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Pharma midterm 1 > 12 - behaviour > Flashcards

12 - behaviour Flashcards

1
Q

Forms of mental distresses (chronic fear)?

A
  • anxiety (aggressivity, restlessness)
  • phobia (sounds)
  • mania (tail/leg biting)
  • depression
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2
Q

Most important drugs to modify behaviour?

A
  • sedatives (neuroleptics, benzodiazepines)
  • antidepressant
  • antiepileptics (carbamazepine, phenobarbital)
  • artificial pheromones (feliway, felifriend, DAP)
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3
Q

Other drugs to modify behaviour?

A
  • β-adrenoceptor blocking drugs (propranolol)
  • opoid antagonists
  • CNS-stimulants
  • antihistamines
  • hormones
  • cerebral vasodilators
  • feed supplements (tryptophan)
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4
Q

Mention 4 antidepressant

A
  • tricyclic antidepressant (TCAs)
  • serotonin reuptake inhibitors (SRIs)
  • monoamine oxidase inhibitors (MAOIs)
  • lithium (narrow, not used)
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5
Q

Tricyclic antidepressant (TCAs)

  • examples
  • mechanism of action
  • pharmacokinetics
A
  • Amitryptiline, Doxepin, Imipramine
  • action: inhibition of serotonin and NA reuptake
  • pharma: good oral absorption, high availability, often bound to albumin, cpss 2 -3 weeks, metabolism in liver, urine elimination
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6
Q

Tricyclic antidepressant (TCAs)

  • side effects
  • warning
  • indications
A
  • side effects: moderate sedation, occasional vomiting, changes in appetite and lethargy, antimuscarinic effects, urinary retention
  • warning: patients with cardiovascular dysfunction may experience epilepsy and hypersensitivity
  • indications: separation anxiety, feline urine spraying, acral lick dermatitis
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7
Q

Serotonin reuptake inhibitors (SRIs)

  • examples
  • mechanism of action
  • pharmacokinetics
A
  • Fluoxetine (Prozac), Sertraline (Zoloft)
  • action: selective inhibition of serotonin reuptake
  • pharma: good oral absorption, high availability, bounded to albumin, metabolism in liver (fluoxetine –> norfluoxetin), elimination half-life 7-9 days
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8
Q

Serotonin reuptake inhibitors (SRIs)

  • side effects
  • warning
  • indications
  • dose
A
  • side effects: occasional vomiting, diarrhea, increased CYP450 activity
  • warning: severe hepatic and/or renal impairment - diabets, epilepsy
  • indications: aggression, depression, fear (separation, feline urine spraying)
  • dose: dogs 1-4 mg/kg bw (1x), cats approx. 4 times less
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9
Q

Monoamine oxidase inhibitors (MAOIs)

  • examples
  • mechanism of action
  • pharmacokinetics
A
  • selegiline (Jumex)
  • action: decreased intracellular metabolism of adrenaline, noradrenaline, prolonged NT action in synapses
  • pharma: bad oral absorption, low oral bioavailability, cpss after 3-4 weeks
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10
Q

Monoamine oxidase inhibitors (MAOIs)

  • side effects
  • indications
  • dose
A
  • side effects: gastrointestinal signs, behavioural changes, excitements
  • indications: stereotypes, aggression
    • older dogs: changes in cognitive function
    • older cats: vocalisation
  • dose: 0.5 - 1 mg/kg bw (1x)
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11
Q

Benzodiazepines characteristics

A
  • sedative, anxiolytic, hypnotic effects
  • relative safe drugs
  • used for phonophobia, fear induced aggreassion, cat vs- cat aggression
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12
Q

Examples of benzodiazepines

A
  • Alprozolam (Sanax) - faster onset, shorter action, big interindividual differences (dose)
  • Diazepam (Ziapam AUV, Seduxen) - short activity in dogs, longer in cats
  • Lorazepam (Loranxil) - in cats, failed depth sensation, appetite, paradoxical reaction
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13
Q

How to describe epilepsy?

A
  • most common cause of recurrent seizures, where seizures are single events that reoccur with seemingly random frequency. Single seizures can be caused by head injury, fever, reactions to medications, tumours or symptoms of a larger disease
  • many different kinds of seizures
  • may be caused by hereditary or unknown causes
  • described by their symptoms and origin in brain
  • tonic-clonic seizures: most commonly associated with epilepsy, generalized seizure affecting the entire brain
  • absence seizures - several forms of epilepsy
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14
Q

How to describe seizure?

A
  • caused by an abnormal high frequency discharge of a group of neurons, starting locally and spreading to affect other parts of the brain
  • may be associated with enhanced excitatory transmission, impaired inhibitory transmission or abnormal electrical properties of the affected cells
  • the glutamate content in areas surrounding an epileptic focus is often raised
  • may be partial or generalised depending on the location and spread of the abnormal neuronal discharge
  • the attack may involve mainly motor, sensory or behavioural phenomena
  • unconsciousness occurs when the reticular formation is involved
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15
Q

Treatment of epilepsy?

