drugs acting on the digestive system Flashcards

1
Q

types of drugs acting on digestive system

A
emetics and antiemetics
prokinetic drugs
drugs for the treatment of GI ulcers
laxatives and antidiarrhoeals
appetite stimulants
liver protectants
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2
Q

emetic mechanism of action

A

ingestion of toxic agent, foreign body

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3
Q

emetics are prohibited to use when

A
seizures
pulmonary edema
unconsciousness
pregnant animals
strong acid, alkali
sharp objects
species
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4
Q

list emetics

A

apomorphine
rpoinirol
xylazine
syrup of ipecacuanha

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5
Q

whats apomorphine

A

morphine and HCl

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6
Q

apomorphine side effects

A

excitation or depression

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7
Q

apomorphine dog admin route

A

po, iv, sc, conjunctival

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8
Q

apomorphine mechanism of action

A

CTZ stimulation, inhibition of emetic centre

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9
Q

apomorphine reapplication

A

no effect

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10
Q

ropinirol mechanism of action

A

dopamine rec agonist, D2

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11
Q

roppinirol how long do we wait to readmin

A

20mins

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12
Q

ropinirol side effects

A

irritation, tachycardia, tremors

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13
Q

xylazine mechanism of action

A

alhpa2 agonist - CTZ stimulus

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14
Q

xylazine admin route

A

iv, im

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15
Q

xylazine side effects

A

sedation, hypotension, bradycardia

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16
Q

in which species is xylazine most reliable as an emetic

A

feline

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17
Q

which emetic is a peripheral emetic

A

syrup of ipecacuanha

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18
Q

local antiemetics

A

local anaesthetics

vit B6

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19
Q

systemic antiemetics

A
phenothiazines
dopamine antagonists
antihistamines
serotonin antagonists
NK1 receptor antagonists
parasympatholytics
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20
Q

phenothiazine receptors

A

dopamine antagonist
alpha1 antagonist
H antagonist
serotonin antagonist

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21
Q

phenothiazine side effects

A
hypotension
sedation
hypothermia
seizures enhancement
PRL incr
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22
Q

phenothiazines contraindicactions

A

other dopamine antagonists
hypovolaemia
seizures
animals with pseudopregnancy

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23
Q

phenothiazines that act as antiemetics

A

chlorpromazine
acepromazine
tiethylperazine - not avaliable

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24
Q

where do dopamine antagonists have their action

A

centrally and peripherally

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25
Q

dopamine antagonists where is there constriction

A

cardia

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26
Q

dopamine antagonists where is there an incr in motility

A

body of stomach

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27
Q

dopamine antagonists where is there relaxation and an incr in motility

A

pylorus

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28
Q

dopamine antagonists admin route

A

im, po, iv

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29
Q

F value after po admin of dopamine antagonists

A

50%

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30
Q

dopamine antagonists side effects

A

excitation, seizures

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31
Q

can dopamine antagonists be given with phenothiazines

A

no

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32
Q

dopamine antagonists indications

A

vomiting, disturbances with gastric emptying

gastroesophageal reflux

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33
Q

dopamine antagonists contraindications

A

phenothiazines
ileus
gastric, duodenal ulcer

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34
Q

dopamine antagonists

A

metoclopramide

domperidone

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35
Q

metoclopramide oral bioavaliability

A

50%

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36
Q

serotonin antagonists efficacy

A

excellent efficacy, wide range of indications

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37
Q

serotonin antagonists name

A

ondansetron

dolasetron

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38
Q

ondansetron admin route

A

PO, IV

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39
Q

antihistamines mechanism of action

A

ACh and H antagonists

vestibular centre -> emetic centre

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40
Q

antihistamines indications

A

motion sickness

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41
Q

antihistamines list

A

dimenhydrinate

diphenhydramine

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42
Q

neurokinin 1 antagonists name

A

maropitant citrate

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43
Q

neurokinin1 antagonists F value

A

better orally than sc

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44
Q

neurokinin1 antagonists Tmax

A

45mins

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45
Q

neurokinin1 antagonists T1/2

A

6-8hrs

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46
Q

neurokinin1 antagonists indications

A

orally for the prevention of motion sickness

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47
Q

neurokinin1 antagonists side effects

A

mild analgesic and antiinflammatory effect
reduces dose of iso/sevoflurane
can accumulate

