Neuro pharm

Question 1

How is it better to start dosing neuro meds?

Answer 1

Better to start at the lower end of dosage range and gradually increase

Question 2

3 types of Types of Psychoactive Meds

Answer 2

Anxiolytics
Antipsychotics
Antidepressant

Question 3

2 types of Anxiolytics
look at word (anxiety lysis)

Answer 3

Benzodiazepines (BDZs)
Azapirones

Question 4

Name 3 of the BENZODIAZEPINES (BDZs) anxiolytics

Answer 4

Diazepam
Alprazolam
Lorazepam, Clonazepam, Oxazepam

Question 5

Name the one AZAPIRONES anxiolytic?

Answer 5

Buspirone

Question 6

How do Benzo anxiolytics work

Answer 6

Enhance ability of GABA to open receptor channel
* BDZs alone can not open GABA receptor channel

Question 7

6 things to treat with BDZ’s

Answer 7

Anxiety
Anticonvulsant
Muscle relaxation
Neuroleptanalgesia
Enhance appetite
Inappropriate elimination

Question 8

• Neuroleptanalgesia is

Answer 8

State of quiescence, analgesia and altered awareness

Question 9

BDZ contraindication

Answer 9

Do not use to treat aggression
Disinhibit aggression tendencies

Question 10

Exception to the BDZ contraindication rule

Answer 10

BDZ given in advance of an event that generates fear may cause fear related aggression

Question 11

When are BDZ good alone?
When are they not?

Answer 11

?

Question 12

BDZ dosing

Answer 12

Class IV controlled
IV oral rectal
1 hr to effect
last different in species
need to withdraw slow

Question 13

Some BDZ side effects

Answer 13

Sedation
Dependence
Hepatic necrosis in cats
Interfere with learning

Question 14

Severe reaction in cats after repeat doing of diazepam?

Answer 14

Hepatic necrosis

Question 15

Azapirone Anxiolytics* Buspirone Indications

Answer 15

Anxiety
Inappropriate elimination
Aggression in dogs

Question 16

What does buspirone typically not do?

Answer 16

Produce sedation, memory impairment, or bite disinhibition

Question 17

Mechanism for action buspirone

Answer 17

• 5-HT1A autoreceptor agonist.
  Partial agonist pre& postsynaptically
  *Antagonist at D2 receptors.

Question 18

Dosing of buspirone

Answer 18

Takes long time to effect 8-12 hours
needs to build up so weeks to notice effects

Question 19

Side effects buspirone

Answer 19

Few side effects: ataxia, friendlier cats.
* contrast to BDZ no withdrawal /dependence effects,
less abuse potential

Question 20

Buspirone Indications in dogs? cats?

Answer 20

Dogs: Anxiety
Cats: Feline urination spraying, Anxiety, aggression

Question 21

Which statement on benzodiazepines is correct ?
* A) Benzodiazepines bind to a-adrenergic receptors.
* B) Benzodiazepines bind to GABAA receptors, major excitatory neurotransmitter receptors in the brain.
* C) Benzodiazepines never disinhibit aggressive tendencies.
* D) Benzodiazepines are not ideal for long-term treatment
as tolerance and dependence may develop.

Answer 21

D

Question 22

Antipsychotics examples

Answer 22

Acepromazine
Chlorpromazine

Question 23

Phenothiazine Tranquilizers Produce a

Answer 23

neuroleptic state:

Question 24

What is a neuroleptic state:

Answer 24

Blunting of normal and abnormal behavior

Question 25

Mechanism of Action & Pharmacokinetics phenothiazine tranq

Answer 25

Dopamine (D2) receptor antagonist

Question 26

How long to act and how long to work phenothiazine tranq

Answer 26

Onset of effect ~ 1 hr. * Effects last 4-24 hrs.

Question 27

Phenothiazines short or long term? why?

Answer 27

Not intended for long term use Does not change underlying chemical disturbances

Question 28

Phenothiazine Side/Adverse Effects

Answer 28

Sedation Hypotension May inhibit learning Extrapyramidal effects

Question 29

Extrapyramidal effects of phenithiazione

Answer 29

Pseudoparkinsonism, motor restlessness, dystonia

Question 30

3 types anti depressants

Answer 30

TCAs SSRIs MAOIs

Question 31

Main effect of antidepressants

Answer 31

Main effects are to ↑ synaptic 5-HT +/- NE

Question 32

Examples of Tricyclic Antidepressants TCA

Answer 32

Amitriptyline • Clomipramine – Clomicalm ® labeled for separation anxiety in dogs • Nortriptyline • Desipramine • Imipramine • Doxepin

Question 33

TCA: Indications

Answer 33

Mild aggressions Compulsive disorders Inappropriate elimination

Question 34

TCA how long to work

Answer 34

2-4 weeks

Question 35

TCA Side/Adverse Effects

Answer 35

Sedation Vomiting Dry mouth Tachycardia or arrhythmias

Question 36

T/F It is easier to OD on TCA

Answer 36

True

Question 37

Contraindications to TCA

Answer 37

Glaucoma or Keratoconjunctivitis Sicca

Question 38

Selective Serotonin Reuptake Inhibitors (SSRI) examples

Answer 38

Fluoxetine Sertraline Paroxetine

Question 39

SSRI mechanism & why

Answer 39

Mechanism * Inhibits 5-HT reuptake by transporters minimal NE effects safer with less side effects d/t this still takes weeks to see effect

Question 40

SSRIs : Indications

Answer 40

Aggressions Separation anxiety Thunderstorms phobia Compulsive disorders

Question 41

SSRIs: Kinetics, Side Effects

Answer 41

Longer 1/2 life than TCAs Side effects: Lethargy – Diminished appetite – GI disturbances

Question 42

Why Do SSRIs Have Less Side/Adverse Effects Than TCAs? 2 reasons

Answer 42

Relative degrees of inhibition of NE and 5-HT Reuptake transporters

Question 43

Which statement on fluoxetine is correct ? * A) Fluoxetine primarily inhibits reuptake of norepinephrine. * B) In contrast to BDZs, clinical actions develop within one hour of administration. * C) Fluoxetine can be used to treat compulsive disorders in dogs and cats. * D) Fluoxetine is the drug of choice for treating phobias.

Answer 43

C

Question 44

a2-adrenergic Agonists examples

Answer 44

Clonidine Dexmedetomidine

Question 45

Alpha-2 (α2) Agonists action

Question 46

What is the key to Alpha-2 (α2) Agonists

Answer 46

Administrator smaller doses for tax behavior so not sedative

Question 47

Clonidine side effects and what not to do

Answer 47

Hypotension Do not use with TCAs

Question 48

why prescribe Dexmedetomidine

Answer 48

Noise aversion