Equine GI Pharmacology

Question 1

A cationic polypeptide with bactericidal activity against gram (-) bacteria.

Answer 1

Polymyxin B

Question 2

To which portion of the endotoxin does Polymyxin B bind?

Answer 2

Lipid A

Question 3

What are 2 side effects associated with Polymyxin B?

Answer 3

1. Nephrotoxicity

2. Neurotoxicity

Question 4

Is Polymyxin B bactericidal or bacteriostatic?

Answer 4

Bactericidal

Question 5

A synthetic xanthine derivative, phosphodiesterase inhibitor.

Answer 5

Pentoxifylline

Question 6

True or False: Polymyxin B has decreased bio-availability after repeated dosing.

Answer 6

FALSE - PENTOXIFYLLINE has decreased availability after repeated dosing.

Question 7

Pentoxifylline suppresses TNF-alpha, ____, and ____ production.

Answer 7

1. IL-1

2. IL-6

Question 8

Dimethylsulfoxide is a what?

Answer 8

Radical scavenger

Question 9

Dimethysulfoxide can cause hemolysis when?

Answer 9

1. Given too concentrated

2. Given too quickly

Question 10

True or False: All anti-endotoxic drugs are more effective if given before exposure to an endotoxin.

Answer 10

TRUE

Question 11

What type of GI drug is Bismuth subsalicylate?

Answer 11

Intestinal protectant (Pepto-bismol)

Question 12

What type of GI drug is Kaolin pectin?

Answer 12

Intestinal protectant

Question 13

What do Bismuth subsalicylate and Kaolin pectin have in common?

Answer 13

Absorb toxins, anti-diarrheal

Question 14

Activated charcoal absorbs toxins and drugs, preventing/reducing systemic absorption. You may follow administration with a laxative when?

Answer 14

30 minutes after

Question 15

Medications other than activated charcoal should not be given until how long after activated charcoal administration?

Answer 15

3 hours

Question 16

____ and ____ decrease absorption of activated charcoal.

Answer 16

1. Dairy products

2. Mineral oil

Question 17

What type of drug is Dimethylsulfoxide?

Answer 17

Anti-endotoxic drug

Question 18

Di-tri-octahedral smectite is an intestinal absorbent that absorbs what 2 toxins in vitro?

Answer 18

1. C. difficile

2. C. perfringens

Question 19

What are 4 indications for the use of laxatives or cathartics?

Answer 19

1. Relive simple impactions
2. Decrease intestinal transit time
3. Increase stool consistency with chronic diarrhea
4. Lubricate passage of ascarids or sand

Question 20

What is magnesium sulfate (epsom salt)?

Answer 20

Laxative - Osmotically draws water into the GI lumen

Question 21

What is Dioctyl sodium succinate?

Answer 21

Laxative

Question 22

How does Dioctyl sodium succinate work?

Answer 22

Stimulates net secretion of water, Na, Cl, and K

Question 23

What are 3 adverse effects of Dioctyl sodium succinate?

Answer 23

1. Abdominal discomfort
2. Intestinal irritation
3. Dehydration

Question 24

When would you use Dioctyl sodium succinate?

Answer 24

Severe/refractory cases of impaction

Question 25

What is mineral oil?

Answer 25

Mild laxative

Question 26

How does mineral oil work?

Answer 26

Prevents the reabsorption of water

Question 27

What would you use to prevent ascarid impactions in heavily infected foals at the time of deworming?

Answer 27

Mineral oil

Question 28

What could develop if mineral oil is aspirated?

Answer 28

Severe granulomatous pneumonia

Question 29

What is psyllium?

Answer 29

Bulk forming laxative

Question 30

What is the main use of psyllium?

Answer 30

Treatment and prevention of sand impaction

Question 31

Water can be utilized as a laxative. What is one side effect to the use of water?

Answer 31

Hyponatremia

Question 32

Caution: do not leave an indwelling nasogastric tube in place for more than ___ days.

Answer 32

2 days

Question 33

Leaving a nasogastric tube in place for more than 2 days may cause what?

Answer 33

Pharyngeal necrosis

Question 34

What is aluminum/magnesium hydroxide?

Answer 34

Anti-ulcer medication

Question 35

True or False: Aluminum/magnesium hydroxide can be used to treat gastric ulcers.

Answer 35

FALSE - aluminum/magnesium hydroxide is a preventative, but is NOT curative for gastric ulcers.

Question 36

What is cimetidine?

Answer 36

Anti-ulcer medication

Question 37

What is the MOA of cimetidine?

