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Pharmacology > Ch.8 GI Drugs > Flashcards

Ch.8 GI Drugs Flashcards

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1
Q

Underlying causes of GI disease

A

-infectious sources, dietary excess, adverse drug effects, systemic disease

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2
Q

Clinical signs of GI disease

A

diarrhea, constipation, vomiting, bloat, ulcer development, or pain

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3
Q

The term Gi tract describes a long, muscular tube that begins and ends at

A

begins at the mouth and ends at the anus

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4
Q

3 basic control systems that the GI tract is under

A
  1. Autonomic nervous system
    2.GI hormones
  2. Special substances (histamine, serotonin, prostaglandin)
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5
Q

Parasympathetic stimulation _ intestinal motility, _ GI secretions and relaxes sphincters

A

increases

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6
Q

GI hormones that are released from intestinal cells and cause gastric secretion and emptying, as well as emptying of the gallbladder

A

gastrin, secretin, cholecystokinin

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7
Q

vomiting is initiated by activation of the

A

emetic center in the brain

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8
Q

Vomiting impulses

A

Peripheral receptors- irritation,
Cerebral cortex- pain, excitement, fear
CRTZ-disturbances of inner ear, drugs, metabolic conditions

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9
Q

Emetics are drugs that _ _ and are used in the tx of

A

induce vomiting; poisoning and drug overdose

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10
Q

When should vomiting not be induced

A

if caustic substances have been ingested

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11
Q

Who should you always check with before inducing vomiting

A

poison control

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12
Q

_ _ is given if emesis is contraindicated (it absorbs many chemicals and drugs in the upper GI tract)

A

activated charcoal

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13
Q

Emetics can be _ acting (working on the CRTZ) or _ acting (working on receptors locally)

A

centrally; peripherally

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14
Q

Centrally acting emetics

A

Apomorphine- dogs (poorly absorbed PO)
Xylazine- cats

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15
Q

Peripherally acting emetics

A

Ipecac syrup
Home remedies
Hydrogen peroxide 1ml/lb, not for cats due to hemorrhagic gastritis and esophagitis

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16
Q

Antiemetics are drugs that

A

control vomiting, help alleviate discomfort and help control electrolyte balance

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17
Q

Examples of antiemetics

A

-Phenothiazine derivatives
-Antihistamines
-Anticholinergics
-Procainamide derivatives
-Serotonin receptor antagonists
-NK-1 Receptor antagonists

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18
Q

Phenothiazine derivatives used as antiemetics act _: inhibit dopamine receptors in the chemoreceptor trigger zone, thus decreasing the stimulation to vomit

A

centrally

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19
Q

Examples of phenothiazine derivatives and side effects

A

-Chlorpromazine
-Prochlorperazine
-Acepromazine

SE: hypotension and sedation

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20
Q

Antihistamines work as an antiemetic by blocking

A

input from the vestibular system to the CRTZ through H1 blockade

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21
Q

Antihistamines control vomiting when the vomiting is due to

A

motion sickness, vaccine rxns, inner ear problems

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22
Q

Examples of antihistamines used as antiemetics

A

-Dimenhydrinate
-Diphenhydramine
-Meclizine
-Promethazine (phenergan)

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23
Q

procainamide derivatives should not be used in animals with

A

GI obstructions, GI perforation, or GI hemorrhage (metoclopramide)

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24
Q

Serotonin receptor antagonists work on the theory that some

A

chemicals cause vomiting because they increase serotonin release from small intestinal cells (ondansetron aka zofran)

