7-GI and repro Flashcards
1
Q
NSAID examples
A
- Aspirin (acetylsalicylic acid)
- Ibuprofen
- Naproxen
2
Q
NSAIDS-about
A
- absorbed well from stomach and intestinal mucosa
- Dogs sensitive to ibuprofen
- Cats sensitive to aspirin (lack glucuronidation)
3
Q
NSAIDS
MOA
A
- uncouples oxidative phosphorylation at high doses
- inc lactic acid
- metabolic acidosis
- Causes gastric ulceration
- renal toxicity
- inhibition of prostaglandin synthesis and renal blood flow
- analgesic nephropathy
- inhibition of prostaglandin synthesis and renal blood flow
4
Q
NSAID renal toxicity
A
- Vasoconstrictive acute renal failure
- Acute interstitial nephritis
- Fluid and electrolyte imbalances
- Renal papillary necrosis
- Chronic renal failure
5
Q
Aspirin clinical signs
Acute toxicity
A
- Nausea, vomiting (poss w/blood), anorexia
- fever and respiratory stim w/ high doses
- depression, muscle weakness, ataxia, lethargy, seizure, coma
- acidosis with anion gap
- reduced renal flow, renal failure
6
Q
Aspirin clinical signs
Chronic toxicity
A
- Gastric irritation and ulceration is most common problem
- anemia, bone marrow depression
- heinz bodies, thrombocytopenia in cats
- toxic dose dogs: 50 mg/kg/day
- toxic dose cats: 25 mg/kg/day
7
Q
Naproxen
Clinical signs
A
- vomiting (+/- blood)
- Black tarry stool
- diarrhea
- anorexica, weakness, lethargy
- painful abdomen
- pale gums
- other rare
- facial twitching (cats)
- seizures
- depression
- coma
8
Q
NSAID Tox
DX
A
- HX and CS
- GI irritation, lethargy, anemia
- Perforating ulcers: abdominal pain, shock, dark red MM, tachycardia
- Anion gap from acidosis (salicylates)
- Inc in liver enzymes, jaundice
- Dec blood clotting time
- Acute renal failure
- renal tubular cell casts in urine sediment
- inc BUN, Creatinine
- renal tubular cell casts in urine sediment
9
Q
NSAID Tox
TX
A
- Induce emesis and several doses activated charcoal
- Ranitidine/ H2 blocker for GI ulcers
- Misoprostol/sulcralfate for GI ulcers
- Supportive care
- acidosis
- hyperkalemia
- correct electrolyte and glucose levels
- inc renal blood flow and maintain urine flow
- transfusion for severe hemorrhage/anemia
10
Q
Arsenic
about
A
- # 1 priority pollutant worldwide
- Sources
- insecticides: lead and calcium arsenate, treated lumber
- medicine: acute promyelocytic leukemia
- food production: organic arsenic chicken and swine feed additive
- Electronics
- shellfish
- water
11
Q
Inorganic Arsenicals
Pentavalent
A
- reduced and metabolized in rume
- reduces available metabolic energy
- some converted to trivalent form => toxicosis
- serious toxicity to
- GI epithelium and capillary endothelium
- enteritis and shock
- GI epithelium and capillary endothelium
12
Q
Inorganic Arsenicals
Trivalent
A
- binds to -SH groups
- disrupts cellular metabolism
- inhibits phosphorylation enzymes
- reduces metabolism….
- serious toxicity toGI epithelium and capillary endothelium
- enteritis and shock
13
Q
Clinical signs of inorganic arsenic poisoning
A
- Depends on dose
- Acute/Sub-acute exposure
- intense abdominal pain, gastroenteritis
- weakness, staggering gait
- salivation, trembling
- vomiting (dogs)
- PU/PD progressing to oliguria and anuria
- Dehydration, thirst
- posterior paresis
- cold extremities due to poor perfusion
- subnormal temp
- may live for 1-3 days
14
Q
Lesions associate with inorganic arsenic toxicity
A
- Brick red gut (abomasum in ruminants)
- Fluid GI contents, st foul smelling
- soft yellow liver, red congested lungs
- damage to glomerulus and tubules in kidney
15
Q
Inorganic arsenic tox
DX
A
- consider in sudden onset of gastroenteritis or sudden death
- esp animals found in/near water
- liver or kidney arsenic > 5ppm
- Should examine stomach contents of vomitis for As
- Readily absorbed from GI tract, rapidly excreted
- take samples early
