GI drugs Flashcards
(50 cards)
1
Q
Dirlotapide (Slentrol)
A
- used to help dogs lose weight
- inhibits MTP so there is less fat absorption
- increases satiety signal, causing decreased appetite
- dont use in cats - can cause hepatic lipidosis
- dont use in dogs on long term glucocorticoid treatment or with liver disease
2
Q
Anabolic Steroids
A
- stimulates hematopoesis, appetite and weight gain
- adverse effects: hepatotoxicity, masculinaization and early bone closure in young animals
3
Q
Diazepam (Valium)
A
- benzodiazepine
- appetite stimulant in cats
- IV, IM or orally
- if given IV cat will begin to eat within a few seconds and then will become sedate so have palatable food ready
4
Q
Oxazepam (Serax)
A
- benzodiazepine
- appetite stimulant in cats
- metabolite of diazepam
- given orally
- not as effective as diazepam but it has less sedative effects
5
Q
Cyproheptadine (Periactin)
A
- appetite stimulant in cats
- inhibits serotonin receptors, which control satiety
- adverse effects: CNS excitement, aggression, decrease seizure threshold, increase seizure intensity and decrease effectiveness of anti epileptic drugs
6
Q
Mirtazapine (Remeron)
A
- used in dogs and cats that have inappetance and nausea
- number 1 treatment for cats with inappetance
- also an antidepressant with less adverse effects then TCAs and SSRI. no anticholinergic or serotonin related side effects but may cause drowsiness
7
Q
Megestrol Acetate
A
- stimulates appetite and weight gain in dogs and cats.
- risk for toxicity in cats so better use in dogs
- antiestrogen and glucocorticoid activity causing adrenal suppression
- dont use in pregnant animals
8
Q
Vitamine B
A
- used in horses
- orally administered to induce appetite
9
Q
Glucocorticoids
A
- appetite stimulus
- increases gluconeogenesis and antagonizes insulin so get hyperglycaemic effect
- long term use causes catabolic effects
10
Q
Apomorphine
A
- emetic drug -opioid drug
- dopamine agonist and CRTZ direct stimulation
- more effective with dogs then cats
- oral or in congunctival and gingival membranes
- depressant affect on emetic centre so if it doesn’t work the first time it won’t work with an increased dose
- vomiting induced in 5-10 min
11
Q
Xylazine
A
- emetic drug
- a2 adrenergic agonist so produces profound sedation and hypotension
- works well in cats
- stimulates CRTZ
12
Q
Hydrogen Peroxide
A
- emetic drug
- stimulates CN 9 when it hits the back of the throat
- induces vomiting through emetic centre
- careful with cats and with aspiration!
- 3% is safe. higher concentrations are more toxic
13
Q
Phenothiazine tranquilizer
A
- antiemetic drug
- a2 adrenergic antagonist and antagonist of CNS stimulatory effect of dopamine = decrease vomiting
- controls motion sickness in cats!
14
Q
Anticholinergic drugs
A
- antiemetic drug
- blocks cholinergic afferent pathways from GIT and vestibular system to vomiting centre
- works better with cats then dogs because cats have muscarinic M1 receptors in vestibular system
15
Q
Antihistaminic drugs
A
- antiemetic drug
- block cholinergic and histaminic nerve transmission to vestibular system in dogs
- not effective in cats
16
Q
Metaclopramide
A
- antiemetic drug
- works better for dogs then cats because it involves dopamine receptors mediating hum oral emesis
- 3 mechanisms of action
- DONT GIVE POSSIBLE GI OBSTRUCTION
17
Q
Serotonin Antagonist
A
- antiemetic
- blocks serotonin receptors so then when animal is exposed to a chemical like chemo (and it releases a lot of serotonin which would normally cause vomiting) the receptors are blocked (cat)
- with dogs, granisetron is more effective than odansetron for inhibiting chemo nausea in dogs
- slightly different for dogs and cats
- adverse reaction is ECG changes
18
Q
Butorphenol
A
- antiemetic
- used for dogs getting chemo
- directly acts on the vomiting center
19
Q
Maropitant
A
- antiemetic drug
- good for dogs and cats
- good for preventing vomiting with chemo and for motion sickness
- expensive
- blocks substance P from binding to NK1 receptors (in gut and in emetic centres of CNS)
20
Q
Antacids
A
- tx for GI ulcers
- neutralize the stomach acid so that you get water and a neutral salt
- not absorbed systemically
- interfere with other drug absorption in the GI because changing the pH
- OTC combos have magnesium hydroxide and aluminium hydroxide so that it balances diarrhea and constipation affects
21
Q
Magnesium and Aluminium Antacids
A
- antiulcer treatment
- can be giving to cattle in a supplement form. if cows have poor renal function then can be fatal
- milk of magnesia: antacid if horse or dog has ingested acid
- Neigh-Lox: antacid for horses
22
Q
H2 histamine receptor antagonist
A
- antiulcer treatment
- cimetidine, ranitidine and famotidine (reverse order of potency)
- antagonizes the H2 receptor on parietal cell so that there is no gastric acid able to be produced
- this allows strengthening of gastric mucosa, increase GI motility and increased lymphocyte stimulation
- it is highly lipid soluble and orally absorbed but has low oral bioavailability so need high doses.
