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End for Exam 2 (GI drugs) Flashcards

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1
Q

what are the basic functions of the GIT? (3)

A
  1. Transport food
  2. Secrete digestive enzymes
  3. Absorb nutrients
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2
Q

what are the factors that influence the GIT? (4)

A
  1. Parasympathetic and sympathetic nervous systems
  2. Prostaglandin E
  3. Hydrochloric acid (HCl) production in the stomach
  4. Irritating compounds and bacterial toxins
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3
Q

where is prostaglandin E produced?

A

GI cells

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4
Q

what is the function of prostaglandin E? (4)

A
  1. inc. intestinal mucus production
  2. dec. HCl acid secretion
  3. inc. intestinal motility
  4. inc. blood supply to GI tract
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5
Q

where is hydrochloric acid (HCI) produce?

A

parietal cells in the GIT

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6
Q

what stimulates the parietal cells to produce hydrochloric acid (HCI)? (3)

A
  1. Histamine
  2. Gastrin
  3. Acetylcholine
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7
Q

Diarrhea

A

abnormally frequent discharge of fecal matter of increased volume and fluid content

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8
Q

what are some causes of diarrhea? (4)

A
  1. Maldigestion or malabsorption of food
  2. Hypersecretion of intestinal fluid
  3. Increased permeability of intestinal mucosal blood vessels
  4. increased intestinal motility
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9
Q

what can cause hypersecretion in the GIT?

A

bacterial infection

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10
Q

what can cause increased permeability?

A

Caused by inflammation

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11
Q

what can cause inflammation in the GIT?

A

IBD or parasite

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12
Q

what can cause an increase of Intestinal motility?

A

toxins and any type of irritation

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13
Q

what are most antidiarrheal drugs used to treat?

A

symptom but not the primary cause of the diarrhea

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14
Q

what the categorites of antidiarrheals? (2)

A
  1. modify intestinal motility

2. act as adsorbents and/or protectants

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15
Q

how do antidiarrheals that modify intestinal motility work?

A

slow movement of bowel contents

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16
Q

what kind of antidiarrheals modify intestinal motility? (2)

A
  1. opioid analgesics

2. anticholinergics

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17
Q

why are opioid analgesics and anticholinergics not frequently used?

A

a large proportion of diarrheas in small animals involve decreased motility

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18
Q

what kind of antidiarrheals act as adsorbents and/or protectants? (3)

A
  1. activated charcoal
  2. kaolin and pectin
  3. bismuth subsalicylate
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19
Q

what are some examples of opiod analgesics antidiarrheals? (3)

A
  1. diphenoxylate (Lomotil)
  2. paregoric (tincture of opium)
  3. loperamide (Imodium)
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20
Q

what class of drugs are opiod analgesics antidiarrheals?

A

Controlled drugs

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21
Q

what is the concerns with using opiod analgesics antidiarrheals?

A

Increase contact time between toxins and mucosa

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22
Q

what is a benefit to using opiod analgesics antidiarrheals?

A

Mask pain associated w/ disease

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23
Q

How do opiod analgesics antidiarrheals work?

A

Increase segmental contrations

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24
Q

how ca Increase segmental contrations Help?

A

work as a trap to keep digesta in intestinal tract longer to hep absorption of water.

