Lecture 8: Anxiolytic drugs Flashcards

1
Q

5-HT is formed from ___

A

Tryptophan

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2
Q

Serotonin is taken up into nerve terminal by ___and metabolized by ___

A

SERT, MAO

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3
Q

Neurons for serotonin transmission originate in the ___

A

Raphe nucleus

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4
Q

Serotonin is involved in ___and ___

A

Appetite and mood

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5
Q

NE is synthesized from ___, terminated by ___and hydrolysis via___

A

Tyrosine, NET, and MAO

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6
Q

NE pathways originate in the ___

A

Locus coeruleus

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7
Q

NE stimulates ___ receptors in spinal cord and decrease ___ and cause __ and ___

A

Alpha2 receptors, pain, sedation and muscle relaxation

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8
Q

NE is important in ___, ___ and ___

A

Attention, memory and mood

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9
Q

Dopamine is synthesized from __, taken up into nerve terminal by ___ and metabolized by ___

A

Tyrosine, DAT, MAO

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10
Q

Blockade of D2 receptors in striatum can cause ___

A

Motor deficits

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11
Q

The VTA nucleus accumbens system is the ___pathway

A

Reward

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12
Q

Stimulation of DA receptors in chemoreceptor trigger zone produce __

A

Vomiting

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13
Q

What are some examples of obsessive compulsive behaviors

A

Cribbing in horses, acral licking and tail chasing in dogs, feather plucking in birds, psychogenic alopecia in cats

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14
Q

What is the mechanism of tricyclic antidepressants (TCA’s)

A

Inhibit reuptake of NE and 5-HT

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15
Q

___amines are more sedating than ___amines for TCA’s

A

Tertiary, secondary

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16
Q

TCA’s block ___ and __ receptors resulting in sedation and memory impairment

A

Muscarinic and histamine

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17
Q

What are the main effects of TCA’s

A

Anti-anxiety, anti-compulsive, and anti-aggressive effects

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18
Q

What is the mechanism of action for clomipramine

A

More specific for 5-HT reuptake than NE

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19
Q

What other receptor does clomipramine block and what is its effect

A

Muscarinic receptors, memory impairment

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20
Q

What are some side effects of clompriamine

A

Sedation, mydriasis, regurgitation, weight gain, urine retention, appetite changes

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21
Q

Clomipramine is not teratogenic but should not be use in __animals

A

Lactating

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22
Q

The chewable form of clomipramine is FDA approved for ___ and ___

A

Separation anxiety in dogs, and behavior modification

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23
Q

In addition to its approved uses, what is clomipramine used for

A

Compulsive disorders such as acral lick dermatitis, tail chasing in dogs, psychogenic alopecia and urine spraying in cats

Decrease feather plucking in parrots

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24
Q

What is the mechanism of amitriptyline

A

Inhibit reuptake of both 5-HT and NE (may play greater role in decreasing pain)

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25
Q

What other receptors does amitriptyline block

A

Muscarinic and histamine receptor blockade- sedation and memory impairment

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26
Q

What are some side effects of amitriptyline

A

Sedation, urine retention, weight gain , mydriasis

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27
Q

Amitriptyline should not e used in ___animals

A

Pregnant or lactating- teratogenic

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28
Q

What are some toxicities associated with amitriptyline

A

Respiratory depression, ataxia, collapse, convulsions

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29
Q

What is amitriptyline used for

A

Psychogenic alopecia and decrease urine marking in cats

Decrease Pain and bladder spasms in treatment of recurring idiopathic interstitial cystitis in cats

Acral lick dermatitis and tail chasing in dogs, separation anxiety, decrease aggression in fear-induced dogs

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30
Q

What is doxepin used for

A

Parrots to decrease stress during shipment and destructive behavior

Used for psychogenic dermatitis in small animals

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31
Q

In what species is doxepin banned and why

A

Competition horses because it is considered psychotropic (calms horses)

32
Q

What is imipramine used for

A

Inappropriate urination, such as excitement in dogs, decreases withdrawn syndrome in beagles and tx ejaculatory dysfunction in horses

33
Q

Do not combine TCA’s with other ___,___, and __ because it can cause ___ which can be fatal

A

SSRI’s, MAO inhibitors or St. John’s worts

Cause serotonin syndrome

34
Q

SSRI’s decrease response to ___, increase ___which may facilitate learning or behavioral recovery

A

Stress and increase neural plasticity

35
Q

T or F: SSRI’s block Muscarinic receptors

A

False

36
Q

What is the main side effect for SSRI’s

A

Anorexia

Cats should especially be monitored

37
Q

What are the general effects of SSRI’s

A

Anti-anxiety, anti-compulsive , and anti-aggression

38
Q

SSRI’s are very useful for __, where animals is in chronic state of fear

A

Generalized anxiety disorders

39
Q

What are some other uses beyond generalized anxiety disorders for SSRI’s

A

Fear induced aggression, acral lick dermatitis in dogs, urine marking and psychogenic alopecia in cats

