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Penn Foster Pharmacology > Chapter 8: Gastrointestinal and Antiemetic Drugs > Flashcards

Chapter 8: Gastrointestinal and Antiemetic Drugs Flashcards

1
Q

Apomorphine

A

Opioid narcotic; stimulates dopamine receptors, causes emesis

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2
Q

How do opioids affect the CNS?

A

Suppress CNS function (causes sedation, causes cardiac and respiratory depressant)

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3
Q

Can apomorphine be reversed?

A

Yes, because it is an opioid. An opioid antagonist such as naloxone can be used.

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4
Q

What type of emetic is the best option for cats? Name some examples

A

Alpha 2 agonist drugs (xylazine and medetomidine/dexmedetomidine)

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5
Q

What is a con to using hydrogen peroxide as an emetic?

A

It is a gastric irritant and can cause gastric ulcers

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6
Q

What are the five categories of anti-emetics?

A

Phenothiazine tranquilizers, antihistamines, promotability drugs, serotonin antagonists, NK-1 receptor antagonists

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7
Q

What is the mode of action for phenothiazine tranquilizers? Examples?

A 
Often used for motion sickness
1-Block dopamine receptors in the CRTZ and emetic center.
2-Antihistamine effect
3-Mild blockage of acetylcholine
Examples: Acepromazine, Chlorpromazine
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8
Q

What are the side effects to using phenothiazine tranquilizers? Contraindications?

A

Side effects: decreased BP, excessive sedation and ataxia

Contraindications: hypotensive patients, use caution with boxers

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9
Q

True or False. Phenothiazine tranquilizers greatly decrease anxiety/fear

A

False

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10
Q

What is the antihistamine mode of action for anti-emetic function?

A

Decreases vestibular apparatus impulse to emetic center (disrupt the signals from the ears that send signals to the brain regarding balance) by blocking H1 receptors in CRTZ. Because dogs have more H1 receptors, they are more receptive to this tx.

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11
Q

How do prokinetic drugs work? What are some examples?

A

Blocks dopamine and serotonin receptors, helps promote peristalsis
Often used as an antiemetic for chemotherapy patients
Examples: metaclopramide, cisapride

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12
Q

What are some contraindications when using metoclopramide?

A

Cause cause sedation, don’t use with phenothiazine tranquilizers, sometimes can cause frenzied behavior in cats, do not use with obstructed patients

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13
Q

What type of anti-emetic drug is ondansetron? What is the mode of action?

A

Serotonin Antagonist; blocks serotonin receptors in CRTZ

Often used in parvovirus candidates, and post-chemo therapy

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14
Q

What is the trade name for maropitant citrate? What type of drug is it?

A

Cerenia; it is an NK-1 Antagonist

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15
Q

What is the mode of action of cerenia?

A

Prevents the binding of substance P and Neurological-1 kinin receptors in the emetic center (that leads to emesis)
Also blocks pain

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16
Q

What are the 4 types of anti-diarrheal drugs?

A

1-Opioid derivatives
2-Anticholinergics
3-Anti-inflammatories
4-Adsorbents and protectants

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17
Q

What is the mode of action of opioid derivatives? What are some examples?

A

Increased segmental contraction, decreased peristaltic contraction. Examples: loperamide (Imodium)-OTC; Diphenoxylate (Lomotil)-Controlled class V

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18
Q

Why are opioid derivatives generally avoided with cats?

A

Can cause potential CNS excitement

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19
Q

Why should opioid derivatives be avoided when a patient has a bacterial pathogen

A

Slows down peristalsis which gives the bacteria (like salmonella) a greater chance of getting into the body.

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20
Q

What is the mode of action for anticholinergic drugs as an anti-diarrheal? What is an example of an anticholinergic drug?

A

Blocks acetylcholine m1 receptor
Decreases parasympathetic GI tract stimulation (motility and secretion).
Decreases segmental and peristaltic contractions
Example: Atropine

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21
Q

Why is atropine (anticholinergic drug) often not used as an anti-diarrheal?

A

It can have parasympathetic blocking effects, and it increases the patient’s heart rate so it can be dangerous when used in patients with cardiac issues.

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22
Q

How do anti-inflammatory drugs function as an anti-diarrheal? What are some examples?

A

Reduce secretions by blocking prostaglandins
Example: Sulfasalazine (antibiotic with mesalamine salicylate molecule)
Bismuth subsalicylate (pepto bismol)

23
Q

Why should pepto bismol generally be avoided?

A

Pepto bismol coats the intestines, where the salicylates are absorbed into the blood stream. Salicylates contains the same ingredient as aspirin, which is toxic in cats in average human doses.
Pepto bismol is also radiopaque and can affect evaluation, and can turn stools black/tarry.

24
Q

How do adsorbents work as an anti-diarrheal drug? What are some examples?

A

Causes other molecules to adhere to their outer surfaces so they are less likely to be absorbed into the body. Examples: Pepto-bismol, activated charcoal, kaolin pectin (kaopectate)

25
Q

How do protectants work as anti-diarrheal drugs? What are some examples?

