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End for Exam 2 (GI drugs) Flashcards

1
Q

what are the basic functions of the GIT? (3)

A
  1. Transport food
  2. Secrete digestive enzymes
  3. Absorb nutrients
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2
Q

what are the factors that influence the GIT? (4)

A
  1. Parasympathetic and sympathetic nervous systems
  2. Prostaglandin E
  3. Hydrochloric acid (HCl) production in the stomach
  4. Irritating compounds and bacterial toxins
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3
Q

where is prostaglandin E produced?

A

GI cells

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4
Q

what is the function of prostaglandin E? (4)

A
  1. inc. intestinal mucus production
  2. dec. HCl acid secretion
  3. inc. intestinal motility
  4. inc. blood supply to GI tract
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5
Q

where is hydrochloric acid (HCI) produce?

A

parietal cells in the GIT

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6
Q

what stimulates the parietal cells to produce hydrochloric acid (HCI)? (3)

A
  1. Histamine
  2. Gastrin
  3. Acetylcholine
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7
Q

Diarrhea

A

abnormally frequent discharge of fecal matter of increased volume and fluid content

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8
Q

what are some causes of diarrhea? (4)

A
  1. Maldigestion or malabsorption of food
  2. Hypersecretion of intestinal fluid
  3. Increased permeability of intestinal mucosal blood vessels
  4. increased intestinal motility
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9
Q

what can cause hypersecretion in the GIT?

A

bacterial infection

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10
Q

what can cause increased permeability?

A

Caused by inflammation

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11
Q

what can cause inflammation in the GIT?

A

IBD or parasite

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12
Q

what can cause an increase of Intestinal motility?

A

toxins and any type of irritation

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13
Q

what are most antidiarrheal drugs used to treat?

A

symptom but not the primary cause of the diarrhea

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14
Q

what the categorites of antidiarrheals? (2)

A
  1. modify intestinal motility

2. act as adsorbents and/or protectants

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15
Q

how do antidiarrheals that modify intestinal motility work?

A

slow movement of bowel contents

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16
Q

what kind of antidiarrheals modify intestinal motility? (2)

A
  1. opioid analgesics

2. anticholinergics

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17
Q

why are opioid analgesics and anticholinergics not frequently used?

A

a large proportion of diarrheas in small animals involve decreased motility

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18
Q

what kind of antidiarrheals act as adsorbents and/or protectants? (3)

A
  1. activated charcoal
  2. kaolin and pectin
  3. bismuth subsalicylate
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19
Q

what are some examples of opiod analgesics antidiarrheals? (3)

A
  1. diphenoxylate (Lomotil)
  2. paregoric (tincture of opium)
  3. loperamide (Imodium)
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20
Q

what class of drugs are opiod analgesics antidiarrheals?

A

Controlled drugs

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21
Q

what is the concerns with using opiod analgesics antidiarrheals?

A

Increase contact time between toxins and mucosa

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22
Q

what is a benefit to using opiod analgesics antidiarrheals?

A

Mask pain associated w/ disease

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23
Q

How do opiod analgesics antidiarrheals work?

A

Increase segmental contrations

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24
Q

how ca Increase segmental contrations Help?

A

work as a trap to keep digesta in intestinal tract longer to hep absorption of water.

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25
Q

How do anticholinergics work as an antidiarrheal?

A

Block the effect of acetylcholine

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26
Q

why are anticholinergics not commonly used as an antidiarrheal in small animals?

A

In small animals increased motility is not a common cause of diarrhea

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27
Q

what are some example of anticholinergics? (3)

A
  1. atropine
  2. isopropamide (Darbazine),
  3. aminopentamide (Centrine)
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28
Q

what kind of diarrheal cases are anticholinergics effective against

A

diarrhea caused by increased colonic contractions

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29
Q

what is the purpose of Adsorbents and Protectants?

A

Prevent irritating compounds and bacterial toxins from contacting the intestinal mucosa

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30
Q

how does Bismuth subsalicylate work as a absorbent/protectant? (3)

A
  1. bismuth carbonate coats intestinal mucosa
  2. salicylate decreases fluid secretion
  3. Decreases fluid secretion by reducing inflammation
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31
Q

what are some example of Adsorbents and Protectants? (3)

A
  1. Activated charcoal
  2. Kaolin and Pectin (Kaopectate)
  3. Bismuth subsalicylate (Pepto-Bismol)
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32
Q

how does Activated charcoal work as a absorbent/protectant?

A

adsorbs enterotoxins to its surface

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33
Q

how does Kaolin and Pectin work as a absorbent/protectant? (2)

A
  1. adsorbs enterotoxins

2. coats the intestinal bowel wall

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34
Q

how do laxatives work?

