Week 13 - SNRIs

Question 1

SNRIs: indications

Answer 1

Major depressive disorder

• Duloxetine (Cymbalta)*
• Diabetic peripheral neuropathy, fibromyalgia, GAD, chronic musculoskeletal pain

Question 2

SNRIs: MOA

Answer 2

Boost serotonin and norepinephrine in the brain; boosts dopamine in the prefrontal cortex

Question 3

Can SNRIs be used to treat pain?

Answer 3

Yes

Dual inhibition of serotonin and norepinephrine reuptake are effective in relieving pain associated w/ fibromyalgia, low back pain, postherpetic neuralgia, and diabetic peripheral neuropathy

Question 4

Venlafaxine and Desvenlafaxine: caution

Answer 4

Monitor for elevated BP and HR

Question 5

Venlafaxine and Desvenlafaxine: indications

Answer 5

• GAD
• Major depressive disorder
• Panic with or without agoraphobia

Question 6

In which situations would a dose adjustment be needed when taking SNRIs?

Answer 6

• Renal impairment (CrCl <30 mL/min)
• Hepatic impairment, chronic liver disease, cirrhosis
• Hemodialysis
• Pregnancy (3rd trimester)
  
  • Taper off dose

Question 7

True/False: Duloxetine decreases concentration of antipsychotics

Answer 7

False - increases concentrations of antipsychotics

Question 8

Fetzima: indications

Answer 8

Depression, somatic symptoms, fatigue, pain