Behavior modifying drugs

Question 1

Major BMD drug classes

Answer 1

Antipsychotics (antidope)
Anxiolytics
Antidepressants
Miscellaneous drugs

Question 2

Antipsychotics

Answer 2

Acepromazine: phenothiazine derivative
Blocks D2 dopamine receptor
Extralabel (tranquilizer) for behavior

Question 3

Different anxiolytics

Answer 3

Benzodiazepines (diapzepam)
Azapirones (buspirone)
Nonbenzodiazepine (zapelon)

Question 4

Benzodiazepines MOA

Answer 4

Positive allosteric modulator of GABA receptor → binds to BZD site of GABA receptor → enhances action of GABA (↑Cl influx) → inhibits monoamine NT release in CNS

Question 5

Clinical uses of Benzodiazepines

Answer 5

Dogs: fears, phobias, anxiety
Cats: urine spraying, travel, anxiety

Question 6

Benzodiazepine drugs

Answer 6

Diazepam*
Alprazolam
Clorazepate
Lorazepam
Oxazepam

Question 7

Benzodiazepines side effects

Answer 7

Sedation, ataxia, muscle relaxation, ↑ appetite, paradoxical excitation, memory deficits
IM: muscle necrosis

Question 8

Benzodiazepines side effect in cats

Answer 8

Hepatic necrosis (rare but fatal)

Question 9

Benzodiazepines dependence

Answer 9

Withdrawal/ discontinuation syndrome
Nervousness, tremors, seizures
Reversed by admin of same drug

Question 10

How is withdrawal/ discontinuation syndrome avoided?

Answer 10

Avoided by tapering the BZD dose 25% per week for a month

Question 11

Buspirone (azapirone, type of anxiolytic)

Answer 11

Few side effects, no dependence or disinhibition
Few drug interactions
Delayed effects, takes weeks

Question 12

Buspirone MOA

Answer 12

Full agonist at presynaptic 5HT1A receptors (↓ serotonin synthesis and release)

Question 13

Busoprione uses

Answer 13

Dogs: general anxiety
Cats: urine spraying, reduce anxiety

Question 14

Nonbenzodiazepine hypnotics

Answer 14

Zaleplon, eszopiclone, zolpidem
Treats acute-onset, severe phobia states: thunderstorm, separation anxiety

Question 15

Antidepressants

Answer 15

TCAs (tricyclic)
SSRIs (selective serotonin reuptake inhibitors)
MAOIs (Monoamine oxidase inhibitors)
Atypical antidepressants

Question 16

TCAs use in dogs

Answer 16

Aggression
Canine compulsive disorders
Various anxiety states

Question 17

TCAs in cats

Answer 17

Aggression
Inappropriate urination and spraying
Excessive grooming
Anxiety states
Excessive vocalization

Question 18

TCAs side effects

Answer 18

Antihistamine: mid sedation, vomiting
Anti-cholinergic: dry mouth, constipation , urinary retention
Lower seizure threshold

Question 19

Contraindication of TCAs

Answer 19

Glaucoma
Keratoconjunctivitis sicca
can use but need to lubricate eyes

Question 20

TCA overdose

Answer 20

Risk of fatal cardiac arrhythmias
Treat with lidocaine (lavage, charcoal too)

Question 21

TCA drugs

Answer 21

Clomipramine (more serotonin selective) **
Antitriptyline
Imipramine

Question 22

Fluoxetine (SSRI)

Answer 22

Only FDA approved drug in group for dogs
RECONCILE in vet med

Question 23

Fluoxetine in dogs

Answer 23

Anxiety
Aggression
Compulsive behavior (acral lick dermatitis)

Question 24

Fluoxetine in cats

Answer 24

Urine spraying
Aggression
Compulsive behavior (psychogenic alopecia and fabric chewing)

Question 25

Fluoxetine side effects

Answer 25

Sedation and anorexia most common More GI side effects in cats

Question 26

Selegiline (MAOIs)

Answer 26

Only approved in group Inhibits dopamine metabolism in the CNS

Question 27

Clinical use for selegiline

Answer 27

K9 cognitive dysfunction (disorder of elderly dogs): ↓ social interactions, loss of house training, confusion, changes in sleep cycle

Question 28

Selegiline side effects

Answer 28

High doses: hyperactivity and stereotypical behavior

Question 29

What happens if you combine MAIOs with TCA or SSRIs?

Answer 29

Fatal serotonin syndrome *not effective in treating condition, use second drug at least 14 days after*

Question 30

Trazadone (atypical antidepressant)

Answer 30

Mixed serotonergjc agonist/ antagonist Used for mild thunderstorm phobia, adjunct to TCA or SSRI

Question 31

Side effects if trazodone

Answer 31

GI: vomiting, diarrhea (start low) first few days of treatment

Question 32

Mirtazapine (atypical antidepressants) MOA

Answer 32

A2 antagonist with noradrenergic and serotonergic effects Antagonist of H1 receptors (sedative) Antagonist of 5HT3 receptors (antiemetic)

Question 33

Mirtazapine uses

Answer 33

Anorexia in dogs and cats

Question 34

Anticonvulsants

Answer 34

Phenobarbital: tail chasing and aggression (dogs) Carbamepine: aggression (cats and dogs) *not used- controlled substance and side effects*

Question 35

Narcotic Antagonists

Answer 35

Naltrexone: compulsive behaviors like self-traumatic licking, tail chasing, pacing in zoos and labs

Question 36

Hormone therapy

Answer 36

Sedating effects of megestrol acetate (harsh effects) Calming effects of melatonin

Question 37

Beta-blockers

Answer 37

Propanolol (adjunct therapy)

Question 38

Tramadol

Answer 38

Opiate agonist and reuptake inhibitors of NE and serotonin

Question 39

Duration of treatment

Answer 39

Treatment for 2 months after satisfactory response, ↓ dose over weeks then discontinue or reinstate for additional 6 months (then repeat)