A

Increase the fluid content of feces to facilitate passage

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35
Q

what are the categories of laxative? (2)

A
  1. Irritant laxatives

2. Bulk laxatives

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36
Q

what are some example of irritant laxatives? (2)

A
  1. castor oil

2. phenolphthalein

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37
Q

how do irritant laxatives work? (2)

A
  1. irritate the intestinal mucosa

2. increase fluid secretion and peristaltic activity

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38
Q

what are some examples of bulk laxatives? (5)

A
  1. bran
  2. methylcellulose
  3. psyllium (Metamucil)
  4. magnesium salts (Milk of Magnesia, Epsom Salts)
  5. phosphate salts (Fleet Enema)
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39
Q

how do bulk laxatives work?

A

osmotically pull water into intestinal lumen

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40
Q

what are some conderns with bulk laxatives? (2)

A
  1. salts may dehydrate the animal

2. absorption of minerals from intestine may cause electrolyte imbalance

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41
Q

how do lubricants work?

A

Make stool more slippery for easy passage through the bowel

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42
Q

what are some examples of lubricants? (3)

A
  1. mineral oil
  2. cod liver oil
  3. white petrolatum
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43
Q

what is he concern with long term use of lubricants?

A

can decrease absorption of lipid-soluble vitamins

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44
Q

what combination of lubricants is Catlax?

A

cod liver and while petrolatum

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45
Q

what is the purpose of stool softeners?

A

Reduce surface tension of the feces allowing water to penetrate dry stool

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46
Q

what is an example of a stool softeners?

A

docusate sodium succinate (Colace)

47
Q

what can docusate sodium succinate cause in the GIT?

A

May increase mucosal fluid secretion

48
Q

what should you not use docusate sodium succinate with?

Why?

A

mineral oil

May promote absorption of it in the GI tract leading to hepatitis

49
Q

what does cisapride doin the GIT?

A

Stimulates colon motility

50
Q

what species is cisapride used on?

what does it help prevent?

A

cats

constipation

51
Q

what is the purpose for antiulcer drugs?

A

Intended to counteract the processes that lead to GI ulcer formation

52
Q

what can lead to GI ulcer formation? (5)

A
  1. hyperacidity
  2. direct injury by drugs or chemicals
  3. reflux of bile from duodenum into stomach
  4. accumulation of metabolic toxins
  5. decreased PGE production
53
Q

what are most antiulcer drug used as?

A

antacids in the stomach

54
Q

what can be the cause of hyperacidity? (2)

A
  1. Glucocorticoids

2. NAIDS

55
Q

how do antacids work?

A

Antacids decrease gastric irritation by decreasing acidity

56
Q

what are the categories of antacids? (2)

A
  1. non systemic

2. systemic

57
Q

what are some nonsystemic antacids?

A 
calcium carbonate (Tums, Rolaids)
magnesium hydroxide (Carmilax, Riopan)
aluminum hydroxide (Amphojel)
58
Q

how do nonsystemic antacids work?

A

minerals directly neutralize acid molecules in the stomach

59
Q

what can Ca and Al nonsystemic antacids cause?

A

constipation

60
Q

what can Mg nonsystemic antacids cause?

61
Q

how can nonsystemic antacids interfere with other drugs?

A

absorption

62
Q

how does aluminum hydroxide work as a nonsystemic antacid?

A

will have a reaction with hydrocholoric acid and produce water, decreases the acidity

63
Q

what is amphojel used to help prevent in cats?

A

constipation

64
Q

what are some systemic antacids?

A

cimetidine (Tagamet)
ranitidine (Zantac)
famotidine (Pepcid)

65
Q

how do systemic antacids work?

A

decrease gastric acid secretion in stomach by blocking histamine receptor on parietal cell

66
Q

what is a concern with cimetidine?

A

inhibits metabolism of some other drugs by the liver

67
Q

how does omeprazole work as an antacid?

A

binds to an enzyme in the parietal cell to prevent secretion of H+ into the intestinal lumen

68
Q

how does sucralfate work?

A
  1. forms sticky paste that protects an active ulcer

2. promotes production of PGE

69
Q

when should sucralfate not be administered?

A

at the same time as antacid medications

70
Q

what is Misoprostol?

A

Synthetic PGE

71
Q

what is miosprostol used to treat?

A

NSAID overdose

72
Q

what is vomiting?

A

a protective mechanism designed to remove irritating substances from the GI tract

73
Q

what are the stiumlie that trigger vomiting? (4)

A
  1. Irritation of tissues innervated by vagus nerve
  2. Stimulation of the chemoreceptor trigger zone
  3. Stimulation of vestibular nerve
  4. Stimulation of cerebral cortex
74
Q

what it the purpose of inducing vomiting?