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25
How do anticholinergics work as an antidiarrheal?
Block the effect of acetylcholine
26
why are anticholinergics not commonly used as an antidiarrheal in small animals?
In small animals increased motility is not a common cause of diarrhea
27
what are some example of anticholinergics? (3)
1. atropine 2. isopropamide (Darbazine), 3. aminopentamide (Centrine)
28
what kind of diarrheal cases are anticholinergics effective against
diarrhea caused by increased colonic contractions
29
what is the purpose of Adsorbents and Protectants?
Prevent irritating compounds and bacterial toxins from contacting the intestinal mucosa
30
how does Bismuth subsalicylate work as a absorbent/protectant? (3)
1. bismuth carbonate coats intestinal mucosa 2. salicylate decreases fluid secretion 3. Decreases fluid secretion by reducing inflammation
31
what are some example of Adsorbents and Protectants? (3)
1. Activated charcoal 2. Kaolin and Pectin (Kaopectate) 3. Bismuth subsalicylate (Pepto-Bismol)
32
how does Activated charcoal work as a absorbent/protectant?
adsorbs enterotoxins to its surface
33
how does Kaolin and Pectin work as a absorbent/protectant? (2)
1. adsorbs enterotoxins | 2. coats the intestinal bowel wall
34
how do laxatives work?
Increase the fluid content of feces to facilitate passage
35
what are the categories of laxative? (2)
1. Irritant laxatives | 2. Bulk laxatives
36
what are some example of irritant laxatives? (2)
1. castor oil | 2. phenolphthalein
37
how do irritant laxatives work? (2)
1. irritate the intestinal mucosa | 2. increase fluid secretion and peristaltic activity
38
what are some examples of bulk laxatives? (5)
1. bran 2. methylcellulose 3. psyllium (Metamucil) 4. magnesium salts (Milk of Magnesia, Epsom Salts) 5. phosphate salts (Fleet Enema)
39
how do bulk laxatives work?
osmotically pull water into intestinal lumen
40
what are some conderns with bulk laxatives? (2)
1. salts may dehydrate the animal | 2. absorption of minerals from intestine may cause electrolyte imbalance
41
how do lubricants work?
Make stool more slippery for easy passage through the bowel
42
what are some examples of lubricants? (3)
1. mineral oil 2. cod liver oil 3. white petrolatum
43
what is he concern with long term use of lubricants?
can decrease absorption of lipid-soluble vitamins
44
what combination of lubricants is Catlax?
cod liver and while petrolatum
45
what is the purpose of stool softeners?
Reduce surface tension of the feces allowing water to penetrate dry stool
46
what is an example of a stool softeners?
docusate sodium succinate (Colace)
47
what can docusate sodium succinate cause in the GIT?
May increase mucosal fluid secretion
48
what should you not use docusate sodium succinate with? | Why?
mineral oil | May promote absorption of it in the GI tract leading to hepatitis
49
what does cisapride doin the GIT?
Stimulates colon motility
50
what species is cisapride used on? | what does it help prevent?
cats | constipation
51
what is the purpose for antiulcer drugs?
Intended to counteract the processes that lead to GI ulcer formation
52
what can lead to GI ulcer formation? (5)
1. hyperacidity 2. direct injury by drugs or chemicals 3. reflux of bile from duodenum into stomach 4. accumulation of metabolic toxins 5. decreased PGE production
53
what are most antiulcer drug used as?
antacids in the stomach
54
what can be the cause of hyperacidity? (2)
1. Glucocorticoids | 2. NAIDS
55
how do antacids work?
Antacids decrease gastric irritation by decreasing acidity
56
what are the categories of antacids? (2)
1. non systemic | 2. systemic
57
what are some nonsystemic antacids?
``` calcium carbonate (Tums, Rolaids) magnesium hydroxide (Carmilax, Riopan) aluminum hydroxide (Amphojel) ```
58
how do nonsystemic antacids work?
minerals directly neutralize acid molecules in the stomach
59
what can Ca and Al nonsystemic antacids cause?
constipation
60
what can Mg nonsystemic antacids cause?
diarrhea
61
how can nonsystemic antacids interfere with other drugs?
absorption
62
how does aluminum hydroxide work as a nonsystemic antacid?
will have a reaction with hydrocholoric acid and produce water, decreases the acidity
63
what is amphojel used to help prevent in cats?
constipation
64
what are some systemic antacids?
cimetidine (Tagamet) ranitidine (Zantac) famotidine (Pepcid)
65
how do systemic antacids work?
decrease gastric acid secretion in stomach by blocking histamine receptor on parietal cell
66
what is a concern with cimetidine?
inhibits metabolism of some other drugs by the liver
67
how does omeprazole work as an antacid?
binds to an enzyme in the parietal cell to prevent secretion of H+ into the intestinal lumen
