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What do we need to know in order to prescribe the correct drugs for a behavior problem?
- medical and behavioral history
- lab testing to make sure blood values are normal
- client understanding and compliance
- feedback from the client (are they giving the medication like they should and is it working)
- follow ups and re-exams
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Are the drugs we use for behavior problems in animals mostly human drugs?
yes
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Do we need to wean the patient off behavior drugs slowly?
yes, don't just stop them cold turkey
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Do behavior drugs take time to work?
yes, and make sure the client understands this
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Can the behavior problem return once we stop the drug therapy?
potentially
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What is the main neurotransmitter?
serotonin
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What do most behavior drugs affect in the body?
neurotransmitters
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How do antihistamines affect behavior and when would we use them?
- used as a mild sedative
- pacing, overactive at night, car travel, pruritis, ALD
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Do antihistamines have some anticholinergic effects? Why is this important to know?
- yes
- can cause dry mouth, make sure client is aware of this
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What are the different antihistamines we can use?
- diphenhydramine (Benadryl)
- chlorpheniramine
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What are the contraindications for the use of antihistamines?
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What do tranquilizers do?
decrease the response to external stimuli
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Do tranquilizers have significant side effects?
yes
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What are the two main tranquilizers?
- phenothiazines (ace)
- benzodiazepines (diazepam)
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How do tranquilizers interfer with training?
because training is an external stimuli and tranquilizers decrease the response to external stimuli
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Out of the two tranquilizers (phenothiazines and benzodiazepines) which one is better for treating behavior?
benzodiazepine (diazepam)
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Should phenothiazines be used short term or long term, why?
- short term
- can have problems if used long term
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What are some problems that can occur if phenothiazines are used long term?
- cardiovascular disturbances
- decreased blood pressure
- ataxia
- sedation
- tremors
- potentiate seizures
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What phenothiazines be paired with?
anxiolytics
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What are anxiolytics?
drugs that help with anxiety
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What types of animals should we avoid using phenothiazines in? Why?
animals that should aggression because phenothiazines are more reactive and cause the patient to startle easily
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What do benzodiazepines do at low doses?
- sedatives
- good for daytime activity
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What do benzodiazepines do at moderate doses?
- antianxiety
- improve social interactions
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What do benzodiazepines do at high doses?
hypnotics (makes animals go to sleep)
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What is the onset time for benzodiazepines?
30 - 60 minutes
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What are the different types of benzodiazepines?
- diazepam (valium)
- alprazolam (xanax)
- oxazepam (serax)
- chlorazepate dipotassium (tranxene)
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What do benzodiazepines do?
- facilitate GABA (inhibitor neurotrasmitter int he brain) activity in the CNS
- activity in hypothalamus and limbic system (affect vigilence, anxiety, muscle tension, memory, and epiletogenic activity)
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What are the uses for benzodiazepines?
- anxiety, fear phobias
- feline spraying
- intercat aggression
- cat appetite stimulation
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Benzodiazepines are a schedule _____ drug.
IV
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How often should we give benzodiazepines?
BID
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What is the most common side effect in benzodiazepines?
sedation
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How do we wean a patient of benzodiazepines?
decrease 25% per week
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What are progestins used for?
- spraying
- aggression
- lick granulomas
- mounting
- to stop and animal from going into heat
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What kind of effect does progestins have?
calming effect
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do we use progestins much today? Why?
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What are the different progestins?
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What are the side effects of using progestins?
- diabetes
- mammary hyperplasia/adnoid carinoma
- endometrial hyperplasia
- pyometra
- PU
- PD
- PP (polyphagic - eating everything)
- marrow suppression
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What do tricyclic antidepressants do?
block serotonin and norepinephrine reuptake
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How long may it take for tricyclic antidepressants to work?
3 - 4 weeks
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What will happen if we don't taper the patient off of tricyclic antidepressants?
rebound
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Are tricyclic antidepressants relatively safe?
yes
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What are some different tricyclic antidepressants?
- clomipramine (clomicalm and anafranil)
- amitriptyline (elavil)
- imipramine (tofranil)
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What are tricyclic antidepressants used for in animals?
- separation anxiety
- generalized anxiety (being nervous all the time)
- compulsive grooming
- acral lick dermatitis (ALD)
- compulsive behaviors (OCDs)
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Which animal is more sensitive to tricyclic antidepressants and are not approved for this animal?
cats
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What can tricyclic antidepressants do to cats?
can see some cardiac signs
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What are the side effects of tricyclic antidepressants?
- dry mouth
- sedation
- vomiting
- constipation
- urine retention
- arrhythmias (mainly in cats)
- ataxia
- anorexia
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What are SSRIs?
selective serotonin reuptake inhibitors (increase serotonin levels)
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What are the different types of SSRIs?
- fluoxetine (reconcile, prozac) - approved for separation anxiety in dogs
- paroxetine (paxil)
- sertraline (zoloft)
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How long do SSRIs need to be used before they start working completely?
7 - 30 days
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What are some contraindications for the use of SSRIs?
- diabetes
- MAOIs (modamine oxidace inhibitor)
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What are SSRIs used for in animals?
- canine aggression
- OCDs
- inapproriate eliminiation
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What can we see when we start using SSRIs?
may see initial sedation
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Who should we avoid SSRIs in?
panic/avoidance disorders
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What can SSRIs affect?
- appetite
- may see GI side effects
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What are nonspecific anxiolytics?
stimulates receptor uptake of serotonin
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What are some nonspecific anxiolytics?
buspirone (buspar)
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Do we see sedation with anxiolytics?
no
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What do we use buspirone in?
- canine aggression
- OCDs
- feline spraying
- thunderstorm phobias
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How often do we give buspirone?
short half life so we need to give it 3 times a day
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What are some side effects of nonspecific anxiolytics (buspirone)?
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What are some different narcotic antagonists?
- naloxine (narcan)
- pentazocine (talwin - v)
- naltexone (trexan)
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What are narcotic antagonists used to treat?
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What is the main side effect of narcotic antagonists?
may suppress appetite
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What is selegiline (anipryl) used to treat?
canine cognitive dysfunction
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What is selegiline?
MAO inhibitor - increases brain oxygenation, increases dopamine
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What kind of drugs should we be careful mixing with selegiline?
drugs that activate MAO
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What are alternatives to drug therapy?
homeopathic drugs but not approved by the FDA
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What do homeopathic drugs affect?
CNS
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Can we use homeopathic drugs with other drugs?
yes
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What are some examples of homeopathic drugs?
- melatonin - used in separation anxiety and other phobias
- flower essence - calming effect
- pheromones
- compusure liquid
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