emesis and ulcer drugs

Question 1

what are our groups of HCl blockers

Answer 1

PPIs and H2 receptor antagonists

Question 2

SA H2 receptor antagonists goto drug.
LA?

Answer 2

famotidine
LA ranitidine (NO PO in ruminal dudes)

Question 3

when do we use famotidine and ranitidine

Answer 3

at beginning of PPI adminstration due to time of onset.
if PPIs aren’t working, try these

Question 4

what do you need to remember about administering H2 antagonists

Answer 4

can have rebound acid if on the drug for longer than 2 weeks. taper the dose down to prevent this

Question 5

most often used HCl blocker

Answer 5

PPIs

Question 6

who is omeprazole for?

Answer 6

dog cat horse. NO RUMINANT OR CAMELIDS

Question 7

what PPIs can ruminants and camelids get

Answer 7

IV, SQ pantoprazole. $$$$$$

Question 8

why are compounded PPIs bad

Answer 8

opmeprazole and pantoprazole must be buffered for them to work

Question 9

important property of PPIs

Answer 9

acid labile. increase the availability of themselves by decreasing acid in stomach

Question 10

when do we give PPIs

Answer 10

Prex: lower dose and hay diet
tx: on empty stomach higher dose

Question 11

what is our mucosal protectant? what things do you need to remember about this drug? (3)

Answer 11

sucralfate.
give 2hr before or after other drugs
increases PGE, so inc blood flow
good [] in colon

Question 12

what is our prosteglandin analog? what does it do?

Answer 12

misoprostol. decreases HCl secretion and increases blood flow.

Question 13

what is the major thing to remember about misoprostol

Answer 13

do NOT use if you are pregnant or the animal is pregnant.

Question 14

ulcer treatment for a pregnant animal?

Answer 14

omeprazole and sucrafate (NO misoprostol)

Question 15

where do are emetic drugs act?

Answer 15

D2: dopamine
NK1: neurokinin
5-HT: serotonin

Question 16

what are our emetic drugs in dogs (2). why do we choose one over the other

Answer 16

ropinirole: OU
apomorphine: needs to be sterile

Question 17

MDR1 dog needs to vomit. what drug do you give

Answer 17

ropinirole. not aopmorphine

Question 18

where do our dog emetics act? (ropinerole and apomorphine)

Answer 18

D2 receptors (dopamine)

Question 19

classes of antiemetics

Answer 19

thiazides, prokinetics, NK1, serotonin antagonists

Question 20

what is our prokinetic drug? when do we use it?

Answer 20

metoclopramide.
mainly used as prokinetic. dogs with ME and horses with ileus

Question 21

MOA of prokinetics (metaclopramide)

Answer 21

antagonists for D2 and HT (emetic receptors)
agonist for 5HT4 (GI motility)

Question 22

MOA of NK antagonists

Answer 22

inhibit substance p binding. in CRTZ

Question 23

what is our NK antagonist

Answer 23

maropitant citrate.
cerenia!

Question 24

when do we give NK antagonist

Answer 24

2 hr prior to car ride, with proemetic sedatives in surgery

Question 25

where is maropitant citrate metabolized

Answer 25

LIVER

Question 26

unique feature about maropitant citrate (cerenia)

Answer 26

visceral pain management due to sub p inhibition.

Question 27

what is our serotonin receptor antagonist?

Answer 27

ondansetron

Question 28

when do we reach for ondansetron vs maropitant citrate?

Answer 28

ondansetron: chemo associated nausea, severe cases (GIFB)

Question 29

where does mirtazapine act

Answer 29

antagonist of A2, HT, and H1

Question 30

capromorelin acts where?

Answer 30

ghrelin hunger hormone mimick. diff dose and [] for dogs and cats

Question 31

mirtazapine works best in

Answer 31

cats. PO in donkeys. ok in dogs.