NEU 6 Flashcards
What are the different types of epileptic seizures?
- Focal (partial) epileptic seizure
- Generalised epileptic seizures (previously called primary generalised seizure)
- Focal seizure with secondary generalisation
Describe the sibdivisions of focal seizures
- Simple: animal usually alert and aware of its surroundings
- Complex: consciousness is altered, fly catching, aggression, running, resonant vocal sounds, crouching or hiding
What is meant by a focal seizure?
A seizure that presents with focal motor, autonomic or behavioural signs alone or in combination
Describe the stages of epileptic seizures in the dog.
- Prodome: subtle changes in behaviour (often overlooked, hours or days)
- Aura or preictus: anxiety, excitability, barking (seconds to minutes)
- Icuts or seizure stage: convulsions (clonic/tonic), loss of consciousness, urination, defecation, salivation (seconds to minutes)
- Postictus: exhaustion, also aggression or increasing appetite (minutes - days)
Describe the mechanisms by which anticonvulsants work
- Decrease excitation or increase inhibition
- Alter intinsic membrane properties (mostly Na+ channels)
- Increase inhibitory transmitter function (mostly GABA system)
- Decrease excitatoy transmitter function (glutamate system)
What drugs are primarily used in veterinary medicine to treat seizures?
- Benzodiazepines
- Barbiturates
- Imepitoin (pexion)
- Bromide
Describe how inhibitory function can be increased to treat seizures
- GABA receptor-Cl- channel complex binding sites, potentiates endogenous GABA (benzodiazepines, barbiturates)
- GABA transaminase inhibition, GABA build up
- Triggered GABA release from presynaptic terminal
- Ion competition with chloride for passage through Cl- channel, increased hyperpolarisation
- Partial agonists at GABA-A receptors (imepitoin)
Describe the mechanism of action of barbiturates
- Bind to GABA receptor Cl- channel complex
- Potentiate GABA
- Metabolised by liver, enzyme induction
- Long half life
- Phenobarbital is drug of choice in cats and dogs, less toxic than benzodiazepine
- Bind to sam receptor but different site as BZD do not need GABA, open channel, influx of Cl-
Describe the mechanism of action of benzodiazepines
- Bind to GABA-A receptors, facilitate endogenous GABA effects
- Also used for sedative-hypnotic, anxiolytic, muscle relaxant and appetite stimulant effects
- Metabolised by liver
- Can be quitte toxic in cats
- Diazepam
- Bind to binding site, agonist effect, facilitate effect and increase frequency of Cl- travel through channel = hyperpolarisation and inhibitory postsynaptic potential
Describe the mechanism of action of bromide as an anticonvulsant
- Competes with Cl- in Cl- channel
- Has more of a hyperpolarising effect than Cl-
- Distributed through body like Cl-
- Very long half life (2-3 months to steady state)
Describe the mechanism of action of imepitoin (pexion)
- Partial agonist
- Potentiates amplitude of GABA - evoked currents by acting at the benzodiazepines recognition site of the GABA-A receptor
- Low affinity partial agonist with low intrinsic activity
- Binds to same site and receptor as a BZD but is not one
List the drugs that can be used to treat anxiety behaviours
- Benzodiazepines
- Tricyclic antidepressants
- Selective Serotonin Uptake Inhibitors (SSRIs)
- Monoamine oxidase inhibitors (MAOIs, not first choice as anxiolytic drug)
- Azapirones
Describe the mechanism of action of benzodiazepines as an anxiolytic drug
- Activate specific benzodiazepine receptor that facilitates inhibitory GABAergic
transmission - Amygdala has BZD receptors
- Reduce anxiety and agression
- Some memory impairment
- Dependence is a problem (need to reduce dose slowly)
Describe the mechanism of tricyclic antidepressants as anxiolytic drugs
- Enhance functioanl acitivity of norepinephrine and serotonin
- Block reuptake of both NTs
- Treat separation anxiety
- Increase availability of serotonin and NE
- Serotonin associated with mood, NE associated with activity
Describe the mechanism of action of selective serotonin reuptake inhibitors (SSRIs) as anxiolytic drugs
- Block reuptake of serotonin
- So increases its functional activity
- Adaptive changes in pre- and postsynaptic receptors (1-4 weeks for benefit), postsynaptic side more receptors and higher affinity for serotonin
Describe the mechanism of action of monoamine oxidase inhibitors as anxiolytic drugs
- Not first choice as anxiolytic drugs
- Enhance functional activity of norepinephrine, serotonin, dopamine
- Inhibit degredation of NTs by monoamine oxidase
Describe the mechanism of action of azapirones as anxiolytic drugs
- Activate a specific serotonin receptor
What is canine cognitive disorder?
- Similar to Alzheimer’s
- Can be summarised by DISH: disorientation, interaction changes, sleep changes, house soiling
Which drug can be used to treat canine cognitive disorder and give its mechanism of action?
- Segeline
- MAOI
- Irreversibe
- Greater affinity for MAO-B (dopamine is the substrate) than MAO-A
- Selectivity not absolute
- Species variations in dopamine metabolism
- Allows more dopamine to be available for release
List some common side effects of anxiolytic drugs
- Sedation
- Appetite changes
- Diarrhoea
- Vomiting
- Anorexia
List the common side effects of selegiline
- Restlessness
- Agitation
- Vomiting
- Disorientation
- Diarrhoea
- Nausea
- Diminished hearing
List the common side effects of anticonvulsants
- Sedation
- Nystagmus
- Ataxia
- Polydipsia
- Polyphagia
- CV and respiratory depression
- Gastric irritation
What does ARAS stand for?
