Gastrointestinal Drugs Flashcards

1
Q

What three segments of the GI tract exist in all animal species?

A
  1. Stomach (Gastric)
  2. Small Intestine (Enteric)
  3. Large Intestine (Colonic)
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2
Q

What three segments of the GI tract exist in all animal species?

A
  1. Stomach (Gastric)
  2. Small Intestine (Enteric)
  3. Large Intestine (Colonic)
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3
Q

What are the three basic functions of the GI system?

A
  1. Transport Food
  2. Secrete Digestive Enzymes
  3. Absorbs Nutrients
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4
Q

What factors influence the functions of the GI system?

A
  1. Parasympathetic Nervous System
  2. Sympathetic Nervous System
  3. Prostaglandin E
  4. Hydrochloride Acid
  5. Irritating Compounds & Bacterial Toxins
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5
Q

How does the parasympathetic nervous system affect the GI system?

A
  1. Increased digestive secretions
  2. Increases blood flow to the GI tract
  3. Increases intestinal motility
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6
Q

How does the sympathetic nervous system affect the GI tract?

A
  1. Decreased digestive secretions
  2. Decreased blood flow to the GI tract
  3. Decreases intestinal motility
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7
Q

Prostaglandin E is produced by?

A

GI Cells

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8
Q

Prostaglandin E affects the GI tract by?

A
  1. Increasing intestinal mucus production
  2. Decreasing hydrochloric acid (HCL) secretions
  3. Increases intestinal motility
  4. Increases blood supply to the GI tract
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9
Q

Hydrochloric Acid abbreviation?

A

HCL

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10
Q

Hydrochloric acid is produced by?

A

parietal cells in the stomach

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11
Q

Hydrochloric acid are produced in response to?

A
  1. Histamine
  2. Gastric
  3. Acetylcholine
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12
Q

HCL stand for?

A

Hydrochloric Acid

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13
Q

What is the drug of choice for treatment of diarrhea in small animal medicine?

A

Metronidazole

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14
Q

What is the laxative of choice in cats?

A

Lactulose

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15
Q

what are the main causes of diarrhea?

A
  1. Maldigestion &/or Malabsorption of food
  2. Hyper-secretion of intestinal fluid
  3. Increased permeability of intestinal mucosal blood vessels
  4. Increased intestinal motility
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16
Q

Most antidiarrheal drugs are use to treat?

A

The symptoms but does not actually treat the primary cause of the diarrhea

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17
Q

Large proportion of diarrhea in small animals involve?

A

Decreased motility

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18
Q

What drugs are used to modify intestinal motility? and why?

A
  • Opioid analgesics & anticholinergic drug’s
  • They slow movement of bowl contents
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19
Q

What antidiarrheal drugs act as adsorbents &/or protectants?

A
  1. Activated Charcoal
  2. Kaolin
  3. Pectin
  4. Bismuth Subsalicylate
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20
Q

TRUE/FALSE: Narcotic/Opioid Analgesics antidiarrheal drugs are the most effective agents in the control of diarrhea

A

True

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21
Q

Narcotic/Opioid Analgesics antidiarrheal drugs work by?

A
  • Increasing segmental contractions
  • Decreasing intestinal secretions
  • Enhancing intestinal absorptions
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22
Q

Which species is the use of Narcotic/Opioid Analgesics antidiarrheal drugs controversial?

A

Cats & Horses due to the drug effects to cause CNS stimulation

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23
Q

Narcotic/Opioid Analgesics antidiarrheal drugs are often used in combination with other antidiarrheal agents?

