Behavior Modifying Drugs Flashcards
What is the biogenic amine hypothesis theory?
A reduction in NE and 5-HT levels might be a causative factor in depression
Which 2 classes of drugs are examples of Anxiolytics?
- Benzodiazepines
2. Azapirones
What is the “goal” of benzodiazepines?
Decrease anxiety, as well as fear, aggression, and noise phobia
Which type of receptors do Benzodiazepines stimulate?
GABA-A receptors
Benzodiazepines work by enhancing GABAergic transmission via stimulation of GABA-A receptors, hence resulting in what?
Membrane hyperpolarization
What are Benzodiazepine sites of action?
- Cerebral cortex
- Limbic system
- Thalamus
Are Benzodiazepines good for long term or short term use?
Short term
True or False: Benzodiazepines need to be given in combination with other psychotrpic drugs.
TRUE
With which types of psychotropic drugs might you combine Benzodiazepines?
TCAs or SSRIs
What are 2 of the adverse effects associated with Benzodiazepines? There are 4 total…
- Liver failure
- Ataxia
- Dependence
- Requires gradual weaning
In which patients would Benzodiazepine use be contraindicated?
Aggressive patients - as Benzodiazepines can lead to disinhibition and increase aggression
What is the best drug of choice for storm phobia and separation anxiety?
Alprazolam
What is the drug of choice for urine spraying behavior in cats?
Diazepam
What are the 2 adverse effects associated with Diazepam?
- Hepatic necrosis in cats
2. Can NOT be used concurrently with CYP-450 metabolizing drugs
Which 2 drugs should NOT be given concurrently with Alprazolam (or any Benzodiazepine)?
- Ketoconazole
2. Itraconazole
True or False: There is a risk of physical dependency with Alprazolam.
TRUE
What happens when there is increased Cl- conductance during GABA-A receptor activation?
Membrane becomes hyperpolarized and neuronal firing is greatly reduced
In which type of patients might you choose to use Oxazepram?
- Aged canine patients
- Patients with compromised liver function
- Cats - less likely to cause idiopathic hepatic necrosis
What would you use Lorazepam for?
To treat victims of inter-cat aggression
What was the first non-sedating anxiolytic drug to be developed and marketed?
Buspirones
What class of drugs are Buspirones?
Azapirones
True or False: Buspirones are non-selective.
FALSE: Buspirones are selective anxiolytics.
At which receptors do Buspirones act as partial agonists? Where are these receptors located?
5-HT 1A receptors located in the dorsal raphe nucleus (DRN) and at synaptic terminals
In dogs, Buspirone and ___ combination therapy has been successfully used for the treatment of aggression and anxiety.
Fluoxetine
Buspirones can be therapeutically used in the management of ___ ___ ___ illness.
Chronic long term
What are the advantages to Buspirone? (4 total)
- Not associated with withdrawal effects
- Not associated with dependence problems
- Does not produce amnestic effects
- Low risk of side effects
With which drugs would Buspirones be contraindicated?
MAOIs (monoamine oxidase inhibitors)
Prolonged activation of ____ autoreceptors in the ____ leads to receptor desensitization results in increased ____ release in the limbic regions.
Prolonged activation of 5-HT 1A autoreceptors in the DRN leads to receptor desensitization results in increased 5-HT release in the limbic regions.
Name the class of drug these are each under:
Amitriptyline, Selegiline, Fluoxetine, Paroxetine, Clomipramine
Amitriptyline = TCA
Selegiline = MAOI
Fluoxetine = SSRI
Paroxetine = SSRI
Clomipramine = TCA
Tricylic antidepressants block the reuptake of ___ and ___.
NE and 5-HT (although to a lesser extent than NE)
Tricylic antidepressants produce desensitization of ____ receptors and ____ autoreceptors.
Alpha-2 adrenergic receptors and 5-HT 1A autoreceptors
Tricyclic antidepressants block muscarinic receptors, responsible for what type of effects?
Anti-cholinergic side effects
What are TCAs main target?
NE (norepinephrine)
What are the 3 therapeutic uses of TCAs?
- Anxiety treatment in dogs and cats
- Pruritic conditions
- Compulsive disorders
TCAs: because of their structural similarity to Phenothiazines, there is increased risk of what?
Seizures
What drug can be used in the treatment of severe recurring idiopathic interstitial cystitis in cats (FIC)?
Amitriptyline (TCA)
What are the 3 adverse effects associated with Amitriptyline?
- Urinary retention
- Dry eye
- Sedation
What is one contraindication associated with Amitriptyline use?
Not to be used with CYP-450 inhibitors (ketoconazole, chloramphenicol, or cimetidine) which may inhibit metabolism of TCA drugs.
What drug is FDA approved for the treatment of separation anxiety in dogs?
Clomipramine (TCA)
What other disorder can Clomipramine be used to treat?
Compulsive disorders (acral lick dermatitis & tail chasing disorders)
SSRIs block presynaptic ____ transporters.
Serotonin
True or false: SSRIs block presynaptic serotonin transporters selectively.
TRUE
By blocking presynaptic serotonin receptors, SSRIs inhibit reuptake of what?
5-HT
What is the result of SSRIs blocking presynaptic serotonin receptors and inhibiting the reuptake of 5-HT?
Elevation of 5-HT in the synapse and desensitization of the 5-HT 1A autoreceptors
There are 4 therapeutic uses for SSRIs listed. What are 3 of those?
- Anxiety
- Depression
- Compulsive disorders
- Aggression
What are the adverse effects associated with SSRIs?
- Withdrawal effects (tremors, anxiety, dizziness, nausea)
- GI disturbance
- Serotonin syndrome when administered concurrently with MAOIs
What are the characteristics of serotonin syndrome?
- Confusion
- Agitation
- Hypertensino
- Tachycardia
- Excessive salivation
- Hyperpyrexia (fever)
Monoamine oxidases catalyse the breakdown of which monoamines?
NE, DA, and 5-HT
Which of these drugs is the most specific: MAOIs, TCAs, or SSRIs?
SSRIs
What class of drug is Selegiline?
MAOI
What does Selegiline selectively inhibit?
MAO-B
What is Selegiline FDA approved for the treatment of?
Canine cognitive dysfunction
