Sketchy Pharm: SSRIs, SNRIs, and Cyproheptadine

Question 1

SNRI stands for _______________.

Answer 1

serotonin and norepinephrine reuptake inhibitor

Question 2

What are two SNRIs?

Answer 2

Venlafaxine (the fax machine) and duloxetine (the dual-copy faxer scanner)

Question 3

Again, what is the mnemonic for depression symptoms?

Answer 3

SIG E CAPS
Sleep disturbances
Interest (loss of...) 
Guilt
Energy
Concentration difficulty
Appetite changes 
Psychomotor agitation
Suicidality

Question 4

SSRIs and SNRIs are used to treat what disorders?

Answer 4

PTSD (Reed with the dogtags)
GAD and PD (nervous “Randy”)
Depression (5H-TV)

Question 5

For what disorders are SSRIs given that SNRIs are not?

Answer 5

OCD (Dwayne near the SSRI posters) 
Bulimia (Pam at the reception desk vomiting into the drawer) 
Social anxiety (Shy Guy hiding behind Pam)

Question 6

For what disorders are SNRIs used that SSRIs are not?

Answer 6

Diabetic neuropathy ("Evan" pinching his distal nerves in the diasweeties machine) 
Fibromyalgia (the fiber bars in the top of the vending machine)

Question 7

What side effects can SSRIs and SNRIs cause?

Answer 7

SIADH (Darryl with the ADH water cooler), weight gain (fat Roy), drowsiness (Erin asleep next to Pam because of the lackluster later seasons), and sexual dysfunction (spurned advances)

Question 8

Describe the symptoms of excessive SSRI use?

Answer 8

Serotonin syndrome (symbolized by Michael) can lead to symptoms of excessive sympathetic input: hypertension, agitation, hyperthermia, and hyperreflexia

Question 9

What can cause serotonin syndrome?

Answer 9

Use of SSRIs/SNRIs with tricyclic antidepressants or MAO inhibitors

Question 10

What drug is an antagonist to serotonin?

Answer 10

Cyproheptadine (Jim’s “SIlly pranks are PROHibited”)

Question 11

What side effect are SNRIs more likely to cause?

Answer 11

Hypertension (Stanley taking the fax machine out)