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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
Q

What is the mechanism of actionof benzodiazapines?

A

Potentiate GABA receptors (hyperpolarization)

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26
Q

What is the use of benzodiazapines

A

anxiolytic

muscle relaxant, hypnotic, appetite stimulant, anticonvulsant

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27
Q

Name three benzodiazapines

A

Diazepam

Midazolam

Zolazepam

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28
Q

What are the two main categories of seizure?

A

Generalised and partial seizures

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29
Q

What are the two main causes of generalised seizure?

A

Grand mal

Petit mal

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30
Q

What are the four typical phases of a grand mal seizure?

A

Prodromal phase (mild behaviour change)

Aura (pronounced behaviour change)

Seizure

Post-ictal (disorientation)

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31
Q

Define status epilepticus

A

A state of seizure/convulsion typically > 1 hr

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32
Q

What are the goals of seizure treatment

A

Lower temperature if hyperthermic

Stop seizures

Determine and treat underlying cause; or suppress therapeutically

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33
Q

What are the guidelines for starting therapy for recurrent seizures?

A

>1 seizure / 6 weeks

> 1 cluster / 8 weeks

Aggression associated with recurrent seizures

Owner distress

34
Q

Name three drug classes that might be useful in the treatment of seizures

A

Barbituates

Benzodiazapines

Potassium bromide (may be adjunct treatment)

35
Q

What are the uses of barbituates?

A

Anticonvulsants

Sedation

Anaesthesia

Euthanasia

36
Q

Name a barbituate

A

Phenobarbitone

37
Q

What is a use of phenobarbitone?

A

Antiepileptic (lower sedation than other barbituates)

Effective in 60-80% dogs

38
Q

What are the side effects of barbituates?

A

Polyphagia

Polydipsia

Polyuria

Hepatotoxicity

Increased CP450 (tolerance)

39
Q

What is the action of flumazenil

A

Benzodiazapine antagonist

40
Q

Name some “other” agents which may be useful in controlling sizures

A

Potassium bromide

Primidone

Gabapentin

Felbamate

Valproic acid

Carbamazepine

Zonisamide

Imepitoin

41
Q

What are some causes of treatment failures in seizures?

A

Incorrect diagnosis

Inadequate dose rate

Increase in tolerance

Owner non-compliance

Contraindications (stimulants)

42
Q

List the steps in treatment for status epilepticus

A
  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
Q

What are some drugs that may be useful in treatment of behavioural disorders?

A

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
Q

Which drug classes may act as an antipsychotic?

A

Phenothiazines

Butryophenones

45
Q

Which anticonvulsant may reduce excessive vocalisation and overactivity in cats?

A

Phenobarbitol

46
Q

Which Beta blocker may reduce the physical manifestations of fear and anxiety?

A

Propranolol

47
Q

What behavioural problem may hydrocodone been used for?

A

Self mutilating cats and acral lick in dogs

48
Q

Which amphetimine may reduce hyperactivity in dogs?

A

Ritalin

49
Q

Which benzodiazapines may be useful for anxiety, phobias, and panic disorders in dogs and cats

A

Diazepam, alprazolam (xanax), imepitoin

50
Q

What are the adverse effects of benzodiazapines?

A

Increased appetitie

transient ataxia

pardoxical hyperexcitability in cats

51
Q

What are the contraindications of prescribing benzodiazapines?

A

Liver or renal failure

aggression

human abuse

52
Q

What is the mechanism of action of tricyclic antidepressants?

A

Block reuptake of amines (NE, 5HT)

Anticholinergic (muscarinic)

H1 and alpha1 adrenergic antagonists

53
Q

What are the indications for use of tricyclic antidepressants in a dog?

A

Anxiety, some aggression, separation anxiety, noise phobias, OCD

54
Q

What are the indications for use of tricyclic antidepressants in cats?

A

Anxiety, spraying, over-grooming

55
Q

Name four tricyclic antidepressants

A

Amitriptyline

Nortriptyline

Doxepin

Clomipramine

56
Q

What are the side effects of tricyclic antidepressants?

A

Sedation

Anticholinergic = (dry mouth, increased thirst, urinary retention, constipation)

Tachycardia

Ataxia

57
Q

Name two important client considerations when prescribing antidepressants

A
  1. may take several weeks to show any improvement
  2. Drugs minimally useful without behavioural changes
58
Q

Name four selective serotonin reuptake inhibitors (SSRIs)

A

Fluoxetine, Fluvoxamine, Paroxetine, Sertraline

59
Q

What are the indications for use of SSRIs in cat?

A

anxiety, spraying, OCD

60
Q

What are the side effects of SSRIs

A

Hepatic

GIT

paradoxical anxiety

61
Q

Name a monoamine oxidase inhibitor (MAOI)

A

Selegiline

62
Q

What are the indications for selegiline?

A

fears, phobias, and age-related problems especially canine cognitive dysfunction

63
Q

What are the side effects of MAOIs

A

GI effects

restlessness, lethargy, anorexia

hyperactivity

depression

64
Q

What are the contraindications of MAOIs

A

Do not combine with SSRIs, ephedrine, opioids, phenylpropanolamine

65
Q

What is the mechanism of action of trazodone?

A

Serotonin 2a antagonist/reuptake inhibitor

66
Q

What are the indications for use of trazodone

A

Adjunct treament for behavioural problems (anxiety/phobia) in dogs (not cats

67
Q

What are the side effects of trazodone?

A

GIT upsets, hyperactivity, sedation, panting

68
Q

What is the mechanism of action of clonidine?

A

alpha 2 agonist

69
Q

What are the indications of clonidine?

A

prior to stressful events (e.g. storms, separation anxiety)

barking

70
Q

Which hormones may be considered in the treatment of behavioural disorders?

A

Progetins (Megestrol acetate)

71
Q

What are the effects of megestrol acetate?

A

Nonspecific CNS depression, barbituate-like activity. Last resort due to side effects

72
Q

What are some considerations of behaviour modifying drugs?

A
  • 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
Q

What are some uses of CNS stimulants in veterinary medicine?

A

Barbituate poisoning

Respiratory collapse, neonatal asphyxia

Drowning

Heat shock

74
Q

What is the use of doxapram hydrochloride?

A

Stimulate respiration

75
Q

What is the mechanism of action of methyxanthine derivatives?

A

Inhibits phosphodiesterases: increase cAMP

Inhibits adenosine receptors (adenosine causes sedation and anticonvulsant)

76
Q

What is the use of methylxanthine derivatives?

A

Respiratory and cardiovascular stimulant

77
Q

Name three methylxanthine derivatives

A

Aminophylline

Caffeine

Theobromime

78
Q

Where is theobromime found?

A

Chocolate, tea, cola

79
Q

What is the LD50 of theobromime in dogs?

A

300 mg/kg

80
Q

What is the half life of theobromime in dogs?

A

17 hours

81
Q

What are the symptoms of theobromime toxicity?

A

Nausea, vomiting, diarrhoea

Cardiac tachycardia and arrhythmias

Seizures

Death

82
Q
A

Pharmacology (12 decks)

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