68
how does sucralfate work?
1. forms sticky paste that protects an active ulcer | 2. promotes production of PGE
69
when should sucralfate not be administered?
at the same time as antacid medications
70
what is Misoprostol?
Synthetic PGE
71
what is miosprostol used to treat?
NSAID overdose
72
what is vomiting?
a protective mechanism designed to remove irritating substances from the GI tract
73
what are the stiumlie that trigger vomiting? (4)
1. Irritation of tissues innervated by vagus nerve 2. Stimulation of the chemoreceptor trigger zone 3. Stimulation of vestibular nerve 4. Stimulation of cerebral cortex
74
what it the purpose of inducing vomiting?
remove toxic substances from GI tract
75
when must vomiting be induce for liquid toxicity?
w/in 2 hrs.
76
when must vomiting be induce for solid toxicity?
w/in 4 hrs.
77
when should vomiting NOT be induced? (4)
1. caustic substance was ingested 2. gasoline or other petroleum products were ingested 3. animal is unconscious or extremely depressed 4. animal can not normally vomit
78
what are the categories of drugs that are used to induce vomiting? (2)
1. Centrally acting emetics | 2. Locally acting emetics
79
how do centrally acting emetics work?
stimulate dopamine receptors in the CNS
80
how do locally acting emetics work?
cause irritation of the GI tract
81
what kind of emetic is apomorphine?
centrally acting emetic
82
how soon does it start to work?
rapid onset of effect
83
what route can it be given?
IV, IM, or subconjunctivally
84
what are some adverse effects of apomorphine?
CNS depression and prolonged vomiting
85
what kind of emetic is Syrup of Ipecac?
locally acting emetic
86
what irritation can Syrup of Ipecac cause?
irritation of the small intestine
87
what can Syrup of Ipecac be toxic to in high concerntrations?
heart muscle
88
what should not be given with Syrup of Ipecac?
activated charcoal
89
what kind of emetic is Hydrogen peroxide?
locally acting emetic solutions
90
what kind of emetic is warm concentrated salt water?
locally acting emetic solutions
91
what kind of emetic is mustard and water?
locally acting emetic solutions
92
what is a concern with locally acting emetic solutions?
may not work consistently
93
what is an emetic drug?
will induce vomiting
94
what is an antiemetic drug?
Drugs used to decrease or prevent vomiting
95
what are the categories of antiemetic drugs?
``` Phenothiazine tranquilizers Antihistamines Anticholinergics Serotonin receptor antagonists Metoclopramide (Reglan) Maropitant (cerenia) ```
96
what are some example of Phenothiazine tranquilizers as an antiemetic?
1. acepromazine 2. chlorpromazine 3. prochlorperazine
97
how do Phenothiazine tranquilizers work as an antiemetic
block dopamine receptors in the CNS
98
why are phenothiazine tranquilizers not the best medication to give to dogs and cats?
do not prevent vomiting caused by GI irritation
99
what are some examples of antihistamines as an antiemetic?
1. diphenhydramine (Benadryl) | 2. dimenhydrinate (Dramamine)
100
how do antihistamines work as an antiemetic?
inhibit transmission of nerve impulses from vestibular nerve by blocking histamine receptors
101
what are the concerns with using an antihistamines as an antiemetic?
can produce a sedative effect and affect allergy testing
102
what are some examples of Anticholinergics as an antiemetic?
aminopentamide (Centrine) isopropamide (Darbazine) atropine
103
how do anticholinergics work as an antiemetic?
block nerve conduction through vagus nerve when there’s GI irritation (block acetylcholine receptors)
104
what can anticholinergic decrease in the GIT?
decrease GI secretions and GI motility
105
what are some examples of Serotonin receptor antagonists as an antiemetic?
ondansetron (Zofran) | dolasetron (Anzemet)
106
how do Serotonin receptor antagonists work as an antiemetic?
block nerve transmission through vagus nerve when there is GI irritation
107
which antiemetic is seldom used in animals?
Serotonin receptor antagonists
108
how does Metoclopramide work as an antiemetic?
blocks dopamine receptors in the CNS | also acts locally in GI tract
109
how does metoclopramide work locally in the GIT?
1. increasing lower esophageal muscle tone 2. causing relaxation of pylorus 3. increasing GI motility
110
what can metoclopramide cause in dogs?
sedation
111
what can metoclopramide cause in cats
excitement
112
which antiemectic is newest and widley used?
Maropitant (cerenia)
113
how does it prevent vomiting?
centrally and locally
114
what is the labeled use for maropitant?
in dogs to prevent vomiting and motion sickness

Pharmacology (9 decks)

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