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Pharmacology > Gastrointestinal (year 2) > Flashcards

Gastrointestinal (year 2) Flashcards

1
Q

what can lead to electrolyte/fluid imbalance in the GI tract?

A

vomiting and obstructed pylorus

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2
Q

what non-specific therapy used to correct fluid/electrolyte imbalances?

A

parenteral fluid therapy

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3
Q

name 4 classes, with examples, of drugs used for pain management

A

NSAIDS - dipyrone, phenylbutazone
Opioids - morphine, butorphanol
Sedative - xylaxine, detomidine
Anti-spasmodic - hyoscine

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4
Q

what class of drugs are used in the management of acid secretion and ulcers?

A

antacids

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5
Q

what is the role of antacids?

A

inhibit acid secretion, neutralise existing acid, coat/protect gastric mucosa

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6
Q

give two groups of drugs that inhibit acid secretion with examples

A

histamine2 blockers - cimetidine, rantidine

proton pump inhibitors - omeprazole

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7
Q

how do proton pump inhibitors work?

A

irreversibly binds to hydrogen potassium ATPase pump

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8
Q

name a locally acting antacid

A

aluminum and magnesium salts

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9
Q

how do locally acting antacids work?

A

neutralise luminal acid, inhibit pepsin cleavage, act as adsorbents, stimulate prostaglandins to enhance mucosal barrier protection

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10
Q

name a gastric protectant that can be given

A

sucralfate

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11
Q

what is sucralfate and how does it work?

A

viscous gel at pHs less than 4, binds to ulcerated proteins to protect from acids and pepsin

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12
Q

what are the drugs called used to stimulate vomiting?

A

emetics

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13
Q

name the four stimuli of vomiting

A

chemoreceptor trigger zone via dopaminergic input
chemoreceptor trigger zone and vomiting centre via substance P binding to neurokinin1 (NK1) receptors
vagal/sympathetic afferent pathways of GI tract
vestibular apparatus via cholinergic/histaminergic afferent pathways

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14
Q

what animals have a well defined vomiting reflex?

A

carnivores and omnivores

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15
Q

name some animals with a poorly developed vomiting reflex

A

cow, horse, rat, rabbit

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16
Q

when may emetics be used?

A

induce vomiting after toxin ingestion or prior to anaesthesia

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17
Q

name a centrally acting emetic

A

apomorphine - stimulate chemoreceptor trigger zone

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18
Q

name a peripherally acting emetic

A

sodium chloride or bicarbonate of soda - stimulate vagal/sympathetic afferent receptors in pharynx/stomach

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19
Q

name the group of drugs used to prevent vomiting

A

anti-emetics

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20
Q

why would you want to use an anti-emetic?

A

vomiting leads to electrolyte and acid/base imbalances along with dehydration

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21
Q

why must diagnosis be confirmed before using an anti-emetic?

A

they may be contraindicative if used when there is a gastric/intestinal obstruction

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22
Q

what are the 4 drug groups used as anti-emetics?

A

anti-histamines, anticholinergics, antidopaminergic agents, NK1 antagonists

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23
Q

give examples of anti-histamines and how they work when used as an anti-emetic

A

diphenylhydramine, promethazine - block histaminergic and cholinergic afferent pathways from vestibular organs to the vomiting centre

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24
Q

give examples of anti-cholinergic and explain how they work when used as anti-emetics

A

propantheline - block cholinergic afferent pathways from the GI tract to the vomiting centre

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25
Q

name the two drugs used as antidopaminergic agents for anti-emetic use

A

phenothiazines and metoclopramide

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26
Q

how do phenothiazines work as anti-emetics?

A

block dopamine receptors in chemo-receptor trigger zones and when used at high doses it can block those in the vomiting centre

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27
Q

how does metoclopramide work as an anti-emetic?

A

blocks dopaminergic receptors in the chemo-receptor trigger zone, also able to stimulate GI motility

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28
Q

name an NK1 antagonist used as an anti-emetic

A

maropitant

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29
Q

how does maropitant work as an anti-emetic?

A

binds to receptors in the chemo-receptor trigger zone and vomiting centre to block the binding of substance P

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30
Q

what are the uses for laxatives/cathartics?