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25
Maropitant citrate (cerenia) is used to prevent _ _ and _ _
acute vomiting and motion sickness
26
Side effects of Maropitant citrate (cerenia)
pain at injection site, anorexia, hyper salivation, and diarrhea
27
Gastric ulceration may occur as a side effect of which drugs
NSAIDS, corticosteriods
28
Clinical signs of gastric ulceration
hematemesis, pain melena
29
Tx of gastric ulcers will decrease _ and control _
acid; CS
30
Antiulcer drug categories
-Histamine 2 receptor antagonists -Proton pump inhibitors -Antacids -Mucosal protective drugs -Prostaglandin analogs
31
Histamine-2 receptor antagonists prevent acid reflux by
competitively blocking the H2 receptors of the parietal cells in the stomach, thus reducing gastric secretion
32
examples of histamine-2 receptor antagonists as anti ulcer drugs
Cimetidine (Tagamet) Ranitidine (Zantac) Famotidine (Pepcid)
33
Proton pump inhibitors as anti ulcer drugs inhibits ion transport into the stomach so that it cannot
secrete HCI
34
Examples of proton pump inhibitors
Omeprazole (Prilosec) Lansoprazole (Prevacid)
35
Antacids promote ulcer healing by
neutralizing HCI
36
Why must antacids be given within 1-2 hours of other medications?
they interact with other drugs (may inhibit their absorption)
37
Examples of antacids
-aluminum/ magnesium hydroxide -magnesium hydroxide -calcium carbonate
38
Mucosal protective drugs combine with protein to form an adherent substance that covers the
ulcers and protects it from stomach acid and pepsin (ex: sucralfate)
39
Mucosal protective drugs must be given 30min-1 hour _ H2 antagonists
before
40
What do prostaglandin analogs do
suppress gastric secretions and increase mucus production in the GI tract (ex: misoprostol, which is usually given to animals taking NSAID)
41
Antidiarrheals are drugs that
decrease peristalsis, thereby allowing fluid absorption from the intestinal contents
42
Examples of antidiarrheals
-Narcotics -Anticholinergics -Protectants/absorbents -Probiotics -Metronidazole
43
Opiate-related agents control diarrhea by
decreasing both intestinal secretions and the flow of feces and increasing segmental contractions
44
Examples of opiate related agents
Diphenoxylate (lomotil) Loperamide (lmodium) Paregoric/ kaolin/ pectin (parepectolin)
45
Side effects of opiate related agents as antidiarrheals
CNS depression, ileus, urine retention, bloat, constipation
46
What do protectants/ absorbents do
coat inflamed intestinal mucosa w/ a protective layer (protectants) or bind bacteria and/or digestive enzymes and/or toxins to protect intestinal mucosa from damaging effects (absorbents)
47
Examples of protectants/absorbents
Bismuth subsalicylate (caution in cats) Kaolin/pectin Activated charcoal Toxiban
48
Side effects of protectants/absorbents
constipation, dark stool
49
Probiotics seed the GI tract with beneficial _; use is based on the theory that some forms of diarrhea are caused by disruption of the normal bacterial flora of the GI tract
bacteria
50
Examples of probiotics
plain yogurt w/ active cultures variety of trade-name products
51
A theory regarding the development of diarrhea is that _ bacteria may increase due to disruption of normal GI flora
anaerobic (metronidazole is an example of an antibiotic used to tx diarrhea)
52
What do laxatives do
loosen bowel contents and encourages evacuation of stool
53
Saline/Hyper-osmotic laxatives pull water into the colon and increase water content in the feces, thereby increasing
bulk and stimulating peristalsis
54
Saline/Hyper-osmotic laxatives are salts or saline which may cause
electrolyte imbalances if absorbed systemically
55
Examples of saline/hyper-osmotic laxatives and side effects
-lactulose -sodium phosphate w/ sodium biphosphate -magnesium sulfate -magnesium hydroxide SE: cramping, vomiting, electrolyte imbalances (esp. cats)
56
Stimulant/irritants increase peristalsis by
chemically irritating sensory nerve endings in the intestinal mucosa
57
Examples of stimulant/irritants as laxatives
bisacodyl (dulcolax) castor oil
58
Bulk-forming laxatives absorb water into the intestine, increase fecal bulk, and stimulate peristalsis, resulting in
large, soft stool production (which tends to look normal)
59
Examples of bulk-forming laxatives
Metamucil, psylliums, bran
60
Emollients/Surfactants/Stool softeners reduce surface tension and allow
water to penetrate the GI contents, softening stool
61
Emollients/Surfactants/Stool softeners can be
stool softeners, lubricants, fecal wetting agents
62
Examples of Emollients/Surfactants/Stool softeners
decusate sodium, decusate calcium, decusate potassium, petroleum products
63
Phosphate enemas should not be used in
cats or puppies bc of the potential to cause electrolyte abnormalites
64
Lubricants typically oils that
soften fecal mass to make it easier to move through the GI tract (ex: mineral oil, laxatone)
65
Prokinetic agents increase
motility of parts of the GI tract to enhance movement of material through it
66
Dopaminergic agents stimulate
gastroesphogeal sphincter, stomach, and intestinal (ex: metoclopramide and domperidone)
67
Serotonergic agents stimulate
motility of gastroesphogeal sphincter, stomach, small intestine, and colon (ex: cisapride)
68
Bloody diarrhea may warrant _ use
antibiotic
69
Most commonly used antibiotic for GI disease is
metronidazole
70
Why are antibiotics not routinely used for GI issues
cause damage to normal flora
71
Anti-inflammatory agents that may be used for immune mediated disease/ inflammatory bowel disease
Prednisone/Prednisolone Azathioprine Sulfasalazine
72
Antifoaming drugs are used in ruminants whose rumens are subject to
acute frothy bloat
73
Antifoaming agents examples
poloxalene and polymerized methyl silicone
74
Pancreatic enzymes must be supplemented in the diet when the
pancreas is not function properly (as in pancreatic exocrine insufficiency)
75
Pancrealipase contains:
primarily lipase but also contains amylase and protease
76
Enzyme supplements can be irritating to the
skin on contact and to nasal passages upon inhalation
77
Serotonin antagonist antihistamines promote appetite by
inhibition at the serotoninergic receptors which control satiety SE: sedation and dry mouth Ex: cyproheptadine
78
Benzodiazepines are effective appetite stimulants in _ but not _
cats; dogs SE:sedation and ataxia Ex: Diazepam
79
Tetracyclic antidepressants stimulate appetite by antagonizing
alpha2 receptors SE: sedation, vocalization Ex: Mirtazipine

Pharmacology (17 decks)

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