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Pharmacology > CNS pharmacology > Flashcards

CNS pharmacology Flashcards

(sedatives, tranquilisers, seizures, behaviour)

1
Q

What is the function of glutamate?

A

Excitatory amino acid

(related to memory and learning)

excess = seizures

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2
Q

What is the function of gamma-aminobutyric acid (GABA)?

A

inhibitory amino acid

motor control, memory, consciousness

muscle relaxation, anxiolytic, anti-convulsant, amnesia

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3
Q

What is the function of dopamine?

A

motivation, emesis, motor control, arousal, behaviour, hormone release

Low: parkinsons

High: psychosis

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4
Q

What is the mechanism of action for amphetamines?

A

Increase dopamine, noradrenaline, serotonin release

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5
Q

What is the mechanism of action of apomorphine?

A

Dopamine agonist

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6
Q

What is the use of apomorphine?

A

Emesis

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7
Q

What is the mechanism of action of metoclopramine?

A

Dopamine antagonist

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8
Q

What is the use of metoclopramine?

A

Anti-emetic

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9
Q

Which muscarinic receptors are inhibitory?

A

M2, M4

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10
Q

Which muscarinic receptors are excitatory?

A

M1, M3, M5

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11
Q

What is the function of norepinephrine in the CNS?

A

Alertness, arousal, reward, sleep, mood, hormone release, body temp

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12
Q

What is the mechanism of action for cocaine?

A

Increase dopamine release

Block reuptake of adrenaline (epinephrine)

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13
Q

What is the function of serotonin?

A

mood, wakefulness, feeding, emesis

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14
Q

What is the function of ondansetron?

A

anti-emetic

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15
Q

What is the mechanism of action of ondansetron?

A

Sertonin antagonist

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16
Q

What are the key features of a drug that allows it to act on the CNS?

A

Must cross bbb

Lipid soluable or transported by a carrier

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17
Q

List four classes of sedatives/tranquilizers

A

Phenothiazines

Butryrophenones

Benzodiazapines

Alpha 2 agonists

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18
Q

What is the mechanism of action of phenothiazines?

A

dopamine antagonists + anticholinergic + anti-histamine + alpha adrenergic antagonist

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19
Q

What are the uses of phenothiazines?

A

anti-emetic/travel sickness

seditive/tranquiliser (dose dependent sedation reaches a plateau)

Premed for anaesthesia (decrease arrhythmia)

Antipsychotic

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20
Q

What are the side effects of phenothiazines?

A

low BP

increase aggression

penis extension in horses (do not use in breeding stallions)

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21
Q

List 3 phenothiazines

A

Acepromazine

Chlorpromazine

Promazine

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22
Q

List a butyrophenone

A

Azaperone

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23
Q

What is the use of azaperone

A

Used for sedation in PIGS : Tranquilizer, reduce sow to piglet aggression, prevent halothane-induced malignant hyperthermia

May be useful for feather plucking/self mutiation of birds

Reducing intercat aggression

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24
Q

What is the mechanism of action of butyrophenones?

A

Dopamine antagonist (+ effects on other transmitters)

