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PHARMACOLOGY - 2 > 22 – GI Miscellaneous > Flashcards

22 – GI Miscellaneous Flashcards

1
Q

Exocrine pancreatic insufficiency

A
  • Failure of exocrine pancreas to produce Lipase Amylase and Tripsin for DIGESTION of normal diet
  • Mainly in dogs
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2
Q

What can be used to treat exocrine pancreatic insufficiency?

A
  • *Pancrelipase (Pank-Aid)
  • (Octreotide (Sandostatin))
  • (Fuzapladib (Panoquell-CA1))
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3
Q

Pancrelipase (Pank-Aid) (‘ground pancreas’)

A
  • Supplement of exocrine pancreas enzymes (lipases, amylase and proteases)
  • Mix it with the food, let it sit so it can start to ‘digest’ the food before feeding it to the dog
  • increased gastric pH may increase the amount of active enzyme reaching duodenum
  • should wipe mouth after eating as it will ‘break down’ the nose structure
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4
Q

What might be used to treat constipation?

A
  • Lubricants
  • (stimulant laxatives)
  • Hyperosmotic laxatives
  • Bulk laxatives
  • Stool softeners
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5
Q

Lubricants to treat constipation

A
  • Mineral oil: cattle, horses
  • Mineral oil + white petroleum: cats=hairball remedy
  • *if get into lungs=bad pneumonia that will kill them!
    o NEEDS to go into the stomach
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6
Q

Stimulant laxatives

A
  • Irritate the mucosa or intrinsic nerves (ENS) causing motility
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7
Q

Hyperosmotic laxatives

A
  • Draw fluid into GI lumen to stimulate motility
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8
Q

What are some examples of hyperosmotic laxatives?

A
  • *Polyethylene glycol (PEG) powder
    o ¼ tsp: Mix in food for cats
  • Sodium phosphate enemas: do NOT use in cats
    o Can cause hyperphosphatemia (absorb P=toxic)
  • Lactulose
    o Non-digestible sugar
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9
Q

Bulk laxatives

A
  • Non-absorbed cellulose material with INCREASE the bulk of fecal material
    o Hydrophilic colloids: Metamucil (Drink right away, otherwise it will turn into gel)
    o Fiber: prunes, pumpkin
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10
Q

Stool softeners (not really used)

A
  • Increase water accumulation in feces
  • Docusates
    o (Dioctyl sodium sulfosuccinate)
    o (Dioctyl calcium sulfosuccinate)
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11
Q

Probiotics for diarrhea/constipation (theory)

A
  • Bacteria or yeast added to food with purpose of relating intestinal flora
  • Mechanism of action: unknown
  • No reports of adverse effects
    o Downsides might be lack of efficacy and expense
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12
Q

Trying to fix motility drugs

A
  • Really DOESN’T work
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13
Q

Motility-modifying drugs

A
  • Metoclopramide: upper GI
  • Cisapride: lower and upper GI
    *used as a prokinetic
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14
Q

Motility-modifying drugs that have prokinetic effect as a side effect

A
  • Erythromycin, azithromycin
  • Cimetidine, ranitidine
  • Lidocaine
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15
Q

Metoclopramide (injectable solution)

A
  • Inhibits dopamine receptors
  • Inhibits serotonin receptors (5HT3)
  • *stimulates serotonin receptor (5HT4)
    o Accounts for prokinetic effect
  • *UPPER GI (stomach)
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16
Q

Metoclopramide in upper GI

A
  • Prokinetic effect: increase gastric and upper duodenal emptying
  • Increase gastroesophageal sphincter tone
17
Q

Metoclopramide adverse effects

A
  • Make sure there is NO GI obstruction
  • Watch for extrapyramidal effects
  • Can increase prolactin secretion
18
Q

Metoclopramide in horses

A
  • AVOID
19
Q

Cisapride

A
  • No approved vet or human formulation
    o Formerly Prepulsid (human tablets)
    o Now compounded products only
20
Q

What is Cisapride mechanism of action

A
  • 5-HT4 agonist
  • 5-HT3 antagonist
  • Likely more effective prokinetic
21
Q

Cisapride vet uses in cats

A
  • Increase smooth muscle motility
    o Used for MEGACOLON
22
Q

Cisapride vet uses in dogs

A
  • Increase smooth muscle motility throughout GIT
    o Increase gastroesophageal sphincter one
    o Delayed emptying, small bowel motility disorders
    o Not effective for megaesophagus in dogs (little smooth muscle present)
23
Q

Cisapride vet uses in horses

A
  • Treatment of ileus after abdominal surgery (IV use)
    o Co-ordinated motility in ileum/cecum/colon
24
Q

PK of Cisapride

A
  • 30-60% oral bioavailability
  • Longer half life in dogs and cats than horses and ruminants
25
Q

Adverse effects of Cisapride

A
  • Cardiac arrythmias and drug interactions
  • Not reported in dogs and cats: but can happen
26
Q

Erythromycin, Azithromycin

A
  • Though to activate motilin receptors in stomach and SI
  • LITTLE effect
  • Not available
  • Can cause vomiting and irritation?
27
Q

Lidocaine

A
  • Horses to reduce post-op ileus (IV infusion)
    o VERY EXPENSIVE
  • Adverse effects: muscle fasciculations, ataxia, seizure

PHARMACOLOGY - 2 (16 decks)

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