E1 GI tract

Question 1

What are the four hormones that inhibit appetite?

Answer 1

Serotonin (5 – HT), calcitonin, CCK, and CRH

Question 2

What hormones are responsible for stimulating appetite? (5)

Answer 2

NE (alpha 2 receptor), dopamine (D1 receptor), GABA (by inhibiting the satiety center), endorphins, pancreatic olypeptides

Question 3

What are the three classifications for drugs that can be therapeutic for anorexia/hyporexia?

Answer 3

GABA agonists, serotonin antagonists, miscellaneous.

Question 4

What drugs are your GABA agonists?

Answer 4

Benzodiazepines (diazepam, midazolam), propofol

Question 5

What drugs are your serotonin antagonists?

Answer 5

cyproheptadine and mirtazapine

Question 6

What other drugs are appetite stimulants?

Answer 6

Glucocorticoids (prednisone), B vitami, megestrol acetate, anabolic steroids (Stanozolol)

Question 7

Which of the following is not true about benzodiazepines?
A. They act by stimulating GABA and thereby inhibit the satiety center to increase appetite.
B. They are more effective in dogs than cats.
C. Generally useful for short-term stimulation.
D. Diazepam is given by IV and midazolam is given IM.
E. Oral use of diazepam in cats can cause idiosyncratic hepatotoxicity.

Answer 7

B. They are more effective in dogs than cats.

*more effective in cats than dogs

Question 8

Which of the following is true about propofol?
A. It provides a very short term increase in appetite if given by IV.
B. The mechanism is not well understood but may involve stimulation of GABA and inhibition of 5 – HT.
C. Effect is seen at hypnotic doses.
D. Heinz body anemia is possible if treating a cat repeatedly (greater than five days)
E. All of the above is true
F. None of the above is true.

Answer 8

E. All of the above is true

Question 9

Which of the following is false about Cyproheptidine?
A. It is for oral use and is well absorbed orally.
B. Generally it takes 2 to 3 days to see a clinical response.
C. A side effect is sedation
D. Is generally more effective in cats and dogs
E. All of the above is true

Answer 9

E. All of the above is true

Question 10

Which of the following is false about Mirtazapine?
A. Blocks both 5-HT1 and 5-HT2 receptors, also increases NE
centrally.
B. It is used more in cats than dogs.
C. Pharmacokinetics not well determined and safety efficacy studies have not been done in dogs/cats.
D. The smallest tablet size is 7.5 mg
E. All of the above is true

Answer 10

B. It is used more in cats than dogs.

*it is used more in dogs than cats

Question 11

Which of the following is false?
A. Prednisone works as an appetite stimulant by negative feedback on CRH.
B. Megestrol acetate Is a synthetic progestin with glucocorticoid activity.
C. B vitamins are the least effective if there is a B vitamin deficiency.
D. Anabolic steroids (stanozolol) has questionable evidence as to if it works, and has risks.
E. Two of the above are false.S

Answer 11

C. B vitamins are the least effective if there is a B vitamin deficiency.

Question 12

What are the drug groupings that induce or suppress emesis? (2)

Answer 12

Emetics and antiemetics

Question 13

What is the peripheral drug that induces emesis?

Answer 13

Hydrogen peroxide 3%

Question 14

What is the issue associated with using hydrogen peroxide 3% to induce emesis?

Answer 14

Direct irritation of oropharynx/G.I. lining.

Use caution in cats may cause hemorrhagic gastritis.

Question 15

What are the central drugs that induce emesis? (2)a

Answer 15

Apomorphine and xylazine/dexmedetomidine

Question 16

Which the following is false about xylazine/dexmedetomidine? A. alpha two agonist
B. more effective in cats than dogs (cats have more alpha-2 receptors and fewer D2 receptors)
C. all of the above are true

Answer 16

C. all of the above are true

Question 17

Which of the following is false about apomorphine?
A. Stimulates dopamine (D2) receptors
B. Can be given by all routes (but mainly done through the conjunctival sac)
C. More effective in dogs (cats efficacy – 10%)
D. Overdose can cause respiratory excitation – reverse with naloxone (note that it won’t reverse the emetic effect)
E. All of the above are true.

Answer 17

D. Overdose can cause respiratory excitation – reverse with naloxone (note that it won’t reverse the emetic effect)
* overdose can cause respiratory depression.

Question 18

Look at slide 17.

Answer 18

.

Question 19

Which of the following is false about neurokinin inhibitors (NK1 antagonists)?
A. Antagonists at NK2 receptors which blocks substance P and reduces its contribution to vomiting. Works at the level of the emetic center and the CRTZ
B. Substance P is involved in integration of pain, stress, anxiety, and vomiting.
C. Maropitant citrate is the drug for this type of inhibitor
D. Labeled for prevention of motion sickness in dogs (oral) and treatment of acute vomiting in dogs (oral or SC) and cats (SC)

Answer 19

A. Antagonists at NK2 receptors which blocks substance P and reduces its contribution to vomiting. Works at the level of the emetic center and the CRTZ
*NK1

Question 20

Which of the following is false about Antihistamines (H1 receptor antagonists)?
A. Reduce vestibular input to the CRTZ
B. Generally few side effects
C. Oral medications, typically last 8-12 hours
D. all of the above are true.

Answer 20

D. all of the above are true.

Question 21

True or false: Meclizine (Antivert®) is labeled for dogs.

Answer 21

False. Human labeled. Has been used to treat old-dog vestibular disease and other similar medical conditions

Question 22

True or false: Dimenhydrinate (Dramamine®) is Human labeled OTC medication sometimes used to prevent motion sickness (eg. traveling).

Answer 22

True.

Question 23

Which of the following is false about serotonin antagonists (5-HT receptors)?
A. Act on serotonin receptors centrally only.
B. Initially used for chemotherapy related nausea.
C. More potent than metoclopramide, but more $$$
D. Usually given by injection but oral formula available.

Answer 23

A. Act on serotonin receptors centrally only.

* Act on serotonin receptors centrally and peripherally

Question 24

Look at slide 22.

Answer 24

.