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Pharmacology > Ch.8 GI Drugs > Flashcards

Ch.8 GI Drugs Flashcards

1
Q

Underlying causes of GI disease

A

-infectious sources, dietary excess, adverse drug effects, systemic disease

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2
Q

Clinical signs of GI disease

A

diarrhea, constipation, vomiting, bloat, ulcer development, or pain

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3
Q

The term Gi tract describes a long, muscular tube that begins and ends at

A

begins at the mouth and ends at the anus

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4
Q

3 basic control systems that the GI tract is under

A
  1. Autonomic nervous system
    2.GI hormones
  2. Special substances (histamine, serotonin, prostaglandin)
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5
Q

Parasympathetic stimulation _ intestinal motility, _ GI secretions and relaxes sphincters

A

increases

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6
Q

GI hormones that are released from intestinal cells and cause gastric secretion and emptying, as well as emptying of the gallbladder

A

gastrin, secretin, cholecystokinin

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7
Q

vomiting is initiated by activation of the

A

emetic center in the brain

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8
Q

Vomiting impulses

A

Peripheral receptors- irritation,
Cerebral cortex- pain, excitement, fear
CRTZ-disturbances of inner ear, drugs, metabolic conditions

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9
Q

Emetics are drugs that _ _ and are used in the tx of

A

induce vomiting; poisoning and drug overdose

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10
Q

When should vomiting not be induced

A

if caustic substances have been ingested

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11
Q

Who should you always check with before inducing vomiting

A

poison control

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12
Q

_ _ is given if emesis is contraindicated (it absorbs many chemicals and drugs in the upper GI tract)

A

activated charcoal

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13
Q

Emetics can be _ acting (working on the CRTZ) or _ acting (working on receptors locally)

A

centrally; peripherally

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14
Q

Centrally acting emetics

A

Apomorphine- dogs (poorly absorbed PO)
Xylazine- cats

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15
Q

Peripherally acting emetics

A

Ipecac syrup
Home remedies
Hydrogen peroxide 1ml/lb, not for cats due to hemorrhagic gastritis and esophagitis

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16
Q

Antiemetics are drugs that

A

control vomiting, help alleviate discomfort and help control electrolyte balance

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17
Q

Examples of antiemetics

A

-Phenothiazine derivatives
-Antihistamines
-Anticholinergics
-Procainamide derivatives
-Serotonin receptor antagonists
-NK-1 Receptor antagonists

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18
Q

Phenothiazine derivatives used as antiemetics act _: inhibit dopamine receptors in the chemoreceptor trigger zone, thus decreasing the stimulation to vomit

A

centrally

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19
Q

Examples of phenothiazine derivatives and side effects

A

-Chlorpromazine
-Prochlorperazine
-Acepromazine

SE: hypotension and sedation

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20
Q

Antihistamines work as an antiemetic by blocking

A

input from the vestibular system to the CRTZ through H1 blockade

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21
Q

Antihistamines control vomiting when the vomiting is due to

A

motion sickness, vaccine rxns, inner ear problems

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22
Q

Examples of antihistamines used as antiemetics

A

-Dimenhydrinate
-Diphenhydramine
-Meclizine
-Promethazine (phenergan)

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23
Q

procainamide derivatives should not be used in animals with

A

GI obstructions, GI perforation, or GI hemorrhage (metoclopramide)

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24
Q

Serotonin receptor antagonists work on the theory that some

A

chemicals cause vomiting because they increase serotonin release from small intestinal cells (ondansetron aka zofran)

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25
Q

Maropitant citrate (cerenia) is used to prevent _ _ and _ _

A

acute vomiting and motion sickness

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26
Q

Side effects of Maropitant citrate (cerenia)

A

pain at injection site, anorexia, hyper salivation, and diarrhea

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27
Q

Gastric ulceration may occur as a side effect of which drugs

A

NSAIDS, corticosteriods

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28
Q

Clinical signs of gastric ulceration

A

hematemesis, pain melena

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29
Q

Tx of gastric ulcers will decrease _ and control _

A

acid; CS

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30
Q

Antiulcer drug categories

A

-Histamine 2 receptor antagonists
-Proton pump inhibitors
-Antacids
-Mucosal protective drugs
-Prostaglandin analogs

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31
Q

Histamine-2 receptor antagonists prevent acid reflux by

A

competitively blocking the H2 receptors of the parietal cells in the stomach, thus reducing gastric secretion

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32
Q

examples of histamine-2 receptor antagonists as anti ulcer drugs

A

Cimetidine (Tagamet)
Ranitidine (Zantac)
Famotidine (Pepcid)

33
Q

Proton pump inhibitors as anti ulcer drugs inhibits ion transport into the stomach so that it cannot

A

secrete HCI

34
Q

Examples of proton pump inhibitors

A

Omeprazole (Prilosec)
Lansoprazole (Prevacid)

35
Q

Antacids promote ulcer healing by

A

neutralizing HCI

36
Q

Why must antacids be given within 1-2 hours of other medications?