Ascending activating reticular system
Describe the reticular formation
- Consists of network of grey and white matter
- Deep thoruhgout brainstem thoruhg pons, midbrain and diencephalon
- Continuous with similar system in spinal cord located deeply around grey matter
- Phylogenetically older region of the brain
- Can be divided into 2 functional divisions: ascending and descending
Describe the descending reticular formation
Linked to sensory and motor nerves and the cerebellum
Describe the ascending reticular formation
Relays impulses to higher centres for arousal (ARAS)
What are the inputs into the reticular formation?
- Spinoreticular tracts from spinal cord
- Collateral neurons from sensory/afferent neurons travelling to diencephalon
What are the outputs of the reticular formation
- Reticulospinal tracts to spinal level
- Intralaminar nuclei of thalamus and on to cerebral cortex
Describe the role of the reticular formation in the transmission of pain
- Pain information transmitted via spinoreticular tract and ascending reticular formation to thalamus and ultimately cerebral cortex
- Projects to cortex via diffuse thalamic projections
Describe the role of the reticular system in arousal
- ARAS sensitises cerebral cortex to particular sensory modalities
- Keeps cortex active during wakefulness
- Reduced activity results in sleep
- Severe lesion usually leasd to coma
Describe the mechanism of sleep
- Main sleep centre believed to be in hypothalamus
- Balance occur between activities of ARAS and sleep centre
- ARAS is main brain structure that maintains wakefulness and arousal
- Is a flip flop system - hypothalamus and ARAS inhibit each other
- Oxinergic neurons in lateral hypothalamus triggers switching between the 2
- Orexin produced - stimulates activity and food intake
- Peptides have receptors on reticular formation and activate it
What is the role of the vlPOA in sleep regulation?
vlPOA = ventrolateral preoptic area
- is the main sleep centre
- Accumulation of adenosine (result of metabolic activity) turns sleep centre on
- Caffeine is an antagonist of adenosine so keeps you awake
What are the inputs into the orexinergic neurons?
- Biological clock (suprachiasmatic nucleus)
- Hunger signlas activate system
- Satiety signals inhibit system
What are the 2 types of sleep?
- Slow wave (deep) sleep
- Rapid eye movement sleep (dreaming, atonia, fluctuating blood pressure, heart rate, respiration)
- They follow each other cyclically during sleep periods
What is orexins mechanism of action?
Inhibits the inhibition of lower motor neurons causing wakefulness
Describe the external ear
- 2 to echolocate
- Cartilages lining the ear help direct the sound
- Pinna (auricle) is vertical canal
- Moved by 5 sets of muscles innervated by VII (rostral, dorsal, caudal, ventral, intrinsic)
- Horizontal part of external acoustic meatus
Describe the pinna
- Receives sound waves
- Reflected and amplified down the canal
- Very directional, heance ear movement helos locate source
- Consducts sound waves to tympanic membrane
- Fine hairs - tragi
- Themoregulatory and behavioural roles
Describe the external acoustic meatus
- Long and curved
- Cartilaginous part (long)
- Osseus part next to bulla (short, longer with age)
- Lined with stratified squamous epithelium
- Contains sebaceous glands producing earwax (cerumen)
- Epithelial cells migrate outwards
- Sliding conveyor for debris etc trapped in cerumen
- Hence vertical canal may be dirty while horizontal canal is clean
Describe the development of the middle and inner ear
- Develops as otic placode of ectoderm lateral to developing rhombencephalon
- Otic placode invaginates to form otic vesicle
- Otic vesicle produces inner ear
- Utricle - semicircular canals
- Saccule - cochlea
- Ossicles form from mesoderm of 1st and 2nd pharyngeal arches
What is the middle ear made up of?
- Tympanic cavity within tympanic bulla
- Auditory ossicles
- Auditory tube (Eustachian tube)
Describe the temporal bone
- Made up of 3 bones
- Squamous - extends into zygomatic arch
- Petrosal - very dense bone, no air chambers, contains inner ear, does not resonate
- Tympanic - resonant cavity, dorsal part contains auditory ossicles
Describe the tympanic cavity
- Normally air filled
- Has epithelial mucosal lining
- Is within tympanic part of petrosal bone
- Contains dorsally the auricular ossicles in the epitympanic recess
- Middle part includes tympanic membrane in lateral wall of cavity and opens into auditory tube
- ventral part is tympanic bulla (enhances hearing at low and high frequencies)
- 2 windows into medial wall: oval vestibular window covered by the stapes and the cochear window closed by the secondary tympanic membrane
Describe the tympanic membrane
- Separates external from middle ear
- 3 layers
- External epithelial lining (ectoderm)
- Connective tissue with collagen and elastic fibres, fibrocartilaginous ring (mesoderm) and inner mucous membrane towards tympanic cavity (endoderm)
- Insertion of malleus (hammer)
- Transmission of sound waves from air onto auditory ossicles
Describe the development of the auditory ossicles
- Incus and malleus develop from 1st pharyngeal arch mesoderm (mammals) from ancient parts of jaw bonw
- Stapes develops from 2nd pharyngeal arch mesoderm
- Mandible derived from 1st arch as well as incus and malleus to make commplex jaw bone in reptiles
- Definind feature of mammals is the presence of 3 ear ossicles
- During evolition, bones of jaw becomes ossicles of ear