A

relief of non-dietary acute constipation, removal of toxic ingestants, prevent tenesmus, evacuation of bowl for surgery/radiography

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31
Q

what is tenesmus?

A

cramping rectal pain

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32
Q

what are the two classes of cathartics?

A

osmotic and irritant

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33
Q

what are some examples of osmotic cathartics?

A

lactulose, magnesium sulphate (Epsom salts), sodium sulphate, polyethylene glycol

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34
Q

how do osmotic cathartics work?

A

they are non-absorbable so draw water into the lumen of the gut causing distention which stimulates contractions

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35
Q

give an example of a irritant cathartic

A

caster oil

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36
Q

name some laxatives

A

ispaghula and sterculia

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37
Q

how do laxatives work?

A

contain hydrophobic colloids that absorb water and increase the ingest bulk to stimulate peristalsis

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38
Q

give an example of a lubricant used as a laxative/cathartic

A

paraffin oil

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39
Q

give an example of a surfactant used as a laxative/cathartic

A

docusate

40
Q

how do surfactants work as laxatives/cathartics?

A

hydrate and soften faeces by emulsifying actions

41
Q

during diarrhoea what needs to be correct and how?

A

dehydration by oral rehydration therapy using glucose/amino acids to enhance water uptake and electrolytes to correct any imbalances

42
Q

what are three classes of drugs used as antidiarrhoeals?

A

protectants/adsorbents, opiates, anti-cholinergic agents

43
Q

how to protectants/adsorbents work? give examples of them

A

adsorbs toxins and provides protective coating to inflame mucosa. also stimulate prostaglandin and bicarbonate secretions - bismuth salts, kaolin-pectin

44
Q

how do opiates work as anti-diarrhoeals? give examples of them

A

inhibit acetylcholine release increase segmental contractions to slow transit and allow more water absorption - loperamide and codeine

45
Q

how do anti-cholinergic agents act as anti-diarrhoeals?

A

inhibit propulsive and non-propulsive GI motility

46
Q

what is anorexia?

A

when an animal won’t eat

47
Q

what non-pharmacological ways can an animal be encouraged to eat?

A

warm palatable food and liquid enteral alimentation

48
Q

give examples of drugs used as appetite stimulants

A

benzodiazepines (diazepam, oxazepam), cyroheptadine, glucocorticoids (prednisolone, dexamethasone)

49
Q

how do benzodiazepines work to stimulate appetite?

A

increase GABA - leading to anti-serotonergic effect depressing the satiety centre in the hypothalamus

50
Q

how does cyroheptadine work to stimulate appetite?

A

it is a serotonin and histamine antagonist suppressing the satiety centre in the hypothalamus

51
Q

what are probiotics?

A

sample of normal intestinal flora

52
Q

what are probiotics?

A

substrates that promote normal intestinal microbes

53
Q

name 4 drugs specifically used as bowel anti-inflammatories

A

sulfasalazine, olsalazine, tylosin, metronidazole

54
Q

how does sulfasalazine work?

A

cleaved by bacteria to sulphapyridine and salicylate, the salicylate has anti-inflammatory effects

55
Q

how does olsalazine work?

A

cleaved by bacteria to salicylate, the salicylate has anti-inflammatory effects, doesn’t contain sulphapyridine so is less toxic than sulfasalazine

56
Q

how does tyrosine work?

A

surpasses bacteria overgrowth by inhibiting protein synthesis in them

57
Q

how does metronidazole work?

A

anti-protozoa and anti-bacterial so suppresses cell mediated immune reaction s

58
Q

what are are 4 main drug groups used for the management of pancreatic and liver disease?

A

digestants, urso-deoxycholic acid, lactulose, hepato-biliary cytoprotective agenst

59
Q

name two digestants

A

pancreatic enzyme supplements and bile acid/salts

60
Q

what are pancreatic enzyme supplements used to treat?

A

exocrine pancreatic insufficiency

61
Q

what do pancreatic enzyme supplements contain?

A

lipase, amylase, protease that are usually administered with acid inhibitors to prevent destruction of enzymes

62
Q

how do bile acid work?

A

stimulate the flow of bile

63
Q

how do bile salts work?

A

emulsify dietary lipids to enhance the digestion and absorption

64
Q

what are urso-deoxycholic acids used to treat?

