GastroIntestinal II

Question 1

What drug is a good adsorbent with anatacid properties?

Answer 1

Aluminium Hydroxide

Question 2

What would you combine with AL salts to combat constipation?

Answer 2

magnesium antacids

Question 3

How to antacids work?

Answer 3

They are weak bases that react with gastric HCl to form an insoluble colloid and water

Question 4

What type of drugs are used to prevent rebound acid hypersecretion?

Answer 4

Antacids and Prost E analogs-Misoprostal

Question 5

Which drug inactivates pepsin, binds bile salts and induces local PG sytnthesis?

Answer 5

Aluminium Hydroxide

Question 6

Is Alum Hyd a systemic or non systemic antacids?

Answer 6

non systemic

Question 7

What drug increases the gastric pH higher than Al?

Answer 7

Magnesium hyd

Question 8

What other effect does magnesium hyd have, other than an antacid?

Answer 8

acts as a laxative-the unabsorbed Mg salts in the intestines pulls in water and causes gastric distension

Question 9

Is magnesium hyd systemic or non systemic?

Answer 9

non systemic

Question 10

What is the antacid drug of choice for ruminal acidosis?

Answer 10

Al Hydr

Question 11

What is a systemic antacid that generally isn’t used bc it can cause alkalosis, and when used in excess can cause liberation of CO2 and distends the stomach

Answer 11

Sodium Bicarbonate

Question 12

What class of drug is Misoprostol? and what does it mainly do?

Answer 12

Prostaglandin E1 analog-cytoprotective and anti-secretory

Question 13

What are a few things that misoprostol does-other than cytoprotective?

Answer 13

Increases mucosal blood flow (which increases bicarb, mucus production, increases epithelial cell turnover)

stabilizes mast cells

Question 14

What cytoprotective drug requires an acidic environment to protect ulcerated tissue from acid, bile and pepsin?

Answer 14

Sucralfate

Question 15

Which cells does sucralfate stimulate?

Answer 15

Parietal cells-so they secrete mucus and bicarb

Question 16

What drug should you not combine with sucralfate?

Answer 16

Anatacids….remember it needs an acidic environment

Question 17

Sucralfate (decreases or increases??) oral bioavailability of concurrently administered drugs

Answer 17

decreases

Question 18

What is the pharmocologic name of Pepto bismol?

Answer 18

Bismuth subsalicylate

Question 19

What does the bismuth part of Bismuth subsalicylate do for the body?

Answer 19

ADsorbs E. coli enterotoxins

coats ulcerated mucosal surfaces

antibacterial action against GI paths

Question 20

What does salicylate part of bismuth subsalicylate do for the body? 3

Answer 20

Decreases intestinal secretions in diarrhea

Adsorbent

anti-inflammatory

Question 21

Caution is given to what animal when giving bismuth subsalicylate?

Answer 21

cats

bc the salicylate goes systemically

Question 22

What are the categories of drugs that stimulate GI motility?

Answer 22

Cholinergic agonists

Prokinetic agents

Question 23

When would you want to use Carbachol or Bethanechol?

Answer 23

Post-operative ileus

GI muscle atony (a lack of muscle tone)

Question 24

What are the SE of Carbachol and Bethanechol?

Answer 24

Abdominal cramps
Diarrhea
Salivation
Bradycardia

Question 25

When would you NOT want to use Carbachol and Bethanechol? (3)

Answer 25

If you have a mechanical obstruction Animals with peritonitis If intestinal wall is less viable

Question 26

What are the actions Metoclopramide has? (2 main ones)

Answer 26

Prokinetic-enhances release of Ach from cholinergic neurons, sensitizes intestinal sm m to Ach, blocks inhibitory effect of dopamine Antagonizes emesis: promotes gastric emptying, increases force and frequency of gastric contractions, increases lower esoph sphincter NO action on gastric acid/pancreatic secretions

Question 27

When would you want to use metaclopramide?

Answer 27

Reflux esophagitis Gastric motility disorders

Question 28

What drug penetrates the BBB and undergoes hepatic 1st pass metabolism?

Answer 28

Metoclopramide

Question 29

Which prokinetic drug has the broadest spectrum of action?

Answer 29

Cisapride

Question 30

Which prokinetic drug is dose dependent, and increases motility of the entire GIT-including the colon?

Answer 30

Cisapride

Question 31

When do you want to use Cisapride?

Answer 31

Gastric motility disorders Post operative ileus IN EQUINE Constipation associated w/megacolon in cats

Question 32

Which prokinetic drug is a dopamine antagonist which act peripherally?

Answer 32

Domperidone

Question 33

What classes of drugs decrease GI motility and secretions?

Answer 33

Anticholinergic: what else does this drug do? Atropine scopolamine ``` Opioids: Morphine Fentanyl Meperidine Paregoric?!?! ```

Question 34

What class of drug is considered to be antispasmodics/spasmolytics?

Answer 34

Anticholinergics

Question 35

When would you want to use Anticholinergics?

Answer 35

Control diarrhea in calves Mild colic in horses

Question 36

Which drug decreases tone and propulsive movements of GI and decreases intestinal secretions?

Answer 36

Anticholinergic: Hyoscine butylbromide and Metamizole combo also called Buscopan Compositum

Question 37

How do opioids work for decreasing GI motility?

Answer 37

They inhibit Ach release in the GIT Increase the sphincter tone so intestinal propulsive movement is reduced, so more time for water re-absorption leading to constipation

Question 38

What receptor do opioids act through?

Answer 38

Mu

Question 39

When would Opioids be the preferred drug?

Answer 39

Non-specifc acute and chronic diarrhea

Question 40

When would you not want to use Opioids for decreasing GI motility?

Answer 40

Diarrhea due to infectious causes

Question 41

Which opioid is well absorbed from GIT and penetrates the BBB

Answer 41

Diphenoxylate

Question 42

An over dose of diphenoxylate in cats can cause?

Answer 42

Excitability Mydriasis goose-stepping gait loss of balance

Question 43

What is the active metabolite of diphenoxylate

Answer 43

Difenoxin

Question 44

What drug is the preferred anti-diarrheal preparation in foals?

Answer 44

Paregoric

Question 45

What are 3 anti-diarrheal drugs in cats?

Answer 45

Propantheline Loperamide hydrochloride Bismuth subsalicylate

Question 46

What do adsorbents do?

Answer 46

Adsorb toxic chemical cmpd in the GI and prevents systemic absorption

Question 47

What can you combine with Bismuth subsalicylate to help with E coli infections?

Answer 47

Activated charcoal

Question 48

What do you use in the emergency treatment of poisonings?

Answer 48

Activated charcoal rapidly adsorbs many drugs and poisons

Question 49

What should you give about 30-45 minutes after giving activated charcoal and why?

Answer 49

Saline laxative to faciliate the movement of the charcoal complex

Question 50

What drug do you use for hypercholesterolemia in humans, and | pruritis in patients with cholestasis and bile salt accumulation?

Answer 50

Cholestyramine

Question 51

What are some adverse effects of cholestyramine?

Answer 51

nausea constipation steatorrhea decrease absorption of fat-soluble vitamins