emesis and ulcer drugs Flashcards
what are our groups of HCl blockers
PPIs and H2 receptor antagonists
SA H2 receptor antagonists goto drug.
LA?
famotidine
LA ranitidine (NO PO in ruminal dudes)
when do we use famotidine and ranitidine
at beginning of PPI adminstration due to time of onset.
if PPIs aren’t working, try these
what do you need to remember about administering H2 antagonists
can have rebound acid if on the drug for longer than 2 weeks. taper the dose down to prevent this
most often used HCl blocker
PPIs
who is omeprazole for?
dog cat horse. NO RUMINANT OR CAMELIDS
what PPIs can ruminants and camelids get
IV, SQ pantoprazole. $$$$$$
why are compounded PPIs bad
opmeprazole and pantoprazole must be buffered for them to work
important property of PPIs
acid labile. increase the availability of themselves by decreasing acid in stomach
when do we give PPIs
Prex: lower dose and hay diet
tx: on empty stomach higher dose
what is our mucosal protectant? what things do you need to remember about this drug? (3)
sucralfate.
give 2hr before or after other drugs
increases PGE, so inc blood flow
good [] in colon
what is our prosteglandin analog? what does it do?
misoprostol. decreases HCl secretion and increases blood flow.
what is the major thing to remember about misoprostol
do NOT use if you are pregnant or the animal is pregnant.
ulcer treatment for a pregnant animal?
omeprazole and sucrafate (NO misoprostol)
where do are emetic drugs act?
D2: dopamine
NK1: neurokinin
5-HT: serotonin
what are our emetic drugs in dogs (2). why do we choose one over the other
ropinirole: OU
apomorphine: needs to be sterile
MDR1 dog needs to vomit. what drug do you give
ropinirole. not aopmorphine
where do our dog emetics act? (ropinerole and apomorphine)
D2 receptors (dopamine)
classes of antiemetics
thiazides, prokinetics, NK1, serotonin antagonists
what is our prokinetic drug? when do we use it?
metoclopramide.
mainly used as prokinetic. dogs with ME and horses with ileus
MOA of prokinetics (metaclopramide)
antagonists for D2 and HT (emetic receptors)
agonist for 5HT4 (GI motility)
MOA of NK antagonists
inhibit substance p binding. in CRTZ
what is our NK antagonist
maropitant citrate.
cerenia!
when do we give NK antagonist
2 hr prior to car ride, with proemetic sedatives in surgery
where is maropitant citrate metabolized
LIVER
unique feature about maropitant citrate (cerenia)
visceral pain management due to sub p inhibition.
what is our serotonin receptor antagonist?
ondansetron
when do we reach for ondansetron vs maropitant citrate?
ondansetron: chemo associated nausea, severe cases (GIFB)
where does mirtazapine act
antagonist of A2, HT, and H1
capromorelin acts where?
ghrelin hunger hormone mimick. diff dose and [] for dogs and cats
mirtazapine works best in
cats. PO in donkeys. ok in dogs.