A

True

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24
Q

Narcotic/Opioid Analgesics antidiarrheal drugs clinical use

A
  1. To control diarrhea
  2. Mask pain associated with disease
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25
what are the common Narcotic/Opioid Analgesics antidiarrheal drugs used in vet med?
1. Dipehoxylate (Lomotil) 2. Paregoric 3. Loperamide
26
Dipehoxylate is what type of drug?
antidiarrheal
27
Paraegoric is what type of drug
Antidarrheal
28
Loperamide is what type of drug
antidiarrheal *trade name Imodium
29
Loperamide poorly penetrates what in what species?
Poorly penetrates the central nervous system in cats
30
Loperamide can be purchased by RX or OTC?
Over the counter (OTC)
31
side effects of opioid analgesic antidiarrheal drugs?
- Constipation - Ileus - Sedation - Central nervous system excitement (Cats & Horses)
32
Anticholinergics antidiarrheal drugs are widely used in vet med because?
Most diarrhea in small animals is caused from hypo-motility rather than hyper-motility. This diarrhea is caused by increased colonic contractions
33
Anticholinergics work by?
Blocking the effects of acetylcholine significantly decreases intestinal motility & secretions
34
What are the common anticholinergics antidiarrheal drugs used in vet meds?
1. Atropine 2. Hyoscyamine
35
What anticholinergics antidiarrheal drug is preferred for treating bradycardia and/or irritable bowel syndrome in dogs?
Hyoscyamine
36
Anticholinergics antidiarrheal drug side effects
1. Dry Mucus Membranes 2. Constipation 3. Urinary Retention 4. Tachycardia 5. Behavior Chnages
37
Adsorbents & Protectants Drug work by?
By coating action of these drugs protects inflamed mucosa from further irritation. The adsorbent activity brings bacteria or their toxins to protect against the harmful effects & are less likely to be further absorbed into the body. *These agents are used to control diarrhea & act as adsorbents to protect the intestinal wall
38
Common adbsorbents & protectant drugs used in vet med?
1. Activated Charcoal 2. Kaolin & Pectin (Kaopectate) 3. Bismuth Subsalicylate (Pepto Bismol)
39
Activated charcoal works by?
Adheres enterotoxins to its surface *Preferred Adsorbent & Protectant
40
Kaolin & Pectin works by?
Absorbing enterotoxins & coats the intestinal bowel wall
41
Bismuth Subsalicylate works by?
Bismuth Carbonate cats the intestinal mucosa. Salicylate decreases fluid secretions
42
Bismuth subsalicylate trade name
Pepto Bismol
43
Bismuth subsalicylate is not safe to use in what species?
Cats
44
Laxatives work by?
Increasing the fluid context of feces to facilitate in passage
45
Laxatives clinical use?
Used in the relief of constipation
46
Laxative examples used in vet med?
1. Saline/Hyperosomotic Agents *Lactulose & Milk of Magnesia 2. Bulk Producing Laxative Agents * Bran, Methyceullose, & Metamucil
47
Saline/Hyperosmotic agents work by?
They contain magnesium or phosphate anions that are very poorly absorbed in the GI tract which causes the GI tract to retain water causing the GI tract limes to increase in result increases the osmolaity of the environment softening the still which stimulates the stretch receptors in the GI tract wall to initiate/enhance peristalsis moving the stool along
48
Saline/Hyperosmotic agent side effects?
Cramping & Nausea *Dehydration &/or electrolyte imbalance can occur in overdoses/overuses cases in Cats
49
Bulk producing laxative agents are?
Often indigestible plant material that act as absorbing water (pulling water from the bowel of the lumber) & swelling to increase the bulk of intestinal content therefore stimulating peristalsis (bowel movement).
50
Bulk producing laxative agents clinical use?
Used for relief of constipation & for the relief of some type of impactions
51
Bulk Producing Laxative agents side effects?
1. Few adverse effects 2. Do not give laxatives to dehydrated animals
52
Lubricants are?
Typically oils or other hydrocarbon derivatives (petrolatum) that softens the fecal mass & makes it easier to move through the GI tract
53
Lubricant clinical use?
Used for the relief of constipation & fecal impaction
54
Lubricant most commonly used in vet med?
1. Mineral Oil 2. Cod Liver Oil 3. White Petrolatum
