Behavior Modifying Drugs Flashcards
Drugs used in small animals
Monoamine oxidase inhibitors
Tricyclic antidepressants
Serotonin/norepinephrine reuptake inhibitors
Drugs in small and large animals
SSRI
SARI
Calcium channel blockers
Alpha 2 agonists
Benzodiazepines
MAOIs
Monoamine oxidase
Membrane w multiple action - mitochondrial membrane
MAO- A - in GIT, breaks down amines from food/med
MAO - B- in CNS, break down monoamines
Selegiline
MAOIs
Selective for MAO-B - Neuro protective
- breaks down free radicals
- increases astrocyte action
Use for Canine cognitive dysfunction - k9
Selegiline mechanism
Metabolized into L-amphetamine
Detected 2 hours post pill
Improve sleeping patterns activity level, spatial memory
Improvement takes 4 weeks up to 2 months
AE of Selegiline
Vomiting, diarrhea, restless, anorexia
Increased stereotypic behavior at high doses
Combo Y/N therapy with Selegiline
Combo Y: benzodiazepines, antioxidant supplements, anticonvulsants, melatonin
Combo N within 2 weeks : TCAs, SSRI - severe adverse effects
Fluoxetine or reconcile (5w washout)
Combo N: other MAOIs, meperidine, alpha2 agonist
X combo within two weeks with Selegiline
Combo N within 2 weeks : TCAs, SSRI - severe adverse effects
Fluoxetine or reconcile (5w washout)
Drugs for combo therapy with Selegiline
Combo Y: benzodiazepines, antioxidant supplements, anticonvulsants, melatonin
Do not combine ever with Selegiline
Combo N: other MAOIs, meperidine, alpha2 agonist
TCAs
Reuptake inhibition of serotonin
NE reuptake inhibition
Alpha 1 adrenergic antagonist
Anticholinergic
Antihistaminic
Benefits and AE of Clomipramine
Benefits: regulates mood, fear, impulsive behaviors, decreases stress response, anti-pruritus effect
AE: ^ urine retention, Cardio effects - arrhythmias, GI - nausea, vomiting. Lowered seizure threshold, check for diabetes
Label use for Clomipramine
For seperation anxiety in dogs >6m
1-2 mg/kg
Caused decreased: destruction, potty in house, vocalization, behavior
Takes 1-2 months
ADR: sleeping, vomiting
SNRI
Serotonin and norepinephrine reuptake inhibitors
Increase dopamine in prefrontal cortex
Stabilize mood, decrease hyperexcitiability
ADR: GI - nausea, diarrhea
Venlafaxine
Common use of SNRI in cats
Highly effective
SSRI
Benefits & ADR are similar to other drugs but this drug works /targets serotonin
**insomnia can develop, good reason to switch drugs
Fluoxetine
FDA approved for separation anxiety
Various but generally good improvement - good for aggressive animals*
Long wash out periods before adding other drugs
TCA vs SSRI vs SNRI
Depends on experience and comfort
Consider side effects - harmful or beneficial
Think ahead abt changing drugs - washout periods
Cases of aggression e GT
Pruritic animals - TCA, SSRI, SNRI
May have more benefit more from TCA than SSRI
Cardiac concerns - TCA, SSRI, SNRI
Cardiac concerns would get SSRI over TCA
Highly vigilant animals - TCA, SSRI, SRNI
Benefit from SNRI
TCA, SSRI, SNRI - changing
TCA —> SSRI can be switched rapidly
Changing drugs - TCA, SSRI, SRNI
SSRI (fluoxetine) —>TCA requires longer washout period bc fluoxetine has a long half life
TCA and SRRIs
Don’t use with each other **
Can be used in combo w other serotonergic meds
In combo with MAOI
Caution with drugs that alter CYP 450 metabolism
Serotonin syndrome
Cause - co admin of drugs that increase serotonin
Agitation/confusion
Myoclonus, tremor, ataxia, seizure, hyperthermia
Treat with benzodiazepine for tremor
Anti-serotonergic - cyproheptadine
Supportive care
SARIs
Serotonin 2A antagonist, reuptake inhibitor
Alpha 1 adrenergic antagonist
Antihistaminic properties
- vitamin T (trazadone)
Trazadone
Developed for major depressive disorder in ppl
- ADR is sleepiness, treatment for insomnia
Use in cats, dogs, horses, alpacas
- use low end of dosing
Observe time to effects and efficacy
Titrate up if needed, tolerance can develop after 2-4weeks
Uses for Trazadone
Anti anxiety
Cage rest/stall rest
Post op confinement
Thunderstorm/noise phobia
Travel anxiety
Veterinary visits
Grooming visits
ADR of Trazadone
Oversedation
Increased hunger, GI
Behavioral disinhibition
Hyperactivity
Muscle fasiculations
Arrhythmias
Short lived
Calcium channel blockers
Gabapentin - common in cats
Use:
When pain is suspected component of anxiety
Vet Visits, grooming, storms
Alpha 2 agonists
Mechanisms of action - alpha 2 agonists, inhibits release of norepinephrine, decreased symp tone
Oral/transmucosal alpha 2 agonists
Clonidine
Dexmedetomidine/detomidine gel form
Delayed action
No analgesia
Benzodiazepines mechanism
Facilitates binding GABA to GABA-a receptors in CNS
Long acting oral formulation - alprazolam
Rapid acting for situational anxiety
- separation anxiety/storm/social
- urine marking
- maternal acceptance
caution with Benzodiazepines
Interfere with learning
Behavioral disinhibition - ^ bite
Idiosyncratic excitatory reactions (15-20% of drugs)
Benzodiazepines- cats & oral diazepam
Do not use chronically
Slower metabolism & inhibition of bile acid efflux
Severe hepatic necrosis
Clinical use for everyday
MAIOs
TCAs
SSRIs
SNRIs
Clinical use for episodic use
Benzodiazepines
SARIs
Alpha 2 agonists
Calcium channel blockers
Drugs for feline urine spraying
Diazepam - benzodiazepines
Buspirone - SNRI
Clomipramine - TCA
Fluoxetine - SSRI
Drugs to avoid
- acepromazine, best use w combo for physical and mental relaxation
Chlorpromazine - horses, can experience agitation, excitement/aggression, spastic & lose balance = injury
Drugs to avoid - Phenothiazine tranquilizers
Fluphenazine - phenothiazine
Desired effects - suppression of spontaneous activity & aggressive behavior, one injection lasts 30 days
Unwanted side effects
-agitation, hypermetria, circling, pawing, episodes of sever stupor
Fluphenazine - avoid
Toxic concentrations in horses in not known
Range between 3.3-3.39ng/ml following IM admin
Toxic doses of 25-125mg IM
Treatment
- anticholinergics - Ben toro pine mesylate & diphenhydramine
Barbiturates - pentobarbital CRI
Reserpine - avoid
Adrenergic antagonist - in horses
Sedative, treatment of agalactia
SE: colic, GI upset, diarrhea, sweating, depression, droopy eye, paraphimosis
IM»>oral
Reserpine effects on anesthesia
Fatal interactions w xylaxine and ketamine
Hypotension - can take d-w but can last for 1-6 w after discontinuing drug
Effects of clotting - blood used for IRAP
Alpha casozepine
Milk protein to chillaxe