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25
What is the mechanism of actionof benzodiazapines?
Potentiate GABA receptors (hyperpolarization)
26
What is the use of benzodiazapines
anxiolytic muscle relaxant, hypnotic, appetite stimulant, anticonvulsant
27
Name three benzodiazapines
Diazepam Midazolam Zolazepam
28
What are the two main categories of seizure?
Generalised and partial seizures
29
What are the two main causes of generalised seizure?
Grand mal Petit mal
30
What are the four typical phases of a grand mal seizure?
Prodromal phase (mild behaviour change) Aura (pronounced behaviour change) Seizure Post-ictal (disorientation)
31
Define status epilepticus
A state of seizure/convulsion typically \> 1 hr
32
What are the goals of seizure treatment
Lower temperature if hyperthermic Stop seizures Determine and treat underlying cause; or suppress therapeutically
33
What are the guidelines for starting therapy for recurrent seizures?
\>1 seizure / 6 weeks \> 1 cluster / 8 weeks Aggression associated with recurrent seizures Owner distress
34
Name three drug classes that might be useful in the treatment of seizures
Barbituates Benzodiazapines Potassium bromide (may be adjunct treatment)
35
What are the uses of barbituates?
Anticonvulsants Sedation Anaesthesia Euthanasia
36
Name a barbituate
Phenobarbitone
37
What is a use of phenobarbitone?
Antiepileptic (lower sedation than other barbituates) Effective in 60-80% dogs
38
What are the side effects of barbituates?
Polyphagia Polydipsia Polyuria Hepatotoxicity Increased CP450 (tolerance)
39
What is the action of flumazenil
Benzodiazapine antagonist
40
Name some "other" agents which may be useful in controlling sizures
Potassium bromide Primidone Gabapentin Felbamate Valproic acid Carbamazepine Zonisamide Imepitoin
41
What are some causes of treatment failures in seizures?
Incorrect diagnosis Inadequate dose rate Increase in tolerance Owner non-compliance Contraindications (stimulants)
42
List the steps in treatment for status epilepticus
1. Diazepam (short acting) 2. If still seizuring, propofol or pentobarbitone slowly to effect 3. Phenobarbitone IV or IM 4. Assess body temperature and cool if \> 41.4 5. May also require anti-inflammatories, glucose, mannitol, thiamine (cats)
43
What are some drugs that may be useful in treatment of behavioural disorders?
Antipsychotics (Phenothiazines, Azaperone) Anticonvulsents (Phenobarbitol) Beta blockers (propranolol) Opiods (Hydrocordone) Amphetamines (Ritalin) Benzodiazapines (Diazepam, Alprazolam, Imepitoin Antidepressants (Tricyclics, SSRIs, MAOI Others (Trazodone, Clonidine) Hormones Pheromones
44
Which drug classes may act as an antipsychotic?
Phenothiazines Butryophenones
45
Which anticonvulsant may reduce excessive vocalisation and overactivity in cats?
Phenobarbitol
46
Which Beta blocker may reduce the physical manifestations of fear and anxiety?
Propranolol
47
What behavioural problem may hydrocodone been used for?
Self mutilating cats and acral lick in dogs
48
Which amphetimine may reduce hyperactivity in dogs?
Ritalin
49
Which benzodiazapines may be useful for anxiety, phobias, and panic disorders in dogs and cats
Diazepam, alprazolam (xanax), imepitoin
50
What are the adverse effects of benzodiazapines?
Increased appetitie transient ataxia pardoxical hyperexcitability in cats
51
What are the contraindications of prescribing benzodiazapines?
Liver or renal failure aggression human abuse
52
What is the mechanism of action of tricyclic antidepressants?
Block reuptake of amines (NE, 5HT) Anticholinergic (muscarinic) H1 and alpha1 adrenergic antagonists
53
What are the indications for use of tricyclic antidepressants in a dog?
Anxiety, some aggression, separation anxiety, noise phobias, OCD
54
What are the indications for use of tricyclic antidepressants in cats?
Anxiety, spraying, over-grooming
55
Name four tricyclic antidepressants
Amitriptyline Nortriptyline Doxepin Clomipramine
56
What are the side effects of tricyclic antidepressants?
Sedation Anticholinergic = (dry mouth, increased thirst, urinary retention, constipation) Tachycardia Ataxia
57
Name two important client considerations when prescribing antidepressants
1. may take several weeks to show any improvement 2. Drugs minimally useful without behavioural changes
58
Name four selective serotonin reuptake inhibitors (SSRIs)
Fluoxetine, Fluvoxamine, Paroxetine, Sertraline
59
What are the indications for use of SSRIs in cat?
anxiety, spraying, OCD
60
What are the side effects of SSRIs
Hepatic GIT paradoxical anxiety
61
Name a monoamine oxidase inhibitor (MAOI)
Selegiline
62
What are the indications for selegiline?
fears, phobias, and age-related problems especially canine cognitive dysfunction
63
What are the side effects of MAOIs
GI effects restlessness, lethargy, anorexia hyperactivity depression
64
What are the contraindications of MAOIs
Do not combine with SSRIs, ephedrine, opioids, phenylpropanolamine
65
What is the mechanism of action of trazodone?
Serotonin 2a antagonist/reuptake inhibitor
66
What are the indications for use of trazodone
Adjunct treament for behavioural problems (anxiety/phobia) in dogs (not cats
67
What are the side effects of trazodone?
GIT upsets, hyperactivity, sedation, panting
68
What is the mechanism of action of clonidine?
alpha 2 agonist
69
What are the indications of clonidine?
prior to stressful events (e.g. storms, separation anxiety) barking
70
Which hormones may be considered in the treatment of behavioural disorders?
Progetins (Megestrol acetate)
71
What are the effects of megestrol acetate?
Nonspecific CNS depression, barbituate-like activity. Last resort due to side effects
72
What are some considerations of behaviour modifying drugs?
- little benefit without behaviour modification - may take several weeks to show an effect - most off label - generally not curative - potential side effects - client communication
73
What are some uses of CNS stimulants in veterinary medicine?
Barbituate poisoning Respiratory collapse, neonatal asphyxia Drowning Heat shock
74
What is the use of doxapram hydrochloride?
Stimulate respiration
75
What is the mechanism of action of methyxanthine derivatives?
Inhibits phosphodiesterases: increase cAMP Inhibits adenosine receptors (adenosine causes sedation and anticonvulsant)
76
What is the use of methylxanthine derivatives?
Respiratory and cardiovascular stimulant
77
Name three methylxanthine derivatives
Aminophylline Caffeine Theobromime
78
Where is theobromime found?
Chocolate, tea, cola
79
What is the LD50 of theobromime in dogs?
300 mg/kg
80
What is the half life of theobromime in dogs?
17 hours
81
What are the symptoms of theobromime toxicity?
Nausea, vomiting, diarrhoea Cardiac tachycardia and arrhythmias Seizures Death
82

Pharmacology (12 decks)

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