A

Coats the GI tract wall to form a physical barrier to reduce contact with toxic/irritating/disease causing compounds.
**Only helps with upper GI tract, no evidence for aiding in lower GI tract (colitis)
Examples: pepto bismol, liquid barium, sucralfate

26
Q

What are some precautions to know when using protectants?

A

Can block drug absorption

Must give separately from medications/food-try to separate dosing by 2 hours to minimize side effect

27
Q

What are laxatives and cathartics used for?

A

Increases fluid content of feces to make stool softer and promote ease of defecation. Examples: Chronic constipation control (cats), trichobezoar (hair balls) control/passage, evacuate the colon to aid in diagnostics, facilitate stool passage.

28
Q

What are the two types of laxatives?

A 
Emollient laxatives (lubricant oils, stool softeners)
Bulk laxatives (Hydrophilic colloids-indigestible plant fiber)
29
Q

What are the 2 categories of cathartics (purgatives)?

A

1-Osmotic (hypertonic, greater osmotic force than bulk laxatives)
2-Irritant (increase peristaltic motility, increased secretions)

30
Q

Why are osmotic cathartics such as magnesium salts never used in cats?

A

Cats are too susceptible to electrolyte imbalance

31
Q

What are the 5 secretory cells of the stomach?

A 
1-Parietal Cells
2-Chief cells
3-Goblet cells
4-Mucus neck cells
5-G-cells
32
Q

What do parietal cells do?

A

Secrete HCl

Stimulated by acetylcholine, gastrin, and histamine

33
Q

What do chief cells do?

A 
Secrete pepsinogen (turns into pepsin). 
Stimulated by acetylcholine
34
Q

What do goblet cells secrete?

A 
Protective mucus (mucus + bicarbonate)
Stimulated by prostaglandins
35
Q

What do mucus neck cells secrete?

A

Thinner, less viscous mucus

Stimulated by prostaglandins

36
Q

What do G cells secrete?

A

Gastin; stimulates HCl production

37
Q

What are the 4 types of anti-ulcer drugs?

A

1-Non-systemic antacids
2-Systemic antacids (H2 receptor antagonists, proton pump inhibitors)
3-Mucosal protectants
4-Prostaglandin E-1 Analogs

38
Q

What are some examples of non-systemic antacids and what is the mode of action?

A

Calcium (TUMS), Magnesium, Aluminum

Mode of action: neutralize acid molecules in the stomach

39
Q

What are some examples of systemic antacids? How do they work?

A

Examples: Cimetidine: (Tagamet), Ranitidine (Zantac), Famotidine (Pepcid),
Circulate in the body then interact with receptors in the stomach. Most common mode of action: H2 antagonist

40
Q

What are proton pump inhibitors?

A

Inhibit protein (H+) pump which decreases acidity in the stomach to help prevent stomach ulcers. A common one is omeprazole (Prilosec, gastrogard)

41
Q

What is sucralfate?

A

A mucosal protectant that binds with the protein in the ulcer to create a thick “bandage” at the ulcer site.

42
Q

What do prostaglandin E-1 Analogs do?

A

Mimic natural PGE1 in the stomach (prostaglandins responsible for helping to produce protective mucus/mechanisms in the stomach)
Example: Misoprostol (Cytotec)

42
Q

What do prostaglandin E-1 Analogs do?

A

Mimic natural PGE1 in the stomach (prostaglandins responsible for helping to produce protective mucus/mechanisms in the stomach)
Example: Misoprostol (Cytotec)

43
Q

Which species should avoid tylosin antimicrobials? Why?

A

Horses; causes severe diarrhea that can lead to death

44
Q

What is the GI configuration of ruminant animals?

A

They have three forestomachs–the reticulum, rumen, and omasum, and the abomasum “true stomach”

45
Q

What do ruminants use to digest coarse plant material?

A

Microorganisms in the rumen

46
Q

What are the 3 basic control mechanisms of the GI tract?

A

1-The autonomic nervous system
2-Hormonal control
3-Chemical control (histamine, prostaglandin, etc.)

47
Q

What is the significance of the presence of bacterial endotoxins in the GI tract?

A

Bacterial endotoxins may increase the permeability of intestinal blood vessels, resulting in increased fluid loss. They may also induce fever and initiate shock.

48
Q

What is the mechanism of action of saline/hyperosmotic laxatives?

A

Increases/retains water in the GI tract so it softens the stool and stimulates stretch receptors in the gut wall to enhance peristalsis.

49
Q

Direct cholinergic drugs stimulate the GI tract by what mechanism?

A

By mimicking the effect of acetylcholine

50
Q

About what percent of stomach’s contents do emetics usually remove?

A

80%

51
Q

How does sucralfate work to treat/prevent gastric ulcers?

A

It forms a pastelike barrier over the surface of the gastric ulcers, like a protective band-aid

52
Q

What is the crop in birds used for?

A

Food storage

Penn Foster Pharmacology (2 decks)

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