SSRI, SNRI, cyproheptadine

Question 1

SSRIs names

Answer 1

fluoxetine (fly out poster)
paroxetine (parrot air oster)
sertraline (desert air)
citalopram (the city poster)

Question 2

how SSRIs work

Answer 2

inhibit presynaptic serotonin re-uptake transporter (5-HT) - smiley post it out of the drawer

Question 3

SNRI names

Answer 3

venlafaxine (fax machine)

duloxetine (dual copier/scanner)

Question 4

how SNRIs work

Answer 4

inhibit presynaptic re-uptake of NE and serotonin (north and south compass)

Question 5

what are SSRIs used for?

Answer 5

OCD (obsessively neat guy fixing the stapler)
bulimia (binge drawer)
social anxiety disorder (shy guy hiding behind desk)

Question 6

what can either SSRIs or SNRIs be used for

Answer 6

major depression (happy and sad masks) 
GAD (anxious coworker) - benzodiazepines work faster, but SSRIs and SNRIs are more effective for long term treatment and don't cause addiction 
Panik Disorder (scream) 
PSTD (guy with PT and SD dogtags) can treat anxiety and hypervigilance but usually need psychotherapy too

Question 7

what are SNRIs used for

Answer 7

diabetic neuropathy (diasweeties vending machine with frayed wire) 
neuropathic pain (frayed wire)

Question 8

duloxetine specific uses

Answer 8

chronic back pain, osteoarthritis, fibromyalgia (fiber bars in vending machine and bent over guy at machine)

Question 9

how long till maximum effect with SNRIs and SSRIs

Answer 9

1-2 months (not for acute treatment)

Question 10

SSRI side effects

Answer 10

hyponatremia and SIADH (guy changing the water cooler)
sexual dysfunction (rejected advances) 
weight gain (fat belly on rejected guy) 
drowsiness (tired receptionist) 
insomnia

Question 11

serotonin syndrome

Answer 11

both SSRIs and SNRIs or SSRI/SNRIs with MAOIs and TCAs can cause excess serotonin causing hyperthermia and hypertension (sweaty and pressure coming out of ears), hyperreflexia and clonus (hyperactive foot)

Question 12

treating serotonin syndrome

Answer 12

discontinue serotonergic agents
stabilize vital signs
cyproheptadine (5HT-2 blockers) (silly pranks prohibited)

Question 13

SNRI side effects

Answer 13

hypertension (guy at fax machine with air out ears)

Question 14

SSRI/SNRI withdrawal

Answer 14

discontinuation syndrome = flu like symptoms like dizzy, fatigue, HA, nausea (out with the flu stickie)
*need to taper

Question 15

fluoxetine

Answer 15

long half life, doesnt need a taper, safe during pregnancy, can increase levels of antipsychotics