Neuro pharm Flashcards
How is it better to start dosing neuro meds?
Better to start at the lower end of dosage range and gradually increase
3 types of Types of Psychoactive Meds
Anxiolytics
Antipsychotics
Antidepressant
2 types of Anxiolytics
look at word (anxiety lysis)
Benzodiazepines (BDZs)
Azapirones
Name 3 of the BENZODIAZEPINES (BDZs) anxiolytics
Diazepam
Alprazolam
Lorazepam, Clonazepam, Oxazepam
Name the one AZAPIRONES anxiolytic?
Buspirone
How do Benzo anxiolytics work
Enhance ability of GABA to open receptor channel
* BDZs alone can not open GABA receptor channel
6 things to treat with BDZ’s
Anxiety
Anticonvulsant
Muscle relaxation
Neuroleptanalgesia
Enhance appetite
Inappropriate elimination
- Neuroleptanalgesia is
State of quiescence, analgesia and altered awareness
BDZ contraindication
Do not use to treat aggression
Disinhibit aggression tendencies
Exception to the BDZ contraindication rule
BDZ given in advance of an event that generates fear may cause fear related aggression
When are BDZ good alone?
When are they not?
?
BDZ dosing
Class IV controlled
IV oral rectal
1 hr to effect
last different in species
need to withdraw slow
Some BDZ side effects
Sedation
Dependence
Hepatic necrosis in cats
Interfere with learning
Severe reaction in cats after repeat doing of diazepam?
Hepatic necrosis
Azapirone Anxiolytics* Buspirone Indications
Anxiety
Inappropriate elimination
Aggression in dogs
What does buspirone typically not do?
Produce sedation, memory impairment, or bite disinhibition
Mechanism for action buspirone
- 5-HT1A autoreceptor agonist.
Partial agonist pre& postsynaptically
*Antagonist at D2 receptors.
Dosing of buspirone
Takes long time to effect 8-12 hours
needs to build up so weeks to notice effects
Side effects buspirone
Few side effects: ataxia, friendlier cats.
* contrast to BDZ no withdrawal /dependence effects,
less abuse potential
Buspirone Indications in dogs? cats?
Dogs: Anxiety
Cats: Feline urination spraying, Anxiety, aggression
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.
D
Antipsychotics examples
Acepromazine
Chlorpromazine
Phenothiazine Tranquilizers Produce a
neuroleptic state:
What is a neuroleptic state:
Blunting of normal and abnormal behavior
Mechanism of Action & Pharmacokinetics phenothiazine tranq
Dopamine (D2) receptor antagonist
How long to act and how long to work phenothiazine tranq
Onset of effect ~ 1 hr.
* Effects last 4-24 hrs.
Phenothiazines short or long term?
why?
Not intended for long term use
Does not change underlying chemical disturbances
Phenothiazine Side/Adverse Effects
Sedation
Hypotension
May inhibit learning
Extrapyramidal effects
Extrapyramidal effects of phenithiazione
Pseudoparkinsonism, motor restlessness, dystonia
3 types anti depressants
TCAs
SSRIs
MAOIs
Main effect of antidepressants
Main effects are to ↑ synaptic 5-HT +/- NE
Examples of Tricyclic Antidepressants TCA
Amitriptyline • Clomipramine
– Clomicalm ® labeled for
separation anxiety in dogs
• Nortriptyline
• Desipramine
• Imipramine
• Doxepin
TCA: Indications
Mild aggressions
Compulsive disorders
Inappropriate elimination
TCA how long to work
2-4 weeks
TCA Side/Adverse Effects
Sedation
Vomiting
Dry mouth
Tachycardia or arrhythmias
T/F It is easier to OD on TCA
True
Contraindications to TCA
Glaucoma or Keratoconjunctivitis Sicca
Selective Serotonin Reuptake Inhibitors (SSRI) examples
Fluoxetine
Sertraline
Paroxetine
SSRI mechanism & why
Mechanism * Inhibits 5-HT reuptake by transporters
minimal NE effects
safer with less side effects d/t this
still takes weeks to see effect
SSRIs : Indications
Aggressions
Separation anxiety
Thunderstorms phobia
Compulsive disorders
SSRIs: Kinetics, Side Effects
Longer 1/2 life than TCAs
Side effects: Lethargy
– Diminished appetite
– GI disturbances
Why Do SSRIs Have Less Side/Adverse Effects Than TCAs?
2 reasons
Relative degrees of inhibition of NE and 5-HT Reuptake transporters
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.
C
a2-adrenergic Agonists examples
Clonidine
Dexmedetomidine
Alpha-2 (α2) Agonists action
What is the key to Alpha-2 (α2) Agonists
Administrator smaller doses for tax behavior so not sedative
Clonidine side effects and what not to do
Hypotension
Do not use with TCAs
why prescribe Dexmedetomidine
Noise aversion
