Behavior Modifying Drugs (Anxiolytics and TCAs) Flashcards
What are some behavioral reasons for relinquishment in dogs?
Destructive, house-soiling, aggression, escapes, disobedient, barking
What are some behavioral reasons for relinquishment?
House soiling, problems with other pets, aggression towards people, destructive behavior, aggression towards animals, bites, disobedience, euthanasia for behavioral reasons, unfriendly, afraid
What are some general abnormalities?
aggression, fear, anxiety, compulsive disorder, inappropriate elimination, and cognitive dysfunction in geriatric patients
What is a behavioral abnormality associated with dobermans? English bull terriors? German Sheperds?
Dobermans - flank sucking
English Bull Terriers - Spinning
German Shepherds - incessant tail chasing
True or False: Behavior modifying drugs are curative.
False - they are for management
Psychotherapy must go hand in hand with what?
pharmacotherapy
What are some behaviors associated with noise aversion?
hiding, vocalizing, panting, shaking or trembling, vomiting, urinating, or defecation on the spot
What neurotransmitters are associated with behavior?
Norepinephrine, dopamine, serotonin, GABA, endorphins
Depression is a ______ disorder.
heterogenous
What is the Biogenic amine hypothesis theory?
reduction in NE and 5-HT (serotonin) levels might be a causative factor in depression
What are the treatment strategies for Biogenic amine hypothesis of mood?
agents that enhance the actions of these monoamines are efficacious in the treatment of depression
What are the drug categories for behavior-modifying drugs?
Anxiolytics, antidepressents, alpha agonists, serotonin antagonist and reuptake inhibitors
What are the types of anxiolytics?
Benzodiazepines, azapirones
What drugs are the benzodiazepines?
Alprazolam (Xanax), Clonazepam (Klonopin), Diazepam (Valium), Lorazepam( Ativan), Oxazepam (Serax)
Benzodiazepines are not a major concern for ______ treatment.
Short-term
What is the goal of the use for benzodiazepines?
decrease anxiety
What is the mechanism of action of benzodiazepines?
Enhancement of GABAergic neurotransmission via stimulation of GABA A receptors, hence resulting in membrane hyperpolarization via ehancement of GABA mediated chloride conductance
What are the sites of action of benzodiazepines?
cerebral cortex, limbic system, and thalamus
Studies have shown that there is a ______ correlation between psychological stress and _____ of the GABA system. In order to correct this, we are trying to _______ GABA neurotransmission.
positive, malfunctioning, enhance
What are the pharmacological effects of benzodiazepines?
lack of behavioral specificity exhibit dose dependent but minimal CNS depressent effects Decrease anxiety, fear, and aggression and noise phobia
What are the actions of benzodiazepines in low doses?
mild sedation
What are the actions of benzodiazepines in moderate doses?
anti-anxiety agents
What are the actions of high doses in benzodiazepines?
hypnotics
Why would benzodiazepines be used in combination with other psychotropic drugs?
to improve clinical outcome
What are the adverse effects associated with benzodiazepines?
Patients experience withdrawals, so you need to wean them off slowly
May cause physical addiction Ataxia Liver failure
What are the disadvantages of using benzodiazepines?
Amnesic effects may interfere with behavior modification therapy
Contradicted in aggressive patients because it can cause paradoxial excitability
Prone to abuse by humans
Which Benzodiazepine will have the biggest therapeutic advantage>
alprazolam
What are the therapeutic uses for Diazepam (Valium)?
treatment of anxiety treatment of urine spraying behavior in cats appetite stimulant in cats
What is Diazepam less effective in treating than alprazolam?
storm phobia and separation anxiety
What are the adverse effects of Diazepam?
hepatic necrosis in cats concurrent administration with CYP 450 metabolizing drugs may reduce drug metabolism
What are the therapeutic uses of alprazolam (Xanax)?
Useful for the treatment of acute fear situations
Panic disorders in dogs
Physical dependence
Alprazolam in combination with _____ is beneficial in the treatment of storm phobia.
clomipramine
What can occur if withdrawal from alprazolam is too quick?
anxiety, tremors, or seizures may occur
When should Alprazolam bot be givien?
concurrently with drugs that inhibit the CYP 450 system including ketoconazole and itraconazole
In what patients would you use Oxazepam (serax)?
In patients with compromised liver function In aged canine subjects
What is Oxazepam (Serax) effective in doing in cats?
appetite stimulant
When would you use Lorazepam (Ativan?
To treat intercat aggression - victim cat (pyriah)
What drug is FDA approved for use in dogs with noise aversion?
Pexion
BuSpar is the first __________ anxiolytic drug to be developed and markeded. It is a _________ used in dogs and cats.
nonsedating, nonbenzodiazepine
What is the mechanism of action of BuSpar?
Acts as a partial agonist at 5-HT 1a receptors (presynaptic serotonin breaking mechanisms)
Also has affinity for D2 receptors
What does prolonged activation of 5-HT 1a autoreceptors in the DRN lead to?
receptor desensitization and results in increase in 5-HT release in the limbic regions
How quickly does buspirone work?
It has a delayed onset which takes several weeks to demonstrate therapeutic effectiveness
What are the therapeutic uses of Buspirone?
Management of generalized anxiety disorder
Treatment of intercat aggression
In dogs, in combination with fluoxetine to treat aggression and anxiety
What are the advantages of using buspirone?
Likelihood of side effects are low not associated with withdrawal effects or dependence
Does not produce amnestic effects
What drugs do buspirone interact with?
mono amine oxidase inhibitors (MAOIs) - causes hypertensive crisis
What are the types of antidepressants used in aniimals?
tricyclic antidepressants (TCAs),
Serotonin selective reuptake inhibitors (SSRIs)
Monoamine oxidase inhibitors (MAOIs)
What are the common TCAs?
Amitriptyline, Clomipramine, Desipramine, Doxepin, Imipramine, and Nortriptyline
How do TCAs work?
They block the reuptake of neurotransmitters so that the synapse remains flooded with neurotransmitters
They also desensitize alpha-2 adrenergic receptors and 5-HT autoreceptors resulting in elevated extrasynaptic levels of 5-HT and NE
What are the therapeutic uses for TCAs?
treatment of anxiety in dogs and cats pruritic conditions compulsive disorders
What is the time of onset of TCAs?
3-4 weeks for behavior improvement
What are the side effects to TCAs?
Anticholinergic effects, tachycardia, H1 antagonism, alpha receptor antagonism, slowed cardiac conduction
What are the ‘nasty’ anticholinergic effects associated with TCAs?
dry mouth, constipation, urinary retention, and blurred vision
What patients should you not give TCAs?
patients with a history of seizures or a risk for siezures
What drugs to TCAs interact with?
SSRIs or MAO inhibitors
What are is the washout period for TCAs before you can initiate MAOI therapy?
2-3 weeks
What are the therapeutic uses of Elavil?
dogs- self-induced mutilation, and separation anxiety
cats - inappropriate urination, psychogenic alopecia, excessive vocalization, and idiopathic intersitial cystitis
What is Clomipramine (Anafranil) FDA approved for?
separation anxiety in dogs
What can Clomipramine (Anafranil) also be used for?
tail chasing behavior acral lick dermatitis
What are the adverse effects of Amitriptyline?
sedation, mydriasis, and urinary retention
What are the contraindications of Amitriptyline?
concomitant use with a CYP450 inhibitors such as cimetidine, ketoconozole, or chloramphenicol may inhibit the metabolism of TCAs