40
Q

What is fluoxetine FDA approved for and what are some other uses

A

FDA approved for separation anxiety in dogs

Other uses: acral lick dermatitis in dogs, inappropriate urination and psychogenic alopecia in cats

41
Q

T or F: fluoxetine inhibit P450 enzymes, so have many drug interactions, especially TCA’s

A

True

42
Q

Fluoxetine should not be combined with other ___ because can cause ___

A

antidepressants cause serotonin syndrome and/or TCA overdose

43
Q

Fluoxetine should not be combined with ___ cause seizures

A

Tramadol

44
Q

What are some side effects of fluoxetine

A

Sedation, aggression, seizures, anxiety

45
Q

Sertraline is less effective for ___than fluoxetine

A

Acral lick dermatitis

46
Q

What is sertraline used for

A

Obsessive behaviors in cats

47
Q

T or F: sertraline inhibits P450 enzyme

A

F

48
Q

What is paroxetine used for

A

Urine marking and aggression in cats

Generalized anxiety disorders in dogs

49
Q

T or F: paroxetine inhibits P450 enzyme

A

True

50
Q

What is the mechanism of action of Mirtazapine

A

Alpha2 antagonist increases release of NE and 5-HT by removing pre synaptic inhibition of release

51
Q

Mirtazapine also blocks ___receptors which makes it very sedating

A

Histamine

52
Q

What is Mirtazapine used for

A

Cats: appetite stimulant, decrease nausea and vomiting

Dogs: sedation

53
Q

What are some side effects of Mirtazapine in cats

A

Vocalizaiton and agitation

54
Q

Mirtazapine has a very long have life and oral form should be dose every ___ in cats

A

3 days

55
Q

What is the mechanism of action of trazodone

A

Antagonist at 5-HT2A/2C receptors and decrease 5-HT reuptake

56
Q

What is trazodone used for

A

Pre-anesthetic to provide sedation, anti-anxiety in dogs or post-sx confinement, decrease anxiety in cats before vets

57
Q

What are some adverse effects of trazodone

A

Sedation, lethargy, priapism

58
Q

What is the mechanism of action of buspirone

A

Partial agonist of 5-HT1a receptor

59
Q

What is buspirone used for

A

Anti-anxiety drug, effective treatment for generalized anxiety in dogs

Cats: urine marking and inter-cat aggression

60
Q

Buspirone can be combined with __ in dogs for treatment of __, ___ and__

A

Fluoxetine
Tx: aggression, anxiety and stereotypic behavior

61
Q

T or F: buspirone is non-sedating

A

True

62
Q

What is the mechanism of action for selegiline

A

Inhibits MAO-B and increase levels of dopamine

63
Q

What is selegiline approved for

A

Canine cognitive dysfunction and pituitary dependent crushings in dogs

64
Q

What are some signs of mild serotonin syndrome and what is treatment

A

Agitation, delirium, insomnia, restlessness, anxiety

Tx: observe for >6hrs and give benzodiazepines

65
Q

What are some signs of moderate serotonin syndrome and what is tx

A

Hyperthermia, diaphoresis, tachycardia, hypertension, tachypnea, mydriasis, seizures

Tx” Admit, cardiac monitoring, benzodiazepines, cyproheptadine

66
Q

What are some signs of severe serotonin syndrome and what is treatment

A

Myoclonus, ocular clonus, rigidity, hyperreflexia, tremor, akasthisia, in coordination

Tx: ICU, esmolol or nitroprusside, cooling, sedation, intubation paralysis

67
Q

What drugs are good for aggression in dogs

A

TCA’s, SSRI,s buspirone

68
Q

What drugs are good for generalized anxiety in dogs

A

TCA’s SSRI’s, buspirone

69
Q

What drugs are good for acral lick dermatitis

A

TCA’s SSRI’s

70
Q

What drug is good for canine cognitive dysfunction

A

Selegiline

71
Q

What drug is good for interstitial cystitis in cats

A

Amitriptyline

72
Q

What drugs are good for urine marking in cats

A

TCAs, SSRIs, buspirone

73
Q

What drug is good for inter-cat aggression

A

Buspirone

74
Q

What drugs are good for compulsive disorders in cats

A

TCA’s, SSRIs

75
Q

What drug is an appetite stimulant in cats and dogs

A

Mirtazapine

76
Q

What drugs are good for feather plucking in parrots

A

TCA’s