A

remove toxic substances from GI tract

75
Q

when must vomiting be induce for liquid toxicity?

A

w/in 2 hrs.

76
Q

when must vomiting be induce for solid toxicity?

A

w/in 4 hrs.

77
Q

when should vomiting NOT be induced? (4)

A
  1. caustic substance was ingested
  2. gasoline or other petroleum products were ingested
  3. animal is unconscious or extremely depressed
  4. animal can not normally vomit
78
Q

what are the categories of drugs that are used to induce vomiting? (2)

A
  1. Centrally acting emetics

2. Locally acting emetics

79
Q

how do centrally acting emetics work?

A

stimulate dopamine receptors in the CNS

80
Q

how do locally acting emetics work?

A

cause irritation of the GI tract

81
Q

what kind of emetic is apomorphine?

A

centrally acting emetic

82
Q

how soon does it start to work?

A

rapid onset of effect

83
Q

what route can it be given?

A

IV, IM, or subconjunctivally

84
Q

what are some adverse effects of apomorphine?

A

CNS depression and prolonged vomiting

85
Q

what kind of emetic is Syrup of Ipecac?

A

locally acting emetic

86
Q

what irritation can Syrup of Ipecac cause?

A

irritation of the small intestine

87
Q

what can Syrup of Ipecac be toxic to in high concerntrations?

A

heart muscle

88
Q

what should not be given with Syrup of Ipecac?

A

activated charcoal

89
Q

what kind of emetic is Hydrogen peroxide?

A

locally acting emetic solutions

90
Q

what kind of emetic is warm concentrated salt water?

A

locally acting emetic solutions

91
Q

what kind of emetic is mustard and water?

A

locally acting emetic solutions

92
Q

what is a concern with locally acting emetic solutions?

A

may not work consistently

93
Q

what is an emetic drug?

A

will induce vomiting

94
Q

what is an antiemetic drug?

A

Drugs used to decrease or prevent vomiting

95
Q

what are the categories of antiemetic drugs?

A 
Phenothiazine tranquilizers
Antihistamines
Anticholinergics
Serotonin receptor antagonists
Metoclopramide (Reglan)
Maropitant (cerenia)
96
Q

what are some example of Phenothiazine tranquilizers as an antiemetic?

A
  1. acepromazine
  2. chlorpromazine
  3. prochlorperazine
97
Q

how do Phenothiazine tranquilizers work as an antiemetic

A

block dopamine receptors in the CNS

98
Q

why are phenothiazine tranquilizers not the best medication to give to dogs and cats?

A

do not prevent vomiting caused by GI irritation

99
Q

what are some examples of antihistamines as an antiemetic?

A
  1. diphenhydramine (Benadryl)

2. dimenhydrinate (Dramamine)

100
Q

how do antihistamines work as an antiemetic?

A

inhibit transmission of nerve impulses from vestibular nerve by blocking histamine receptors

101
Q

what are the concerns with using an antihistamines as an antiemetic?

A

can produce a sedative effect and affect allergy testing

102
Q

what are some examples of Anticholinergics as an antiemetic?

A

aminopentamide (Centrine)
isopropamide (Darbazine)
atropine

103
Q

how do anticholinergics work as an antiemetic?

A

block nerve conduction through vagus nerve when there’s GI irritation (block acetylcholine receptors)

104
Q

what can anticholinergic decrease in the GIT?

A

decrease GI secretions and GI motility

105
Q

what are some examples of Serotonin receptor antagonists as an antiemetic?

A

ondansetron (Zofran)

dolasetron (Anzemet)

106
Q

how do Serotonin receptor antagonists work as an antiemetic?

A

block nerve transmission through vagus nerve when there is GI irritation

107
Q

which antiemetic is seldom used in animals?

A

Serotonin receptor antagonists

108
Q

how does Metoclopramide work as an antiemetic?

A

blocks dopamine receptors in the CNS

also acts locally in GI tract

109
Q

how does metoclopramide work locally in the GIT?

A
  1. increasing lower esophageal muscle tone
  2. causing relaxation of pylorus
  3. increasing GI motility
110
Q

what can metoclopramide cause in dogs?

111
Q

what can metoclopramide cause in cats

A

excitement

112
Q

which antiemectic is newest and widley used?

A

Maropitant (cerenia)

113
Q

how does it prevent vomiting?

A

centrally and locally

114
Q

what is the labeled use for maropitant?

A

in dogs to prevent vomiting and motion sickness

Pharmacology (9 decks)

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