55
Lubricant side effects?
1. Aspiration may occur if mineral oil is given orally 2. Longer term use can decrease absorption of lipid soluble vitamins
56
Stool Softeners/Surfactants are used?
To reduce surface tension & allow after to penetrate the dry stool thus softening the stool increasing intestinal secretions
57
Stool Softeners/Surfactants clinical use?
1. The treatment f hard, dry feces in small animals 2. Impaction in horses 3. Occasionally digestive upset in cattle
58
Common stool softener/surfactant used in vet med?
Docusate Sodium Succinate *Colace
59
Docusate Sodium Succinate side effects
1. May increase Mucosal Fluid Secretion 2. May promote absorption of mineral oil in GI tract leading to hepatitis
60
Gastrointestinal Prokinetic Drugs/Stimulants work by?
Increasing the motility of a part or parts of the GI tract which enhances the transit of material through the GI tract.
61
Common gastrointestinal prokinetic drug used in vet med?
Cisapride
62
Cisaapride is what type of drug & works by?
A Gastrointestinal prokinetic stimulant drug that stimulated colon motility
63
Cisparide clinical use?
Used to prevent constipation in cats
64
Antiulcer drugs are used to?
To counteract the processes that lead to GI ulcer formation
65
What causes a GI ulcer to form?
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
66
Antiulcer drugs are commonly known as?
Antacids
67
Antiacids work by?
Decreasing gastric irritation by decreasing acidity in the stomach
68
Non-Systemic Antacids commonly used in Vet Med?
1. Calcium Carbonate (Tums & Rolaids) 2. Magnesium Hydroxide (Carmilax & Riopan) 3. Aluminum Hydroxide (Amphojel
69
Nonsystemic antacid side effects?
Constipation Diarrhea May interfere with absorption of other drugs
70
Calcium Carbonate possible side effect?
Constipation
71
Aluminum Hydroxide side effect
Can cause constipation
72
Magnesium Hydroxide side effects?
Diarrhea
73
Calcium Carbonate is an?
Non-Systemic Antacid
74
Magnesium Hydroxide is an?
Non-Systemic Antacid
75
Aluminum Hydroxide what type of drug?
Non-Systemic Antacids
76
Common system antiulcer drugs used in vet med?
1. Cimetidine (Tagamet) 2. Ranitidine (Zantac) 3. Famotidine (Pepcid)
77
How do systemic antiulcer drugs work?
By decreasing gastric acid secretion in stomach by blocking histamine receptors on the partial cells
78
What is one special concern you need to be aware about when prescribing Cimetidine?
This drug can inhibit metabolism of some other drugs by the liver
79
Cimetidine is what type of drug?
A Systemic Anti-ulcer/Antacid Drug
80
Ranitidine is what type of drug?
Systemic Anti-Ulcer/Antacid Drug *Trade Name: Zantac
81
Famotidine is what type of drug?
A Systemic Anti-Ulcer Drug *Trade Name: Pepcid
82
Omeprazole is what type of drug?
An Anti-Ulcer Drug *Trade Name: Prilosec & Pantoprazole
83
Sucralfate is what type of drug?
Anti-Ulcer Drug *Trade Name: Carafate
84
Omeprazole works by?
It’s considered a Proton Pump Inhibitor. It works by binding to an enzyme in the parietal cell that prevents the secretion of H+ into the intestinal lumen
85
Sucralfate works by?
- Forming a sticky paste that protects an active ulcer. - Promotes production of PGE
86
Should Sucralfate be andministered at the same time as other antacids?
No
87
Misoprostol is what type of drug?
An antiulcer drug - Synthetic PGE
88
Misoprostol clinical use?
- Treat NSAID overdose/Toxicity as it helps with absorption - Helps in crease GI blood flow
89
Misoprostol can cause?
Abortion
90
Emetics Drugs are?
Drugs to induce vomiting - Vomiting is a protective mechanism designed to remove irritating substances from the GI tract. *Vomiting may be the direct result of many different diseases
91
Vomiting is triggered by what stimuli?
1. Irritation of tisssues innervated by the Vagus Nerve 2. Stimulation of the Chemoreceptor Trigger Zone (CRTZ) 3. Stimulation of vestibular Nerve 4. Stimulation of the Cerebral Cortex
92
Stimulation of the Chemoreceptor Trigger Zone (CRTZ) are triggered by?
Toxins & Overdose
93
Stimulation of the Vestibular Nerve refers to?
Motion Sickness
94
Emesis refers to?
Induction of vomiting which is sometime indicated in animals to remove toxic substances from the GI tract
95