Answer 37

Antagonizes H2 receptors

Question 38

What is ranitidine?

Answer 38

Anti-ulcer medication

Question 39

What is the MOA of ranitidine?

Answer 39

Antagonizes H2 receptors

Question 40

True or False: Ranitidine is effective in healing gastric ulcers.

Answer 40

TRUE

Question 41

What is sucralfate?

Answer 41

Anti-ulcer medication (sulfated polysaccharide)

Question 42

Sucralfate stimulates mucus secretion and increases what?

Answer 42

PGE synthesis

Question 43

What is the MOA of omeprazole?

Answer 43

Irreversibly inhibits proton pumps (H/K ATPase pumps)

Question 44

True or False: Omeprazole can be used both curatively and as a prevention of gastric ulcers.

Answer 44

TRUE

Question 45

What is pantoprazole?

Answer 45

Anti-ulcer medication (second generation proton pump inhibitor)

Question 46

What is misoprostol?

Answer 46

Anti-ulcer medication (prostaglandin E1 analog)

Question 47

Misoprostol stimulates the production of ____ and ____.

Answer 47

1. Mucus | 2. Bicarbonate

Question 48

Misoprostol inhibits the secretion of what?

Answer 48

Gastric acid

Question 49

What are 2 adverse effects of misoprostol?

Answer 49

1. Abdominal pain | 2. Diarrhea

Question 50

What are 4 indications for prokinetics?

Answer 50

1. Delayed gastric emptying 2. Post-operative ileus 3. Cecal impaction 4. Proximal enteritis

Question 51

Lidocaine has prokinetic effects on the small intestine and ____.

Answer 51

Large colon

Question 52

What 3 effects does lidocaine have?

Answer 52

1. Anti-inflammatory 2. Anti-arrhythmic 3. Analgesic

Question 53

With what 2 drugs does lidocaine interact?

Answer 53

1. Cimetidine | 2. Metronidazole

Question 54

Lidocaine is beneficial in the treatment of proximal enteritis and what?

Answer 54

Post-operative ileus

Question 55

What are 4 toxic effects of lidocaine?

Answer 55

1. Muscle fasciculations 2. Ataxia 3. Collapse 4. Seizures

Question 56

What is erythromycin lactobionate?

Answer 56

Prokinetic (motilin receptor agonist)

Question 57

Which parts of the bowel will erythromycin lactobionate work on?

Answer 57

1. Stomach 2. Ileum 3. Cecum 4. Pelvic flexure

Question 58

What are 2 side effects of erythromycin lactobionate?

Answer 58

1. Abdominal pain | 2. Diarrhea

Question 59

What is the name of the chemical that makes up cisapride?

Answer 59

Benzamide

Question 60

What is the MOA of cisapride?

Answer 60

Increases acetylcholine release at myenteric plexus, promoting generalized increase in motility

Question 61

What type of prokinetic is bethanechol chloride?

Answer 61

Synthetic muscarinic cholinergic agonist

Question 62

What would an overdose of betansechol chloride case?

Answer 62

1. Salivation 2. Lacrimation 3. Urination 4. Defecation (SLUD)

Question 63

What type of prokinetic is neostigmine methylsulfate?

Answer 63

Acetylcholinesterase inhibitor

Question 64

What is butylscopolammonium bromide?

Answer 64

Antispasmodic

Question 65

What is one side effect of butylscopolammonium bromide?

Answer 65

Tachycardia

Question 66

What type of antispasmodic is butylscopolammonium bromide?

Answer 66

Anticholinergic

Question 67

Metronidazole is used to treat ____ in neonatal foals.

Answer 67

Clostridium perfringens

Question 68

Metronidazole is used to treat ____ in foals and adults.

Answer 68

Clostridium difficile

Question 69

What are 2 indications for the use of macrolide antibiotics in the horse?

Answer 69

1. Proliferative enteropathy (Lawsonia intracellularis) | 2. Pyogranulomatous enterocolitis (Rhodococcus equi)

Question 70

Name 3 macrolide antibiotics.

Answer 70

1. Clarithromycin 2. Azithromycin 3. Erythromycin

Question 71

What would you use for the treatment of Lawsonia intracellularis in animals that develop diarrhea on macrolides?

Answer 71

Chloramphenicol

Question 72

What is indicated for the treatment of Potomac Horse Fever (Neorickettsia risticii)?

Answer 72

Oxytetracycline

Question 73

What is the one adverse effect associated with oxytetracycline?

Answer 73

Nephrotoxicity