- Vd tends to be moderate to high depending on drug (same order of potency) and elimination 1/2 life is moderate.
- there will be acid rebound when taken off of treatment because there is excess amount of gastrin in the serum, there may be up regulation of histamine receptors and with increased gastrin, there will be increased histamine build up
23
Q
Sucralfate
A
- antiulcer treatment
- dissociates within the acid environment of the stomach into sucrose octasulfate and aluminium hydroxide. the aluminium hydroxide is an antacid and the sucrose octal sulfate forms a sticky layer ontop of ulcerative mucosa protecting it from H ions going back in
- it is not absorbed so there is no adverse reactions
- there is also synthesis of prostaglandins
24
Q
Proton Pump Inhibititor
A
- antiulcer treatment
- ex/ omeprazole
- it irreversibly inhibits the H/K ATPase pump on the parietal cells resulting in less acid being secreted
- it is given in an inactive, liophilic form and then when it crosses cell membranes into an acidic environment it becomes activated and it irreversible deactivates the proton pump
- used in dogs and horses
- has a short half life but since it is irreversible it lasts for a long time
- it will help heal ulcers but once the treatment has been stopped ulcer may form again
- it may result in bone fractures because with the change in pH in the stomach there is less Ca being absorbed and decreased vitamin B12 being absorbed
25
Misoprostol
- antiulcer treatment
- synthetic prostaglandin which inhibits acid secretion from parietal cell by inhibiting adenylate cyclase
- used in dogs that are being administer NSAIDs to decrease risk of ulcer formation
- better preventative then treatment
- has cytoprotective effects such as increasing biocard, increase mucous production, increasing mucous blood flow, increasing cell proliferation
- dont use if pregnant
- completely orally absorbed and quickly metabolized
26
Arachadonic Acid precursor (corn oil)
- antiulcer treatment in horses
- increases the amount of prostaglandin produced so that there is less acid released
- dietary supplement in horses
27
Raw Linseed Oil
- antiulcer treatment
| - given to horses to prevent them from getting ulcers
28
Metaclopramide
- prokinetic drug
- increases the amount of ACh being released from the presynaptic cleft and increases the sensitivity of the neurons to ACh
- increasing the coordinated movement from esophagus to the duodenum (not much affect in the colon)
- most effective with diseases that have decreased or impaired neural function
- antagonist to dopamine so decreases the chance of vomiting but since it goes in the BBB there is chance of extrapyrimidal signs, which can be reversed if give diphenhydromine to repair the ACh: dopamine ratio
29
Domperidone
- prokinetic drug
- works from the esophagus to the small intestine with little effect on the colon
- antidopaminergic drug so it is antiemetic
- doesnt cross the BBB so no extrapyrimidal signs
- good alternative to metaclopramide
30
Cisapride
- prokinetic drug
- no antidopaminergic effect so there is no antiemetic response, and it doesn't cross the BBB so no extrapyrimidal signs
- increases motility and heart rate because there is increase ACh release and inhibition of serotonin at myenteric plexus
- works from the esophagus to the colon
- good for treating dogs and cats, including megacolon cats
- adverse effects are uncommon
- more potent and better pro kinetic than metaclopramide
31
Motilin receptor agonist
- prokinetic drug
- ex/ erythromycin and clarithromycin
- stimulate cholinergic and noncholinergic neuronal pathways to induce motility and peristalsis
- with small animals: erythromycin stimulates up until the colon so doesn't work in colon diseases
- large animals: erythromycin stimulates cecum and large intestine
- clarithromycin: increases motility in patients that have helicobacter gastritis
- metabolized in the liver so if the animal is being treated with other drugs that get metabolized in the liver then this will inhibit that
32
Acetylcholinesterase inhibitor
- prokinetic drug
- ranitidine and nizatidine
- H2 histamine receptor antagonist
- increases the amount of ACh while also decreasing the amount of gastric acid being secreted
- results in increase of motility
- wide safety margin
33
Lidocaine
- prokinetic drug
- treatment for irritated or inflammated duodenum and jejunum. when this happens there is inhibition of motility
- suppresses the inhibitory action of the inflammation, and starts motility of the duodenum and jejunum again
34
alpha 2 adrenergic antagonist
- prokinetic drug
