Behaviour Modifying Drugs Flashcards

1
Q

How may personality predisposition and life events lead to ultimate behaviour?

A

Combination of personality (genetic traits, developmental experiences) and life events interpretted in light of innate personality ->
“normal” well adapted with good emotional homeostasis
“abnormal” poorly adapted poor emotional homeostasis

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2
Q

Egs. of life events

A
  • situation of emotional conflict or frustration
  • experiences of threat or fear
  • conditioned contextual associations with anxiety
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3
Q

How do arousal and emotional response interact to give rise to a behavioural outcome?

A

Additive to push arousal over a threshold where behavoiur ocours
- hence why behaviour may be elicited in some situations and not others (d/t initial underlying arousal state)

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4
Q

What are the 2 potential appliactions for drugs?

A
  • anxiety reduction to v baseline levels of arousal

- fear reduction, impulse inhibition or memory suppression to avoid negative life events

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5
Q

When is drug therapy indicated?

A
  • specidic drug indication eg. separation anxeity (LIC clomipramine)
  • if emotion so intense that it is interfering with therapy (intense anxiety, fear or phobia, risk to people or property)
  • animals sufering or distress could be alleviated
  • prognosis improved or improvement speeded up
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6
Q

What are the 3 phases of drug therapy?

A
  • initiation
  • maintainance
  • withdrawal
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7
Q

What can occour during the initiaion phase?

A
  • adverse effects (may predispose/increase aggression)
  • changes in emotionality (may make behaviour unpredictable, increase confidence or disinhibition)
  • delay in onset of main effects can take 4-8 weeks
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8
Q

When is treated maintained until?

A
  • end of period drug is licensed for
  • period of normal behaviour
  • indication that emotional component is less significant and behavioural modification alone will be successful
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9
Q

How should withdrawal be carried out?

A
  • no information on data sheeets but unpleasant side effects welld ocumented in man
  • discontinuationi syndrome with TCA/SRI/SSRI with short t1/2 eg. clomipramine (+ selegeline?)
  • potential for recidivism if drug withdrawn suddenly
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10
Q

General time span for medication

A
  • 6-8months
  • until 6-8 weeks with no signs
  • then decrease by 25% per week
  • for 1 week per month of treatment
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11
Q

Hazards of using medication

A
  • adverse effects
  • therapeutic failure (~60-70% effective tx)
  • disinhibition (benzos, TCA. SRI, SSRIs, acepromazine)
  • excessive confidence and assertiveness (selegeline)
  • owner ocerdependence, poor concurrent behavioural modification
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12
Q

What is selegeline lic for?

A

emotional disorders in dogs

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13
Q

3 classes of drugs?

A

> serotonergic
dopaminergic
GABA ergic

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14
Q

How to SRIs work?

A

> immediate effect
- prevent re-uptake of serotonin at the synapse
- ^ [serotonin] -> moe occupied receptors
- ^ serotonin may ^ anxiety
delayed effect (desired changes in animal behaviour)
- receptor downregulation
- maintainance of ^ [serotonin] with drug withdrawal

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15
Q

What causes most side effects of serotonergic (TCAs/SRIs/SSRIs) drugs

A

mixed antagonism also of other receptors

  • Histamine H1 (weight gain, sedation)
  • Acetyl choline M1 (constipation,d ry mouth, urinary retention)
  • a adrenoceptor (hypotension and sedation)
  • Noradrenaline reuptake inhibition
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16
Q

Eg of TCAs

A

Amitriptyline

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17
Q

Eg of SRIs

A

Clomipramine

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18
Q

Egs of SSRIs

A

Fluoxetine

Sertraline

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19
Q

Eg of SARIs? How should this be given??

A

Trazodone

- in combo with SSRIs

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20
Q

Eg of MAOb inhibitor

A

Selegeline

21
Q

Eg of GABA-ergic drugs

A

Benodiazepines

22
Q

Which drugs are serotonergic?

A

TCAs
SRIs
SSRIs
SARIs

23
Q

Which drugs are dopaminergic

A

MAOb inhibitors

24
Q

How selective is Amytriptaline for serotonin? What is it indicated for use in?