Vomiting must be induced within how many hours for liquids?
2 hours
96
Vomiting must be induced for solids after how many hours?
4 hours
97
Vomiting should not be induced if?
1 Caustic substance was ingested 2. Gasoline or other petroleum products were ingested 3. Animal is unconscious or extremely depressed 4. Animal cannot vomit normally (Horses, Rabbits, Guinea Pigs, etc)
98
What ate the two types of Emetics drugs?
1. Centrally Acting Emetics 2. Locally acting emetics
99
How do centrally acting emetics work?
By stimulating dopamine or alpha 2 receptors in the central nervous system
100
How do locally acting emetics work?
Cause irritation of the GI tract to induce vomiting
101
Apomorphine is what type of drug?
A Centrally Acting Emetic
102
Apomorphine is used in what species?
Dogs
103
Apomorphine has a rapid onset or slow onset of affect?
Rapid Onset of Effect
104
Apomoprhine can be given?
IV, IM, or Subconjunctivally
105
Xylazine is what type of drug?
A Centrally Acting Emetic
106
Xylazine is used mostly in what species?
Cats
107
Xylazine dose is lower or high than the preanesthetic sedation dose?
Lower
108
Xyalzine effects can be reversed with what drug?
Yohimbine
109
Dexmedetomidine is what type of drug?
Is an Alpha 2 Agonist that is more commonly used than Xyalazine as a centrally acting emetic
110
Hydrogen Peroxide is considered what type of drug?
An Locally Acting Emetic Solution
111
What are other alternatives to Hydrogen peroxide as emetics?
1. Salt Water 2. Mustard & Water
112
Antiemetic drugs are used to?
Decrease &/or prevent vomiting
113
What are common antiemetic drugs used in Vet Med?
1. Phenothiazine Tranquilizers 2. Antihistamines 3. Anticholinergics 4. Serotonin Recepter Antagonists 5. Metoclopramide 6. Maropitant
114
Phenothiazine Tranquilizers that are used as antiemetics?
1. Acepromazine 2. Chlorpromazine 3. Prochlorperazine
115
Acepromazine is what type of drug?
A Phenothiazine tranquilizer Antiemetic drug
116
Chlorpromazine is what type of drug?
Phenothiazine tranquilizer antiemetic drug
117
Prochlorperazine is what type of drug?
An antimetic phenothiazine tranquilizer
118
Phenothiazine tranquilizers work as an antiemetic by?
Block dopamine receptors in the central nervous system. Does NOT prevent vomiting caused by GI irritation
119
Antihistamines antiemetic drug examples?
1. Diphenhydramine (Benadryl) 2. Dimenhydrinate (Dramamine)
120
Antihistamine work as antiemetics by?
Inhibiting transmission of nerve impulses from vestibular nerve by blocking histamine receptors. Can produce a sedative effect & affect allergy testing.
121
Anticholinergics that are antiemetic drugs used in vet med?
1. Aminopentamide (Centrine) 2. Isopropamide (Darbazine) 3. Atropine
122
Anticholinergics work as antiemetics by?
Blocking nerve conduction through the vagus nerve when there a GI irritation by blocking the acetylcholine receptors which decrease GI secretions & GI motility.
123
Serotonin Receptor Antagonists antiemetics work by?
Blocking nerve transmission through vagus nerve & prevent stimulation of chemoreceptor trigger zone (CRTZ)
124
What is the least commonly used antiemetic?
Serotonin Receptor Antagonists * Ondanstron (Zofran) & Dolaston (Anzemet)
125
Ondanstron & Dolasetron are examples of what type of antiemetic?
Serotonin Receptor Antagonist
126
metoclopramide is an example of what type of drug?
Antiemetic Drug
127
Metoclopramide works as an antiemetic by?
Blocking dopamine receptors in the central nervous system & acts locally in the GI tract by increasing lower esophageal muscle tone, causing relaxation of pylorus, & increasing GI motility. *It may cause sedation in dogs & excitement in cats
128
Maropitant is what type of drug?
Antimetic *The newest widely used antiemetic *Trade Name: Cerenia
129
Maropitant works as an antiemetic by?
Prevent vomiting centrally & locally Blocks neurokin-1 receptors found in the GI tract, CRTZ, Vestibular nerve, & the vomiting center Helps prevent coughing Provides visceral analgesia during abdominal surgery as a preanesthetic
130
Maropitant label for use?
In dogs & Cats to prevent acute vomiting & vomiting due to motion sickness in dogs
131
Caution should be used when prescribing Maropitant during what situations?
Animals with asthma