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#Sedation
 
#Sedation
 
#Central and peripheral anticholinergic action
 
#Central and peripheral anticholinergic action
#Presynaptic blocking of CNS biogenic amines such as noradrenaline and serotonin (5-HT) and therefore their potentiation <ref name="Overall">Overall, K.L., 2004. Paradigms for pharmacologic use as a treatment component in feline behavioral medicine. Journal of Feline Medicine and Surgery 6, 29-42.</ref>.
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#Presynaptic blocking of CNS biogenic amines such as noradrenaline and serotonin (5-HT) and therefore their potentiation <ref name="Overall1">Overall, K.L., 2004. Paradigms for pharmacologic use as a treatment component in feline behavioral medicine. Journal of Feline Medicine and Surgery 6, 29-42.</ref>.
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The blocking ratio indicates the relative effect of the agent on reuptake of 5-HT vs. noradrenaline. Fluoxetine is 3 times more selective for 5-HT than clomipramine. Clomipramine is the only TCA that whose ratio favours 5-HT reuptake inhibition, and hence its title of non-selective serotonin reuptake inhibitor (SRI).
 
The blocking ratio indicates the relative effect of the agent on reuptake of 5-HT vs. noradrenaline. Fluoxetine is 3 times more selective for 5-HT than clomipramine. Clomipramine is the only TCA that whose ratio favours 5-HT reuptake inhibition, and hence its title of non-selective serotonin reuptake inhibitor (SRI).
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In cases where animals experience sedation or other unwanted side effects awareness of the intermediate metabolites can be essential. This is because when treated with the intermediate compound on its own animals may respond better, with fewer adverse side effects. <ref name="Overall"/ >
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In cases where animals experience sedation or other unwanted side effects awareness of the intermediate metabolites can be essential. This is because when treated with the intermediate compound on its own animals may respond better, with fewer adverse side effects<ref name="Overall1" />.
    
==Use==
 
==Use==
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*Impaired liver function (TCAs metabolised by liver)
 
*Impaired liver function (TCAs metabolised by liver)
 
*Hyperthyroidism (enhanced response to TCAs)
 
*Hyperthyroidism (enhanced response to TCAs)
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*Urinary retention <ref name="Overall2">Overall, K.L. Pharmacological Treatment in Behavioural Medicine: The Importance of Neurochemistry, Molecular Biology and Mechanistic Hypotheses. The Veterinary Journal 2001, 162, 9-23</ref>.
    
'''Care should be taken if used in conjunction with any of the following drugs, which may interact and cause adverse effects:'''
 
'''Care should be taken if used in conjunction with any of the following drugs, which may interact and cause adverse effects:'''
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*SSRIs: Fluoxetine inhibits Cytochrome p450, leading to toxic levels of TCA. Cimetidine also has this effect.
 
*SSRIs: Fluoxetine inhibits Cytochrome p450, leading to toxic levels of TCA. Cimetidine also has this effect.
 
*Fibre rich diets reduce availability of TCAs.
 
*Fibre rich diets reduce availability of TCAs.
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*Thyroid medications: can interfere, therefore if simultaneously used must be carefully monitored <ref name="Overall2"/ >
    
If the drug is overdosed/combined with an inappropriate drug (see above) an increased sedation and degree of adverse effects as listed will be seen. If the drug dose is persistently high or the drug is combined with an MAOI, serotonin syndrome is a possible consequence:
 
If the drug is overdosed/combined with an inappropriate drug (see above) an increased sedation and degree of adverse effects as listed will be seen. If the drug dose is persistently high or the drug is combined with an MAOI, serotonin syndrome is a possible consequence:
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==References==
 
==References==
 
<references/>
 
<references/>
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{{unfinished}}
 
{{unfinished}}
 
[[Category:To Do - Behaviour GGP]]
 
[[Category:To Do - Behaviour GGP]]

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