Pharmacological Approaches to Behavior Problems
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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
Are the drugs we use for behavior problems in animals mostly human drugs?
Do we need to wean the patient off behavior drugs slowly?
yes, don't just stop them cold turkey
Do behavior drugs take time to work?
yes, and make sure the client understands this
Can the behavior problem return once we stop the drug therapy?
What is the main neurotransmitter?
What do most behavior drugs affect in the body?
How do antihistamines affect behavior and when would we use them?
- used as a mild sedative
- pacing, overactive at night, car travel, pruritis, ALD
Do antihistamines have some anticholinergic effects? Why is this important to know?
- can cause dry mouth, make sure client is aware of this
What are the different antihistamines we can use?
- diphenhydramine (Benadryl)
What are the contraindications for the use of antihistamines?
What do tranquilizers do?
decrease the response to external stimuli
Do tranquilizers have significant side effects?
What are the two main tranquilizers?
- phenothiazines (ace)
- benzodiazepines (diazepam)
How do tranquilizers interfer with training?
because training is an external stimuli and tranquilizers decrease the response to external stimuli
Out of the two tranquilizers (phenothiazines and benzodiazepines) which one is better for treating behavior?
Should phenothiazines be used short term or long term, why?
- short term
- can have problems if used long term
What are some problems that can occur if phenothiazines are used long term?
- cardiovascular disturbances
- decreased blood pressure
- potentiate seizures
What phenothiazines be paired with?
What are anxiolytics?
drugs that help with anxiety
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
What do benzodiazepines do at low doses?
- good for daytime activity
What do benzodiazepines do at moderate doses?
- improve social interactions
What do benzodiazepines do at high doses?
hypnotics (makes animals go to sleep)
What is the onset time for benzodiazepines?
30 - 60 minutes
What are the different types of benzodiazepines?
- diazepam (valium)
- alprazolam (xanax)
- oxazepam (serax)
- chlorazepate dipotassium (tranxene)
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)
What are the uses for benzodiazepines?
- anxiety, fear phobias
- feline spraying
- intercat aggression
- cat appetite stimulation
Benzodiazepines are a schedule _____ drug.
How often should we give benzodiazepines?
What is the most common side effect in benzodiazepines?
How do we wean a patient of benzodiazepines?
decrease 25% per week
What are progestins used for?
- lick granulomas
- to stop and animal from going into heat
What kind of effect does progestins have?
do we use progestins much today? Why?
What are the different progestins?
What are the side effects of using progestins?
- mammary hyperplasia/adnoid carinoma
- endometrial hyperplasia
- PP (polyphagic - eating everything)
- marrow suppression
What do tricyclic antidepressants do?
block serotonin and norepinephrine reuptake
How long may it take for tricyclic antidepressants to work?
3 - 4 weeks
What will happen if we don't taper the patient off of tricyclic antidepressants?
Are tricyclic antidepressants relatively safe?
What are some different tricyclic antidepressants?
- clomipramine (clomicalm and anafranil)
- amitriptyline (elavil)
- imipramine (tofranil)
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)
Which animal is more sensitive to tricyclic antidepressants and are not approved for this animal?
What can tricyclic antidepressants do to cats?
can see some cardiac signs
What are the side effects of tricyclic antidepressants?
- dry mouth
- urine retention
- arrhythmias (mainly in cats)
What are SSRIs?
selective serotonin reuptake inhibitors (increase serotonin levels)
What are the different types of SSRIs?
- fluoxetine (reconcile, prozac) - approved for separation anxiety in dogs
- paroxetine (paxil)
- sertraline (zoloft)
How long do SSRIs need to be used before they start working completely?
7 - 30 days
What are some contraindications for the use of SSRIs?
- MAOIs (modamine oxidace inhibitor)
What are SSRIs used for in animals?
- canine aggression
- inapproriate eliminiation
What can we see when we start using SSRIs?
may see initial sedation
Who should we avoid SSRIs in?
What can SSRIs affect?
- may see GI side effects
What are nonspecific anxiolytics?
stimulates receptor uptake of serotonin
What are some nonspecific anxiolytics?
Do we see sedation with anxiolytics?
What do we use buspirone in?
- canine aggression
- feline spraying
- thunderstorm phobias
How often do we give buspirone?
short half life so we need to give it 3 times a day
What are some side effects of nonspecific anxiolytics (buspirone)?
What are some different narcotic antagonists?
- naloxine (narcan)
- pentazocine (talwin - v)
- naltexone (trexan)
What are narcotic antagonists used to treat?
What is the main side effect of narcotic antagonists?
may suppress appetite
What is selegiline (anipryl) used to treat?
canine cognitive dysfunction
What is selegiline?
MAO inhibitor - increases brain oxygenation, increases dopamine
What kind of drugs should we be careful mixing with selegiline?
drugs that activate MAO
What are alternatives to drug therapy?
homeopathic drugs but not approved by the FDA
What do homeopathic drugs affect?
Can we use homeopathic drugs with other drugs?
What are some examples of homeopathic drugs?
- melatonin - used in separation anxiety and other phobias
- flower essence - calming effect
- compusure liquid
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