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48
Q

prokinetic drugs list

A
metoclopramide
cisapride
prukaloprid
ranitidine
erythromycin
tegaserod
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49
Q

which prokinetics have their effect on the stomach

A
metoclopramide
domiperidone
ranitidine
cisapride
prukalopride
tegaserod
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50
Q

which prokinetics have their effect on the colon

A

cisapride
prukalopride
tegasaerod

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51
Q

where does metoclopramide have its effect

A

centrally and peripherally

cardia, stomach, pylorus, duodenum

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52
Q

cisapride does it cross the BBB

A

no

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53
Q

cisapride mechanism of action

A

serotonin agonist in myenteric plexus -> ACh release

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54
Q

ranitidine mechanism of action

A

mild AChE receptors -> cholinergic effect - incr motility

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55
Q

erythromycin mechanism of action

A

motilin rec agonist

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56
Q

groups of drugs against GI ulcers

A

acid neutralisers/antacids
acid secretion inhibitors
drugs increasing mucosal resistance

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57
Q

types of acid secretion inhibitors

A

H2 antagonists

proton pump inhibitors

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58
Q

drugs increasing mucosal resistance

A

PGE analogues

coating agents

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59
Q

drugs against GI ulcers indications

A
gastroduodenal ulcer
long acting NSAID and GCC therapy
anorexia
gastritis
ureamia
pancreatitis
hepatopathia
excerise induced lesions
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60
Q

systemic antacids

A

baking soda

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61
Q

non systemic antacids

A

MgO
CaCO3
Al(OH)3

62
Q

can non systemic antacids be used together

A

yes

63
Q

MgO mechanism of action

A

mainly neutralises acid, milk laxative agent

64
Q

Al (OH)3 mechanism of action

A

mainly coats mucosa, milder neutraliser, mild constipation

65
Q

H2 antagonists mechanism of action

A

competitive antagonists of histamine on H2 receptors on parietal cells -> HCl production decr

66
Q

H2 antagonists list

A

cimetidine
ranitidine
famotidine
nizatidine

67
Q

cimetidine half life

A

short

68
Q

cimetidine mechanism of action

A

CYP enzyme inhibitor -> drug interactions

69
Q

ranitidine half life

A

longer in dogs and cats, horse shorter

70
Q

ranitidine admin route

A

po, iv, im

71
Q

famotidine absorption

A

good

72
Q

famotidine half life

A

longest

73
Q

H2 antagonists tolerance

A

can be formed in 3-13 days -> there could also be rebound effect

74
Q

proton pump inhibitors list

A

omeprazole, pantoprazole

75
Q

are omeprazole and pantoprazole prodrugs

A

yes, activated in parietal cells at acidic pH

76
Q

where are omeprazole and pantoprazole activated

A

parietal cells

77
Q

why are proton pump inhibitors given in capsule or coated tablet

A

acid sensitive

78
Q

where do proton pump inhibitors accumulate

A

parietal cells

79
Q

max effect of proton pump inhibitors happens after how long

A

3-4days

80
Q

pharmacokinetics of PPIs after per os admin

A

long effect, even for days, can reduce its own decomposition in the stomach

81
Q

PPIs side effects

A

CYP enyme inhibition

dysbacteriosis -> probiotics

82
Q

PPIs effects after 3-4 weeks

A

tolerance and rebound -> slow completion

83
Q

coating agents list

A

sucralfate

84
Q

whats sucralfate made up of

A

sucrose octasulphate

Al(OH)3

85
Q

whats sucrose octasulphate

A

viscious coating agent
bound to damaged proteins
inactivates pepsin and bile acids

86
Q

whats Al(OH)3

A

antacid and coating

87
Q

what happens to EGF and PGE levels after coating agents

A

increases

88
Q

side effects coating agents

A

rare, constipation

89
Q

when should we give coating agents

A

1hr before feeding

90
Q

PGE analogues list

A

misoprostole

91
Q

misoprostole mechanism of action

A

PGE -> HCl, mucus secretion, vasoregulation -> regeneration

92
Q

misoprotole usage

A

for prevention

93
Q

types of laxatives

A
stimulant laxatives
osmotic
colloidal
coating agents
others - phosphate-salt
94
Q

stimulant laxatives list

A
ricinus
phenolphtalein
bisacodyl
emodin
docusate
95
Q

stimulant laxatives mechanism of action

A

direct smooth muscle stimulation and plexus myentericus stimulation

96
Q

when shouldnt we use stimulant laxatives

A

in severe constipation

97
Q

duration of stimulant laxatives

A

4-6 hours

98
Q

phneolphtalein side effects

A

pink or red discolouration of urine and faeces

99
Q

osmotic laxatives list

A

Na2(SO4)
MgSO4
Na citrate
lactulose

100
Q

osmotic laxatives absorption

A

bad - water retention - diarrhoea

101
Q

lactulose admin route

A

per os or per rectum

102
Q

lactulose what does it do to NH3 abosorption

A

decreases it -> hepatic encephalopathy

103
Q

what happens to luminal pH after admin of lactulose

A

decr in number of NH3 producing bact

104
Q

colloidal laxatives mechanism of action

A

absorb water - extension - increased peristalsis

105
Q

name colloidal laxatives

A

cornmeal
psyllium spp
pumpkin

106
Q

coating agents laxatives list

A

liquid paraffin

107
Q

liquid paraffin admin route

A

po

108
Q

liquid paraffin side effects

A

fat soluble vitamins deficit
paraffin granulomas
decr peristalsis in long term - decr normal stimulus