A

they interact with other drugs (may inhibit their absorption)

37
Q

Examples of antacids

A

-aluminum/ magnesium hydroxide
-magnesium hydroxide
-calcium carbonate

38
Q

Mucosal protective drugs combine with protein to form an adherent substance that covers the

A

ulcers and protects it from stomach acid and pepsin (ex: sucralfate)

39
Q

Mucosal protective drugs must be given 30min-1 hour _ H2 antagonists

A

before

40
Q

What do prostaglandin analogs do

A

suppress gastric secretions and increase mucus production in the GI tract (ex: misoprostol, which is usually given to animals taking NSAID)

41
Q

Antidiarrheals are drugs that

A

decrease peristalsis, thereby allowing fluid absorption from the intestinal contents

42
Q

Examples of antidiarrheals

A

-Narcotics
-Anticholinergics
-Protectants/absorbents
-Probiotics
-Metronidazole

43
Q

Opiate-related agents control diarrhea by

A

decreasing both intestinal secretions and the flow of feces and increasing segmental contractions

44
Q

Examples of opiate related agents

A

Diphenoxylate (lomotil)
Loperamide (lmodium)
Paregoric/ kaolin/ pectin (parepectolin)

45
Q

Side effects of opiate related agents as antidiarrheals

A

CNS depression, ileus, urine retention, bloat, constipation

46
Q

What do protectants/ absorbents do

A

coat inflamed intestinal mucosa w/ a protective layer (protectants) or bind bacteria and/or digestive enzymes and/or toxins to protect intestinal mucosa from damaging effects (absorbents)

47
Q

Examples of protectants/absorbents

A

Bismuth subsalicylate (caution in cats)
Kaolin/pectin
Activated charcoal
Toxiban

48
Q

Side effects of protectants/absorbents

A

constipation, dark stool

49
Q

Probiotics seed the GI tract with beneficial _; use is based on the theory that some forms of diarrhea are caused by disruption of the normal bacterial flora of the GI tract

A

bacteria

50
Q

Examples of probiotics

A

plain yogurt w/ active cultures
variety of trade-name products

51
Q

A theory regarding the development of diarrhea is that _ bacteria may increase due to disruption of normal GI flora

A

anaerobic (metronidazole is an example of an antibiotic used to tx diarrhea)

52
Q

What do laxatives do

A

loosen bowel contents and encourages evacuation of stool

53
Q

Saline/Hyper-osmotic laxatives pull water into the colon and increase water content in the feces, thereby increasing

A

bulk and stimulating peristalsis

54
Q

Saline/Hyper-osmotic laxatives are salts or saline which may cause

A

electrolyte imbalances if absorbed systemically

55
Q

Examples of saline/hyper-osmotic laxatives and side effects

A

-lactulose
-sodium phosphate w/ sodium biphosphate
-magnesium sulfate
-magnesium hydroxide

SE: cramping, vomiting, electrolyte imbalances (esp. cats)

56
Q

Stimulant/irritants increase peristalsis by

A

chemically irritating sensory nerve endings in the intestinal mucosa

57
Q

Examples of stimulant/irritants as laxatives

A

bisacodyl (dulcolax)
castor oil

58
Q

Bulk-forming laxatives absorb water into the intestine, increase fecal bulk, and stimulate peristalsis, resulting in

A

large, soft stool production (which tends to look normal)

59
Q

Examples of bulk-forming laxatives

A

Metamucil, psylliums, bran

60
Q

Emollients/Surfactants/Stool softeners reduce surface tension and allow

A

water to penetrate the GI contents, softening stool

61
Q

Emollients/Surfactants/Stool softeners can be

A

stool softeners, lubricants, fecal wetting agents

62
Q

Examples of Emollients/Surfactants/Stool softeners

A

decusate sodium, decusate calcium, decusate potassium, petroleum products

63
Q

Phosphate enemas should not be used in

A

cats or puppies bc of the potential to cause electrolyte abnormalites

64
Q

Lubricants typically oils that

A

soften fecal mass to make it easier to move through the GI tract (ex: mineral oil, laxatone)

65
Q

Prokinetic agents increase

A

motility of parts of the GI tract to enhance movement of material through it

66
Q

Dopaminergic agents stimulate

A

gastroesphogeal sphincter, stomach, and intestinal (ex: metoclopramide and domperidone)

67
Q

Serotonergic agents stimulate

A

motility of gastroesphogeal sphincter, stomach, small intestine, and colon (ex: cisapride)

68
Q

Bloody diarrhea may warrant _ use

A

antibiotic

69
Q

Most commonly used antibiotic for GI disease is

A

metronidazole

70
Q

Why are antibiotics not routinely used for GI issues

A

cause damage to normal flora

71
Q

Anti-inflammatory agents that may be used for immune mediated disease/ inflammatory bowel disease

A

Prednisone/Prednisolone
Azathioprine
Sulfasalazine

72
Q

Antifoaming drugs are used in ruminants whose rumens are subject to

A

acute frothy bloat

73
Q

Antifoaming agents examples

A

poloxalene and polymerized methyl silicone

74
Q

Pancreatic enzymes must be supplemented in the diet when the

A

pancreas is not function properly (as in pancreatic exocrine insufficiency)

75
Q

Pancrealipase contains:

A

primarily lipase but also contains amylase and protease

76
Q

Enzyme supplements can be irritating to the

A

skin on contact and to nasal passages upon inhalation

77
Q

Serotonin antagonist antihistamines promote appetite by

A

inhibition at the serotoninergic receptors which control satiety

SE: sedation and dry mouth
Ex: cyproheptadine

78
Q

Benzodiazepines are effective appetite stimulants in _ but not _

A

cats; dogs

SE:sedation and ataxia
Ex: Diazepam

79
Q

Tetracyclic antidepressants stimulate appetite by antagonizing

A

alpha2 receptors

SE: sedation, vocalization
Ex: Mirtazipine

Pharmacology (17 decks)

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