A

cholestatic liver disease in which bile acids build up in the body, the hydrophobic bile acids are toxic to hepato-biliary cell membranes

65
Q

how do urso-deoxycholic acids work?

A

it is a hydrophilic bile acid that inhibits the ideal absorption of hydrophobic bile acids. acts as a cyto-protective of the biliary system

66
Q

when is lactulose used?

A

used for patients with hepatic encephalopathy to reduce the blood anaemia levels as the acid traps ammonia and ammonium ions that are egested

67
Q

what happens to lactulose when in the body?

A

metabolised by colonic bacteria into organic acids (lactic, formic, acetic) that aren’t well absorbed and trap ammonia and ammonium ions

68
Q

name three hepato-biliary cytoprotective agents

A

S-adenosylmethionine, silymarin, vitamin E

69
Q

how does S-adenosylmethionine work?

A

antioxidant used to stabilise membrane function and modulate cytokine expression

70
Q

how does silymarin work?

A

it is a reactive oxygen species scavenger that increases hepatic protein synthesis and bile secretions. also works as an anti-inflammatory and antifibrotic

71
Q

what is vitamin E used as?

A

antioxidant and anti-inflammatory

72
Q

what is the chemical name for vitamin E?

A

tocopherol

73
Q

what is an important consideration when giving oral medication to young calves/lambs?

A

oesophageal groove must be stimulated to ensure the drug bypasses the developing g rumino-reticulum

74
Q

what is the pH of the rumen needed for efficient fermentation?

A

5.5-7

75
Q

what are two requirements of the rumen microbes?

A

proper nutrient intake and normal gut motility

76
Q

what is the extrinsic and intrinsic innervation of the ruminants GI system?

A

extrinsic - vagal

intrinsic - enteric nervous system

77
Q

how can you stimulate the closure of the oesophageal groove to allow bypass of the rumino-reticulum and passage of drugs into the abomasum and small intestine?

A

warm milk, copper sulphate, sodium bicarbonate

78
Q

what are cholinergics used for when restoring rumen function?

A

to increase the frequency of contractions

79
Q

what drug can be administered parenterally to stimulate extrinsic contractions when restoring rumen function?

A

opiate antagonists

80
Q

what can be done to introduce more healthy bacteria and protozoa into the rumen?

A

rumen transfer of fluids from a viable patient

81
Q

give two examples of rumen antacids and what they are used for

A

aluminium hydroxide and calcium carbonate used to treat mild cases of rumen acidosis

82
Q

what is used to treat more severe cases of rumen acidosis?

A

parenteral fluid therapy and/or evacuation of the rumens contents

83
Q

give examples of products able to be used as rumen acidifiers

A

vinegar and acetic acid

84
Q

when may rumen acidifiers be used?

A

treat excess bicarbonate influx from hyper-salivation or in acute area poisoning to convert ammonia into ammonium to reduce absorption

85
Q

what are viscosity altering agents used for?

A

anti-bloat

86
Q

give an example of anti-bloat agents and how it is used

A

mineral/vegetable oil to treat frothy bloat by altering the surface tension of bubbles and allowing them to break up

87
Q

what is colic?

A

abdominal pain of the GI tract

88
Q

what defines the difference between surgical and medical colic?

A

if the pain can be managed then it is medical

89
Q

what drugs can be given to manage pain?

A

NSAIDs - phenylbutazone and flunixin meglumine

opiates - butorphanol

90
Q

how long do the drugs used to manage pain work for and when are they used?

A

phenylbutazone - short acting for mild pain
flunixin meglumine - long acting for severe pain so may mask signs
butorphanol - short acting for moderate pain

91
Q

name the three medical colics

A

spasmodic, pelvic flexure impaction and flatulent

92
Q

what is spasmodic colic and how is it treated?

A

hypermotility of the small intestines treated by anti-spasmodics such as butylscopolamine and analgesics

93
Q

how does butylscopolamine work?

A

inhibits M1 muscarinic acetylcholine receptors

94
Q

what is pelvic flexure impaction colic and how is it treated?

A

impaction of the narrowing between left ventral and right dorsal colon treated with oral fluid for lubrication/softening on impaction

95
Q

what is flatulent colic and how is it treated?

A

build up of gas causes distention treated with pain management using opioids

Pharmacology (25 decks)

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