Behavior Modifying Drugs

Question 1

what is the biogenic amine hypothesis of mood?

Answer 1

• Depression is a heterogenousdisorder
• Biogenic amine hypothesis theory
  
  • Reduction in NE and 5-HT levels might be a causative factor in depression
• Treatment strategies
  
  • Agents that enhance the actions of these monoamines are efficacious in the treatment of depression
    
    • Very effective and advantageous

Question 2

Explain the mechanism of Benzodiazepines

Answer 2

The goal is to decrease anxiety

Enhancement of the GABAergic neurotransmission through stimulation of GABAa receptors, hence resulting in membrane hyperpolarization by enhancement of GABA mediated chloride conductance

site of action: cerebral cortex, limbic system, and thalamus

Question 3

What are the pharmacological effects of Benzodiazepines?

Answer 3

• Lack of behavioral specificity
• Exhibit dose dependent but minimal CNS depressant effects

Actions:

• Low doese: mild sedatives
• Moderate doses: Anti-anxiety agents
• High doses: hypnotics

Decreased anxiety, fear and aggression and noise phobia.

Good choice for acute treatment of anxiety disorders on a short term basis

Question 4

What are advantages of using Benzodiazepines?

Answer 4

Can be used in combination with TCAs or SSRIs to improve clinical outcome

Question 5

What are adverse effects of Benzodiazepines?

Answer 5

• You should gradually wean them off the drug
• May cause physical addiction
• Ataxia
• Liver Failure

Disadvantages

• Amnestic effects may interfere with behavior modification therapy.
• Contraindicated in aggressive patients due to paradoxical excitability
  
  • in cases fear or anxiety is masking aggressive behavior, then BDZ’s can lead to disinhibition and can increase aggression
• Prone to abuse by humans

Question 6

What are theraputic uses for Diazepam (Valium)

Answer 6

Treatment of anxiety

Les effective in the treatment of storm phobia and separation anxiety as compared to alprazolam

Treatement of urine spraying behavior in cats

Question 7

What are adverse effects for Diazepam (Valium)

Answer 7

Hepatic necrosis in cats

Concurrent administration with cytochrome P-450 metabolizing drugs may reduce drug metabolism.

Question 8

What drug is more theraputic?

Diazepam or Alprazolam?

Answer 8

Alprazolam- this has increased efficacy

Question 9

What is Alprazolam

Answer 9

This is considered a Benzodiazepines

• Useful for the treatment of acute fear situations
• Good choice for treating panic disorders in dogs
  
  • Combination of Alprazolam and Clomipramine is beneficial in treatment of storm phobia
• Physical dependence
• Withdrawl should be gradual otherwise anziety tremors or seizures may occur

Question 10

What are adverse effects of Alprazolam?

Answer 10

Should not be given concurrently with drugs that inhibit the cytochrome P-450 system including ketoconazole and itraconazole

Question 11

Explain the theraputic uses for Oxazepam

Answer 11

• This is an effective appetite stimulant in cats
• Can be used in patients with compromised liver function and in aged canine subjects
  
  • ​This drug is a metabolite from Diazepam, and reduces the need for hepatic metabolization

This will be an exam question

Question 12

What are the theraputic uses for Lorazepam

Answer 12

slower onset of action but has a sustained release

This is used to treat intercat aggression- victim cat

(treat the cat that is victimized)

Question 13

What is Pexion for?

Answer 13

This is a drug used for its theraputic effect for noise aversion.

This is related to fireworks, gun shots, street traffic noise.

Question 14

What is Buspirones?

include the mechanism of action

Answer 14

this is the first nonsedating anxiolytic drug to be developed and marketed.

Acts as a partial agonist at 5-HT 1a receptors

• Located int he dorsal raphe nucleus and at synaptic termianls

Also has an affinity for D2 receptors.

Question 15

What happens to the 5-HT release if there is a 5HT1A agonist present?

Answer 15

5-HT release inc reases from the limbic region.

Question 16

How long do you have to wait for theraputic effectiveness for Buspirone?

Answer 16

Several weeks to demonstrate theraputic effectiveness.

Question 17

What are the theraputic effects for Buspirone?

Answer 17

• Management of generalized anxiety disorder-chronic long term illness but less successful in treating storm phobia.
• This can be administered with fluoxetine for a combination therapy has been successfully used for the treatment of aggression and anxiety

Question 18

What are the drug interactions of Buspirone?

Answer 18

This can be used concurrently with Mono-amine oxidase inhbitors (MAOIS) and busipirone is not recommended for hypertensive crisis.

Question 19

What does TCA stand for

Answer 19

Tricyclic Antidepressants

Question 20

What are the mechanisms of action for TCA’s?

Answer 20

Block the reuptake of NE, and, to a lesser degree, 5-HT reuptake

Produces desensitization fo alpha-2 adrenergic receptors and 5-HT autoreceptors resulting in elevated extrasynaptic levels of 5-HT and NE

Blockaid of muscarinic receptors responsible for its anticholinergic side effects

Question 21

What are the theraputic uses for TCA’s

Answer 21

Treatment of anziety in dogs and cats

Pruritic conditions

Compulsive disorders.

Question 22

will you get withdrawal responses with TCA’s if you suddenly stop them?

Answer 22

yes- there would be witdrawal resposnes

Question 23

What is the time of onset for TCA’s?

Answer 23

3-4 weeks following the initiation of drug therapy

Question 24

What are side effects for TCA’s

Answer 24

Anticholinergic effects

Tachycardia

H1 antagonism (sedation)

Alpha receptor antagonism

Can cause seizures due to structural similarity to Phenothiazines

Question 25

What drug intercations should be considered with TCA's?

Answer 25

Should not be concurrently used with SSRI's and MAO inhibitors Give at least a 2-3 week wash out period is required before initiation of MAOI therapy.

Question 26

What are the features of Amitriptyline?

Answer 26

Thisis a TCA antidepressant * Realatively **inexpensive** and popular among veterinarian Theraputic uses: * In dogs commonly used for the treatment of self-induced mutilation and separation anxiety * In cats it is used int he treatment of psychogenic alopecia and excessive vocalization. Most commonly used for the management of inappropriate urination * Used in the treatment of severe recurring **idiopathic interstitial cystitis in cats -FIC**

Question 27

Clomipramine Theraputic uses

Answer 27

FDA approved for treatment of **Separation anxiety** when used in combination with behavior modification therapy. - can be used for the treatment of compulsative disorders - tail chasing behavior - avral lick dermatitis

Question 28

Amitriptyline adverse effects and contraindications

Answer 28

Adverse effects * sedation, mydriasis, and urinary retention Contraindications * concomitant use with a CYP450 inhibitors such as cimetidine, ketoconozol or chloramphenicol may inhibit the metabolism of TCA's