Week 7 - Behavior Modifying Drugs - Part 1 Flashcards
The only two FDA-approved drugs used in veterinary medicine for _____ only.
▪ “Reconcile” (_______) for dogs with separation _____
▪ “Clomicalm” (______) for dogs w/ separation ____
▪ “Anipryl” (______ or ___-_____) for canine _____ dysfunction
▪ “Sileo” (_______ transmucosal gel) for dogs w/ ____ aversion
dogs, fluoxetine, anxiety, clomipramine, anxiety, Selegiline, L-deprenyl, cognitive, dexmedetomidine, noise
What does FDA approved mean? Approved by the food and drug administration. Very long process and expensive.
Most psycho-active drugs we use are extra-labeled b/c cheaper.
Why is it important that we communicate with our clients if the drug we are used are Extra-label ?
(most psychoactives used)
▪ VCPR
▪ Veterinarian - why not using FDA-approved choice
▪ Inform client and consent
Why use psycychotropics in vet med?
▪ Reduce underlying emotional _____ (?) that contributes to ______ behaviors.
▪ Almost always an ______ to behavioral modification. Don’t just prescribe a drug to a patient without addressing a behavior.
▪ ___/_____ interferes with learning or other
normal behaviors
▪ Reduce ____ → better learning
▪ Improve ____ of life for pet AND owner
arousal, fear,
anxiety, stress, undesirable, ADJUNCT, Fear, anxiety, FAS, quality
Mental health is important for… _____
WELFARE
Mental state = green box
Four feeds into the five
Affective states = green box
When to use psychotropics
▪ _____
▪ After rule-out of _____ medical causes/etiology
▪ After thorough behavior history → _____ diagnosis
▪ AWB recall: _____ description of behaviors
▪ _____ / ____ with behavioral modification
▪ AWB recall: counter-conditioning, systematic
desensitization, positive reinforcement, etc.
VCPR (veterinary client patient relationship), underlying, behavioral, OBJECTIVE, ADJUNCT, COMBO
List the Biogenic amine transmitters/ neurotransmitters?
- Serotonin (see L12, L16; more now)
- Dopamine (see L16)
- Norepinephrine (see L14, 17 and Physio)
- Acetylcholine (L12 and Physio)
List the Amino acid neurotransmitters
- GABA (gaba-aminobutyric acid) (L14, 15)
- Glutamate (L13)
Serotonin aka ?
▪ In CNS – regulates ?
▪only __-___% in brain; most in ___ nervous system
5-HT or 5-Hydroxytryptamine, mood, appetite, sleep, and some cognitive functions, 1-2, enteric
_______ ______ → 5-hydroxytryptamine
(serotonin)
Dietary tryptophan
At rest, serotonin stored in vesicles of _______ neurons
▪ Stimulation → serotonin released into
synapses → binds to _______ receptor
→ activation
presynaptic, postsynaptic
Action of serotonin ends _____ high-affinity reuptake of serotonin into presynaptic
terminal – by ?
d/t serotonin transporter (SERTs)
proteins
2 Major Categories
1. ___-term or “_____” for chronic use
▪ Takes _____ to take effect
2. ___-term or “____” medication for acute use
▪ ______ events
▪ ____ onset, last for ___ # of hours
▪ Sometimes daily as ______/____-therapy.
A few of the short-term meds can also be used ____-term but not the first choice use for long term.
Long, Daily, weeks, Short, Event, Stressful, Quick, set, multimodal, poly, long
Indications for long-term (daily)
▪ ________ anxiety
▪ ____ behavior leading to ____ aggression
▪ _____-____ conflict
▪ ______ anxiety
▪ ______ _____ Syndrome
▪ ____ marking (vertical) in cats
▪ _____ related house soiling
▪ _____ behaviors (Compulsive
disorders, e.g., spinning, licking, fly-biting, etc)
Generalized, Fearful, potential, Inter-pet, Separation, Cognitive Dysfunction, Urine, Stress, Repetitive
List the Common classes: Long-term psychoactives
- Selective serotonin reuptake inhibitors (SSRIs)
▪ Fluoxetine, Paroxetine, Sertraline - Tricyclic antidepressants (TCAs)
▪ Clomipramine, amitriptyline - Azapirones (Serotonergic)
▪ Buspirone - Monoamine oxidase inhibitors (MAOIs)
▪ Selegiline - Selective serotonin/norepinephrine reuptake inhibitors (SNRIs)
▪ Venlafaxine (not commonly used; not discussed)
ALL of the drugs that will be discussed in this section of long-term psychotropic
medications are ORALLY administered
List three examples of SSRI’s used for behavior modification.
1. Who are these drugs most commonly used by?
2. Preferable due to _____
and ___ side effects
(transitory)
Fluoxetine, Paroxetine, Sertraline
1. Most commonly used by behaviorist
2. efficacy, few
SSRIs
Mechanism of action: _____ reuptake of
serotonin by blocking ____ transporter
(SERT) for serotonin →
serotonin molecules act for _____ periods of time = _____ in serotonergic
neuro-transmission
Inhibits, reuptake, longer, INCREASE
SSRI’s initial actions
Initially: serotonin
floods ___ of its
receptors b/c reuptake
is _____; different
subtype serotonin
receptors get saturated
→ leading to ___ ____
ALL, blocked, side, effects
SSRI actions
▪ Most receptors
downregulate over __-___ weeks → side effects ____
▪ BUT _____
auto receptor does
NOT down regulate
as much; becomes ___ active with
time → therapeutic
effect
4- 6, wane, Postsynaptic, MORE
SSRI actions
▪ Takes __-___ weeks to work
▪ Once the presynaptic
serotonin autoreceptor is
activated → _____ _____ synthesis and _____ release from the
axon
▪ So have to wait for ______ of serotonin autoreceptor which takes _____ weeks.
3-6, inhibits, serotonin, decreases, desensitization, several
SSRI Clinical Overview
▪ Classified as ______
▪ Other properties: (3)?
▪ Common, preferred, selective
Uses / Indications:
▪ _______ ____ disorders
▪ ______ ____ or
repetitive/stereotypic behaviors
▪ Urine ___
▪ Some _____ behaviors (caution:
assess, safety, etc.)
▪ In conjunction w b-mod and can be used w acute/event drugs
antidepressant, anxiolytic, anti-compulsive, some anti-aggression, Generalized anxiety, Obsessive compulsive, marking, aggressive
SSRI Efficacy onset:
▪ Onset of improvement is ___: takes _-__ weeks
▪ Response can’t be evaluated until at least __ month
▪ Can NOT be used “___ _____”
→ INEFFECTIVE
slow, 3-6, 1, as needed