A
  • monotherapy is preferred if possible
  • combination if necessary:
    • phenytoin + phenobarbital
    • carbamazepine + phenobarbital
    • carbamazepine + phenytoin
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16
Q

What agents are forbidden to combine in case of combination treatment of epilepsy?

A

phenobarbital and primidone!

17
Q

What is important to remember in case of treatment of epilepsy?

A
  • selection of drug depends on the type of epilepsy and the specie
  • the dose should be tailored
  • start the treatment with low dose and increase gradually
  • abrupt cessation of treatment precipitate convulsion
  • any change in the drug selection should be implemented gradually
  • good co-operation with the owner is necessary
18
Q

Drug requirement for status epilepticus (life threatening)?

A
  • effective, centrally acting muscle relaxant properties
  • rapid onset
  • formulation suitable for IV, IM application
  • minimal effects on cardiovascular and respiratory system
19
Q

Drug requirement for maintenance therapy (prevention, life long)?

A
  • long duration of action
  • drug tolerance should be low
  • good bioavailability
  • effectiveness in sub-sedative dose rates
  • absence of major side effects
20
Q

Classification of antiepileptics?

A

hvorfor får jeg ikke legge inn bilde!!

21
Q

The drug action of anticonsulvant drugs may be directed to?

A
  • inhibitory synaptic processes
  • excitatory neurotransmission
  • stabilisation of membrane
    - modulation of the release of
    neurotransmitters
22
Q

Phenobarbital

  • examples
  • effect
  • pharmacokinetics
  • metabolism
  • side effects
  • dose
A
  • Luminal, Sevenal
  • pronounced depression of the CNS, Ach, NE, glutamate release decreases, GABA-mimetic
  • pharma: PO bioavailability: 90%, tmax 4-8 hours, long t1/2 (37-73 hours), cpss after 30-45 days, plasma binding 40-45%
  • metabolism: liver strong micros. enzyme induction
  • side effects: sedation, drowsiness, ataxia, polyphagia, polyphagia, polyuria
  • dose: 1 - 5 (40) mg/kg bw. PO
23
Q

Use of Diazepam and Midazolam (benzodiazepines) in dog, cat and horse

  • usage
  • dose
A

DOG
- for controlling status epilepticus, not suitable for oral maintenance therapy
- IV bolus 5-10 mg/kg, followed by infusion 2-5 mg/hour / per rectum 0.5-2 mg/kg, up to 3x in 24 hours
CATS
- maintenance therapy (0.25-0.5 mg/kg, PO, bid-tid)
- status epilepticus (0.5-2 mg/kg, IV)
HORSE
- used because of long half life elimination
- 5-20 mg/dose, IV, for seizures: 25-50 mg/dose, IV

24
Q

Other benzodiazepines

A

Clonazepam
Chloeazeopate
Carbamazepine
(not recommended)

25
Q

Phenytoin

  • examples
  • effect
  • metabolism
  • dose
A
  • Neophedan, Epanutin
  • effect: a membrane stabilising agent (use-dependent block of sodium channels and GABA enhancing activity)
    –> cardiac anti-dysrhythmic activity and
    anticonvulsant activity
  • metabolism: absorption and metabolism are variable, short elimination half-life in dog (difficult to achieve therapeutic plasma-drug concentrations), very long in cat!
  • dose: individual (8-15 mg/kg in divided doses, up to 35 mg/kg)
  • not recommended recently!
26
Q

Primidone (Sertan)

A
  • the 2-deoxy analogue of phenobarbitone
  • the antiepileptic activity is due to its metabolites
  • do not use together with barbiturates
27
Q

Sodium (potassium) bromide

  • effective blood level
  • half life
  • dose
  • side effects
A
  • in monotherapy effective blood level: 2.5 mg/ml (with K: 1-1.5 mg/ml)
  • long half life: 21-24 days in dog
  • dose: 20-40 (60) mg/kg once a day
  • side effect: sedation, ataxia, atupor, pruritic skin lesions
28
Q

Further individual drugs

A 
Sodium valproate
- rapid oral absorption, short half life, mainly combination, not recommended recently
Gabapentin
- 30% metabolised in liver, rest excreted by kidneys, in dogs side effects is uncommon, not sedating, mainly combination
Felbamate
- well tolerated in dogs
Topiramate
- for dogs, effectiveness not yet known
29
Q

Drugs contraindicated in epileptic patients

A 
Tranquillisers
- phenothiazine derivatives 
     - propiopromazine
     - acepromazine (!)
- butyrophenones
     - azaperone
Other drugs capable of inducing 
- morphine and related opioids
- ketamine (!)

Pharma midterm 1 (14 decks)

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