Behavior Modifying Drugs - SSRIs Flashcards
How do SSRIs work?
They block presynaptically located serotonin transporter selectively thus inhibiting reuptake of 5-HT
What is the result biochemically of the use of SSRIs?
elevation of synaptic 5-HT levels
What do SSRIs desensitize?
5-HT 1A receptors and alpha 2 receptors
Why would we want to desensitize 5-HT 1A receptors?
so that serotonin can stay in the synapse for longer
What are the SSRIs mentioned in class?
Fluoxetine (Reconcile/Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Citalopram
What is the preferred SSRI in animal medicine and why?
Fluoxetine because it is safe and tolerable
What are the therapeutic uses for SSRIs?
depression, anxiety, aggression, compulsive disorders
What are the advantages to SSRIs?
not sedating, dont cause learning impairment, no cardiac toxicity
What are the therapeutic uses of fluoxetine?
agression, acral lick dermatitis, hyperactivity in dogs
Treatment of urine spraying behavior, aggression, and compulsive disorders such as psychogenic alopecia in cats
What animals can you not give fluoxetine to?
breeding animals
How do monoamine oxidases work?
they catalyse the break down of monoamines including NE, 5-HT, and DA
Where is MAO present and what does it do?
it is present in the liver and facilitates the breakdown of tyramine rich foods
What happens in the absence of MAO?
hypertensive crisis
How does Selegiline (MAOI) work?
It is a irreversible and selective inhibitor of MAO-B
It acts as a free radical scavenger of DA derived oxidative species in the CNS
What is Selegiline FDA approved to treat?
canine cognitive dysfunction
What are the contraindications for Monoamine Oxidase Inhibitors?
Should not be given in combination with TCAs and SSRIs due to the risk of serotonin syndrome
Should not be concurrently administered with amitraz (flea collar)
What are the adverse effects of SSRIs?
Withdrawal syndrome and serotonin syndrome
What are the signs of withdrawal syndrome?
tremor, dizziness, anxiety, electric shock like sensations, and flu like symptoms
How do you stop SSRIs?
gradually
What chemical process causes serotonin syndrome?
excessive serotonin transmission (release)
What drugs are gabapentinoids?
gabapentin (neurontin) and Pregabalin (lyrica)
What properties do gabapentinoids have?
anxiolytic, sedative, analgesic, and anticonvulsant properties
What do gabapentinoids bind to?
They bind to the alpha-2-delta-1 subunit of presynaptic voltage-sensitive calcium channels blocking release of excitatory transmitters (glutamate, substance P, Norepinephrine)
What are gabapentinoids administered in combination with?
SSRIs or TCAs
Gabapentin can be effective and safe ______ agent for the management of ______ in dogs?
adjunctive, anxiety
If you secrete glutumate, what is the associated effect?
reduction of depression
What do alpha-2-delta ligands do therapeutically?
Reduce the signs of stress in cats, facilitate transport, and compliance during vet examination
What side effects are associated with alpha-2-delta ligands (gabapentin?
sedation and ataxia
What would happen if you didn’t wean a patient off of gabapenin slowly?
they can have seizures
True or False: The liquid form of gabapentin is the preferred type.
False - it often times contains xylitol
xylitol = bad
What patients should you use caution with when prescribing gabapentin?
patients with kidney conditions
What do alpha 2 - adrenergic agonists do?
block sympathetic drive
What is dexmedetomidine hydrochloride oromucosal gel (Sileo) FDA approved for?
canine noise phobias
What effects does Sileo cause?
dose dependent seedation, muscle relaxation, and analgesia in dogs and cats
What are the therapeutic uses for Sileo?
noise aversion and anxiety treatment
What is the extralabel use indication of Dexmedetomidine hydroxhloride in dogs?
chemical restraint of aggressive dogs requiring medical examination
What is the extralabel use indication of Dexmedetomidine hydroxhloride in cats?
adequate sedation for clinical procedures for moderate duration - emesis is common
What drug is a serotonin antagonist reuptake inhibitor (SERTi) and serotonin (5-HT)2a antagonist?
Trazodone
What dogs would you use trazodone in?
dogs for postoperative confinement, hospitalization, and the treatment of multiple behavioral disorders in conjunction with other psychiatric drugs
What can happen with high doses of trazodone?
serotonin syndrome
What is Cyproheptadine?
an antidote for serotonin syndrome
What drug classes can be used to treat aggression?
SSRIs, azapirones, TCAs, hormones, combinations
What drug classes can be used to treat anxieties, fears, phobias; without agression?
BZs, SSRIs, azapirones,m MAOIs, TCAs
What drug classes can be used to treat cognitive dysfunction in geriatric patients?
MAOIs
What drugs classes can be used to treat compulsive disorders?
SSRIs, antipsychotics, TCAs, opioids and opioid antagonists
What drugs classes can be used to treat hyperkinesis or ADD?
CNS stimulants