A

SRI:NRI 1:4 (more selective for noradrenaline, ^ no. side effects)

  • anxiety and pain
  • especially good for feline idiopathic cystitis
25
How selective is clomipramine for serotonin? What is it indicated for use in?
SRI:NRI 5:1 (quite serotonin selective, can ^ dose without side effects) - anxiety and compulsion
26
How selective is fluoxetine for serotonin? What is it indicated for use in?
SRI:NRI 15:1 (very seletive!!!) | - anxiety, compulsion, impulsion, aggression
27
Egs of when serotonergic drugs are indicated for use
- compulsive circling (dogs) or kneading (cats d/t poor weaning) - feline hyperaesthesia [clomipramine] - impulse control (when mid-level behaviours are inhibited) [fluoxetine "prozac"] - separation anxeity
28
How selective is sertraline for serotonin? What is it indicated for use in?
SRI:NRI 150:1 (VERY selective! But v range of useful situations for indication)
29
Specific uses of amitriptaline
- feline interstitial cystitis
30
Specific uses of clomipramine
- generalised anxiety - separation anxeity - compulsive disorders - indoor spray marking (cats) - felin hyperaesthesia syndrome
31
Specific uses of fluoxetine
- generalised anxiety - separation anxeity - compulsive disorders - indoor spray marking (cats) - felin hyperaesthesia syndrome - impulsive aggression (eg. owner directed) - frustration related aggression (cats)
32
Specific uses of sertraline
- generalise anxiety | - noise phobias
33
Common adverse effects of serotonergic drugs in man and in general
``` >man - headache - abdo pain - muscular rigidity > general - delirium - hyperthermia - insomnia - v seizure threshold - constipation - photophobia ```
34
Drug specific adverse effects of amitryptaline?
- irritability, agitation, tachydysrhythmia
35
Drug specific adverse effects of TCAs
- corneal drying | - TCAs that are strongly noradrenergic can -> explosive emotional reactions in man
36
What potential drug interactions can happen with serotonergic drugs?
- Amitraz (not used much UK) - Opioids (resp depression) - MAOIs (selegeline) - phenothiazines
37
Specific medical cautions of serotonergic drugs?
- CV Dz (arrythmias) - DIabetes (TCA/SRI drugs hyperglyceamic) - thyroid dz alters metabolism of TCAs - epilepsy - narrow angle glaucoma
38
What is a SARI? Give specific eg.
serotonin receptor agonist and reuptake inhibitor > Trazodone (Trazonil, Desyrel) - published trial as adjunct tx including dogs with noise phobias - NOT LIC - use adjunct if dogs have not responded well to others - risk of serotonin syndrome
39
What should selegeline (MAOI) not be combined with?
SRIs
40
How does selegeline work?
- selective MAO1b inhibitor - has very low levle of MAO1a inhibition - can be given WITHOUT DIETARY REQUIREMEMTS needed for MAO1a drugs - other MAOIs cannot be substituted for selegeline
41
Main effects of selegeline?
- MILD v anxiety - ^ conditionability even in normal animals - ^ exploratory and risk taking behaviour - v FEAR - CARE! NEEDS CONCURRENT BEHAVIOURAL MOD OR CAN BE DANGEROUS
42
What are dopaminergic drugs choice for?
CCD and fear and phobias
43
Adverse effects of dopaminergic drugs
- agitation - GI signs - Drowsiness - man headache,d rowsiness, abdo pain , hallucinations
44
Drug interactions of MAOIs
- TCA/SRI/SSRI - Phenothiazines - potentiates benzos (may be useful??) - pethidine
45
How do benzos work?
- ^ Cl concentration in post synaptic membrane via GABA-A ligand gated ion channel - stabilises membrane and v firing - rapid onset - affect memory
46
Main effects of benzos
- amnesia (anterograde and retrograde) - anxiety reduction - reduced panic - ^ exploratory and risk taking behaviour
47
Adverse effects of benzos
- agitation (inc hyperexcitability esp greyhounds) - ataxia - sedation - amnesia - recidivism - tolerance - disinhibition of aggression
48
Are benzos indicated for long term use?
NO!! | - cannot do behaviour mod at same time as wont learn anything