, disulfiram.

Amitriptyline enhances the effect on the cardiovascular system of phenylephrine, norepinephrine, epinephrine, isoprenaline. The risk of hyperpyrexia increases with the use of antipsychotics, m-anticholinergics.

Pharmacodynamics and pharmacokinetics

The drug reduces appetite, eliminates bedwetting, has an antiserotonin effect. The drug has a pronounced central and peripheral anticholinergic effect..

The antidepressant effect is achieved by increasing the concentration of serotonin in the nervous system and norepinephrine in the synapses. Long-term therapy leads to a decrease in the functional activity of serotonin and beta-adrenergic receptors in the brain.

Amitriptyline reduces the severity of depressive manifestations, agitation, anxiety in anxiety-depressive states. By blocking the H2-histamine receptors in the wall of the stomach (parietal cells) an antiulcer effect is provided.

The medication is able to lower body temperature, blood pressure with general anesthesia. The drug does not inhibit monoamine oxidase. Antidepressant effect manifests itself after 3 weeks of therapy.

The maximum concentration of a substance in the blood occurs after a few hours, usually after 2-12. It turns out metabolites with urine. It binds well with proteins.

Contraindications

Contraindications to the use of amitriptyline tablets:

 

  • Hypersensitivity to the components of the drug;
  • Myocardial infarction (acute phase and rehabilitation period);
  • Use in the 2 weeks prior to treatment, antidepressants (MAO inhibitors);
  • Arterial hypertension;
  • BPH;
  • Pyloric stenosis;
  • Heart failure (decompensation stage);
  • Blockade of the heart (violation of intracardiac conduction);
  • Atony of the bladder;
  • Intestinal obstruction;
  • Children's age up to 6 years;
  • Pregnancy and lactation;
  • Renal and liver failure.

 

Side effects of amitriptyline

Negative reactions when using the drug are mainly associated with its anticholinergic effect. So, the following phenomena are possible, which, as a rule, pass after adaptation to Amitriptyline or a dose reduction:

 

  • Blurred vision;
  • Dry mouth;
  • Paresis of accommodation;
  • Increased intraocular pressure;
  • Urinary retention;
  • Intestinal obstruction;
  • Constipation;
  • Fever.

 

When using Amitriptyline for treatment Migraines more info, the following side effects may also occur:

 

  • Cardiovascular system: arrhythmia, tachycardia, impaired conduction, heart failure, fainting;
  • CNS and peripheral nervous system: weakness, increased fatigue, headache, dizziness and tinnitus, irritability, confusion, motor agitation;
  • Digestive system: heartburn, nausea and vomiting, taste disturbance, stomatitis, gastralgia, diarrhea;
  • Endocrine system: changes in libido and potency, breast enlargement in women and men;
  • Allergic reactions: urticaria, rash, itching, angioedema;
  • Other: hair loss, weight gain, sweating, leukopenia, agranulocytosis, thrombocytopenia, eosinophilia, purpura, etc..

 


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