| - inhibit NE actions on the intrinsic and smooth muscles within the GI, treating ileus
35
Stimulant (irritant) laxative
- laxatives
- caster oil, raw linseed oil, senna and bisacodyl
- each have their own want of stimulating laxative effect
36
Hyperosmotic cathartics
- laxative and cathartic
- ex/ polyethylene glycol
- high osmolarity in the lumen causes water to be drawn into the lumen, increasing the water content within the feces, causing distension of the lumen and peristalsis
- generally safe but need to make sure that animal is well dehydrated
- dont use sodium biphosphate in cats
37
Hydrophilic Colloid
- laxative and cathartic
- carbohydrate, fiber or nondigestable material goes into the bowel, water is absorbed by it within the lumen, increasing its size causing peristalsis
38
Lubricant Laxatives
- laxative
- coats the surface of the stool with a film and increase the water content of the stool so that the stool has lubricative action
- if use this chronically then there may be decreased fat absorption
39
Stool Softeners
- laxatives
- decrease the surface tension of the stool allowing more water absorption of the stool so it is more easily passed
- safe
- dont use it with mineral oil because it will produce foam
40
Kaolin Pectin Formulation
- antidiarrhetic drug
- for a soothing and absorbing layer on the mucosa of GIT
- doesnt decrease the length of illness or prevent electrolyte loss
- might change consistency of the stool
41
Activated Charcoal
- antidiarrhetic drug
- forms large pores that are within the lumen of the intestine increasing its surface area so that it absorbed the enterotoxins that are causing the diarrhea instead of the GI absorbing it
- it is very safe because it doesn't get absorbed at all
42
Bismuth Subsalicylate
- antidiarrhetic drug
- bismuth may have some absorbent abilities with the enterobacteria and may form a bit of a protective layer
- subsalicylate component has antiinflammatory component and can systemically be absorbed so this is that part that can cause toxicity
43
Anticholinergic drugs
- antidiarrhetic drug
- ex/ buscapan
- decreases GI motility and secretions. this makes the diarrhea less of an emergency because there isn't as much fluid loss
- also is an antispasmodic drug
- can be used for uncomplicated colic in horses or choke (because it relaxes the esophagus)
- adverse effects include: tachicardia, CNS excitement
44
Opioids
- antidiarrhetic
- ex/ diphenoxylate, loperamide and paregonic
- decreases motility and fluid secretion in the GI lumen when drug binds to mu and delta receptors on the lumen wall
- increases sphincter tone
- increases fluid, electrolyte and glucose absorption from the lumen
- used in dogs
- with loperamide because careful with ABCB-1 gene mutation dogs. also, it can be found over the counter and it may actually worsen the diarrhea because the enterbacter may get absorbed with the decreased GI movement
45
Antimicrobials -diarrhea
-used as antidiarrhetics?
-normally they just cause diarrhea, but some cases of diarrhea actually do have a bacterial infection and need intervention
ex/ camplylobacter enteritis in dogs and cats (zoonotic) or tritrichamonus fetus - recurring colitis in multicat households
-or general septicemia
46
NSAIDs -diarrhea
- use as antidiarrhetics? - controversial
- it can be beneficial in some situations when there is inflammation
- can decrease the fluid loss and electrolyte secretion
47
Antitoxins -diarrhea
- antidiarrhetic
- expensive and needs to be caught early
- antiserum available for horses and canon endotoxemia
- can help in some cases like the spread of parvo in dogs
- may cause anaphylaxis
48
5-aminesalicylic acid products
- treatment for chronic colitis
- ex/ mesalamine
- sulfapyridine and 5-aminosalicylate break apart and sulfpyradine gets absorbed and goes systemically and acts as an anti-inflammatory
- used in dogs and cats
- 5-aminosalicylate acts within the GIT
- less toxic for dogs than cats
- mesalamine has a polymer coating which prevents it from becoming active until it reaches the colon
49
Antimicrobials -chronic colitis
- treatment for chronic colitis
- ex/ tylosin and metronidezole
- tylosin: used as an alternative for 5aminesalicylic acid products. used for spirochetes, chlamydia
- metronidazole: used for giardia and IBD in horses cats and dogs
50
glucocorticoids - chronic colitis
- treatment for chronic colitis
- immunosuppressive and anti-inflammatory
- it is useful for immunosuppressive if the reason for the colitis is because there is auto reaction with self lymphocytes.
- can use in combination with 5-aminesalicylic acid products and metronidezole
