Course Summary

Duloxetine is an antidepressant that acts as a serotonin and norepinephrine reuptake inhibitor. It is approved to treat generalized anxiety disorder, chronic musculoskeletal pain, diabetic peripheral neuropathic pain, and fibromyalgia. Individuals diagnosed with chronic liver disease should avoid duloxetine treatment due to the risk of liver damage. Other warnings pertaining to the risk of suicidal thoughts in youth, pregnancy, and comorbid conditions need to be raised with patients prior to initiating treatment. An emphasis is placed on differential diagnosis and the options for treating varied patient groups with duloxetine. When deciding the dosing regimen for duloxetine during early initiation of treatment and when evaluating patient progress, consideration should be given to the patient’s age, comorbidities, and quality of life goals, in addition to any possible drug-drug interactions.

Course Format

Homestudy

Course Syllabus

• Introduction
• Pharmacological Profile, Uses, and Warnings
  • Major Depressive Disorder
  • Generalized Anxiety Disorder
  • Chronic Musculoskeletal Pain: Osteoarthritis and Low Back
  • Diabetic Peripheral Neuropathy
  • Fibromyalgia
  • Recommended Dosing and Dosing Adjustments
  • US Boxed Warning and Contraindications
• Diagnosing Adverse Drug Reactions
  • Cardiovascular
  • Central Nervous System
  • Dermatologic
  • Endocrine
  • Hyponatremia and SIADH
  • Hematologic
  • Gastrointestinal and Hepatic
  • Urinary Hesitancy and Sexual Dysfunction
  • Orthopedic
  •  Opthalmic
  • Psychiatric
• Drug Interactions, Serotonin and Discontinuation Syndromes
  • Serotonin Syndrome
  • Discontinuation Syndrome
• Treatment Risks and Benefits
  • Pregnancy and Breastfeeding
  • Fibromyalgia
  • Diabetic Peripheral Neuropathic Pain
  • Neuropathic Cancer Pain
• Case Study: Duloxetine Toxicity and Hyponatremia
  • Differential Diagnosis and Treatment
• Summary

Author

Richard Daniels, PharmD, BCPS

Richard “Cole” Daniels earned his Doctor of Pharmacy(PharmD) from the Skaggs School of Pharmacy at the University of Montana in 2018. Throughout pharmacy school he completed a 3-year internship at Community Medical Center in Missoula, Montana in which he gained valuable experience in an acute care setting. Cole currently serves as a psychiatric clinical staff pharmacist at the Montana State Hospital. He has over 11 years of pharmacy experience having worked in several settings including retail, acute care, and inpatient psychiatric care. Cole has a diverse set of interests. However, acute care medicine, infectious disease, pain management, and asthma/COPD are a primary focus of his at the Montana State Hospital. He obtained board certification as a certified pharmacotherapy specialist in the Spring of 2022.