109
Q

types of antidiarrhoeal drugs

A

absorbents
adstringents
motility modifiers
treatment of chronic colitis

110
Q

absorbents mechanism of action

A

bind toxins, gases, drugs in the GI tract

111
Q

absorbents are they reliable

A

no

112
Q

name three absorbents

A

activated charcoal
kaolin
montmorillonit

113
Q

activated charcoal what does it bind

A

enterotoxins, endotoxins

114
Q

name two adstringents

A

bismuth salts

tannic acid

115
Q

adstringents mechanism of action

A

vasoconstriction - antisecretory and anti-inflammatory

binds to damaged proteins - coagulation - protective layer

116
Q

what do adstringents do to toxins

A

inactivates them

117
Q

when shouldnt we use motility modifiers

A

not in bacterial gastroenteritis

118
Q

two groups of motility modifiers

A

parasympatholytics

morphine derivatives

119
Q

name two morphine derivatives that act as motility modifiers

A

diphenoxylate

loperamide

120
Q

do these morphine derivates acting as motility modifiers cross the BBB

A

slightly

121
Q

treatment of chronic colitis

A

frequently idiopathic - diet and symptomatic treatment

122
Q

types of drugs for appetite stimulus

A
B vitamins
anabolic steroids
benzodiazepines
cyproheptadin
propofol
mirtazapine
123
Q

b vitamins admin route

A

po and parenteral

124
Q

anabolic steroids indications

A

appetite stimulation, haematopoeisis, weight gain

125
Q

anabolic steriods side effects

A

hepatotoxicity, masculinisation, Na and water retention

126
Q

name two anabolic steroids

A

nandrolone, stanzolole

127
Q

benzodiazepines contraindications

A

cat

128
Q

benzodiazepines for use as appetite stimulants

A

diazepam, oxazepam

129
Q

whats cyproheptadin

A

histamine and serotonin antagonist

130
Q

cyproheptadin side effect

A

aggressivity

131
Q

propofol admin

A

low dose, even sc admin

132
Q

mirtazapine can it be used in cats

A

yes

133
Q

three types of hepatoprotectives

A

cholagogues
hepatoprotectants
lipotropic agents

134
Q

two types of cholagogues

A

cholekinetics

choleretics

135
Q

cholekinetics list

A

MgSO4, some volatile oils

136
Q

choleretics list

A

UDCA, menbuton, clanobutin

137
Q

whats UDCA

A
ursodeoxycholic acid - ursodiol, hydrophilic bile acid
choleretic effect
antioxidant
anti apoptotic
cytoprotective
prevents gallstone formation
138
Q

UDCA indications

A

chronic hepatic disease
biliary cirrhosis
cholangitis

139
Q

how often do we admin UDCA

A

SID

140
Q

clanbutin, menbutone effects

A

incr biliary secr
inc pancreatic enzyme secr
incr gastric acid secr

141
Q

clanbutin, menbutone indications

A

inappetance, dyspepsia, cholestasis

142
Q

clanbutin, menbutone contraindications

A

pancreatitis, gastric ulceration,

severe heart failure

143
Q

silymarin effects

A

antioxidant, decr lipid peroxidation
membrane stabiliser, decr penetration
protein synthesis, regen capabilities
decr collagen synthesis

144
Q

silymarin indications

A

acute and chronic heart failure
fibrosis, cirrhosis
hepatotoxic substances

145
Q

choline, methionine effects

A

lipotropic agents

methyl donor, optimise liver funct

146
Q

primary drugs for treatment of hepatic lipidosis

A

choline, methionine

147
Q

choline mechanism of action

A

incr lipoprotein synthesis

148
Q

SAMe what is it

A

derivative of methionine

reactivated by vitB

149
Q

SAMe effects

A

supporting bichemical functions

150
Q

D penicillamine features

A

copper storing hepatopathy

cystinuria

151
Q

other hepatoprotectives

A
glucose
fructose
N acetyl cysteine
vitE
vitC