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Flashcards in Behaviour Modifying Drugs Deck (48):
1

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

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

2

Egs. of life events

- situation of emotional conflict or frustration
- experiences of threat or fear
- conditioned contextual associations with anxiety

3

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

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)

4

What are the 2 potential appliactions for drugs?

- anxiety reduction to v baseline levels of arousal
- fear reduction, impulse inhibition or memory suppression to avoid negative life events

5

When is drug therapy indicated?

- 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

6

What are the 3 phases of drug therapy?

- initiation
- maintainance
- withdrawal

7

What can occour during the initiaion phase?

- 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

8

When is treated maintained until?

- 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

9

How should withdrawal be carried out?

- 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- potential for recidivism if drug withdrawn suddenly

10

General time span for medication

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

11

Hazards of using medication

- 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

12

What is selegeline lic for?

emotional disorders in dogs

13

3 classes of drugs?

> serotonergic
> dopaminergic
> GABA ergic

14

How to SRIs work?

> 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

15

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

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

16

Eg of TCAs

Amitriptyline

17

Eg of SRIs

Clomipramine

18

Egs of SSRIs

Fluoxetine
Sertraline

19

Eg of SARIs? How should this be given??

Trazodone
- in combo with SSRIs

20

Eg of MAOb inhibitor

Selegeline

21

Eg of GABA-ergic drugs

Benodiazepines

22

Which drugs are serotonergic?

TCAs
SRIs
SSRIs
SARIs

23

Which drugs are dopaminergic

MAOb inhibitors

24

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

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