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pharm II > GI and Hepatobiliary drugs > Flashcards

GI and Hepatobiliary drugs Flashcards

1
Q

What drugs can be used to induce vomiting in dogs?

A
  1. Apomorphine
  2. Ropinirole
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2
Q

What drugs can be used to induce vomiting in cats?

A
  1. Dexmedetomidine
  2. Xylazine (unlikely to have in stock in SA clinic)

(A2 agonists)

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3
Q

What is the MOA of apomorphine?

A

central dopamine agonist in the CRTZ

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4
Q

What is the MOA of ropinirole?

A

central dopamine agonist in the CRTZ

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5
Q

Which of the following emetics has this MOA: central alpha-2 agonism in the vomiting center & CRTZ

A. Dexmedetomidine
B. Ropinirole
C. Apomorphine
D. 3% Hydrogen peroxide

A

A. Demedetomidine

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6
Q

What is the MOA of 3% Hydrogen peroxide?

A

direct irritation to the oropharynx and GIT lining

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7
Q

Inducing emesis with hydrogen peroxide is indicated in what species?

A

Dogs only

hemorrhagic gastroenteritis in cats

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8
Q

Contraindications of using hydrogen peroxide to induce emesis?

A
  • Dont use in cats, hemorrhagic gastroenteritis
  • Dont use with pre-existing GI ulcers or bleeding
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9
Q

What receptors stimulate appetite?

A
  • Norepinephrine
  • Dopamine
  • GABA agonists (benzos, propofol)
  • Ghrelin
  • Serotonin antagonists
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10
Q

Which of the following drugs could be used to treat serotonin syndrome or serotonergic drug toxicity?

A. Propofol
B. Cyproheptadine
C. Capromorelin
D. Metoclopramide

A

B. Cyproheptadine

  • serotonin receptor antagonist
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11
Q

What is the MOA of Mirtazapine?

A. Ghrelin agonist
B. Serotonin antagonist
C. GABA agonist
D. Dopamine agonist

A

B. Serotonin antagonist

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12
Q

What is the MOA of Cyproheptadine?

A. Ghrelin agonist
B. Serotonin antagonist
C. GABA agonist
D. Dopamine agonist

A

B. Serotonin antagonist

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13
Q

What is the MOA of Capromorelin?

A. Ghrelin agonist
B. Serotonin antagonist
C. GABA agonist
D. Dopamine agonist

A

A. Ghrelin agonist

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14
Q

What is the MOA of maropitant?
A. Serotonin antagonist
B. Dopamine antagonist
C. Neurokinin receptor antagonist
D. Ghrelin antagonist

A

C. Neurokinin receptor antagonist

(Cerenia, antiemetic)

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15
Q

What is the MOA metoclopramide?
A. Serotonin antagonist
B. Dopamine antagonist
C. Neurokinin receptor antagonist
D. Ghrelin antagonist

A

A. Serotonin antagonist (at higher doses)
B. Dopamine antagonist

(Dopamine antagonist gives antiemetic effects, Serotonin antagonist gives prokinetic effects)

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16
Q

What is the MOA of ondansetron?
A. Serotonin antagonist
B. Dopamine antagonist
C. Neurokinin receptor antagonist
D. Ghrelin antagonist

A

A. Serotonin antagonist

(antiemetic)

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17
Q

When is use of any antiemetic contraindicated?

A

Contraindicated if GI obstruction cannot be ruled out

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18
Q

Main uses of maropitant citrate?

A

(cerenia)

  • Antiemetic in dogs and cats
  • Prevents motion sickness in dogs
  • Tx of acute vomiting
  • Adjunct analgesic (blocks substance P)
  • Adjunct anti-inflamm for resp dz (asthma)
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19
Q

List the drugs used to inhibit emesis

A
  1. Maropitant citrate (Cerenia)
  2. Metoclopramide
  3. Ondansetron, dolasetron

Others
1. Acepromazine

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20
Q

Which of the following antiemetics also blocks substance P and has a role in adjunct analgesia?

A. Metoclopramide
B. Ondansetron
C. Maropitant
D. Dolasetron

A

C. Maropitant (cerenia)

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21
Q

Which of the following has antiemetic and prokinetic activity?

A. Metoclopramide
B. Ondansetron
C. Maropitant
D. Dolasetron

A

A. Metoclopramide

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22
Q

Main uses of ondansetron?

A
  • Antiemetic for irretractable vomiting (no prokinetic activity)
  • Chemo related nausea
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23
Q

Precautions when using ondansetron?

A
  1. GI obstruction
  2. QT interval prolongation
  3. Extra-pyramidal signs
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24
Q

Main uses of metoclopramide?

A
  • Anti emetic, prokinetic
  • Tx of regurg and ileus
  • Antagonist (Reversal) for apomorphine/Ropinirole induced vomiting
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25
Q

What animals are most at risk of extra-pyramidal signs when using metoclopramide?

A
  • Brachycephalics
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26
Q

Which of the following antacids does not work by competitive inhibition of histamine receptors?
A. Famotidine
B. Cimetidine
C. Omeprazole
D. Ranitidine

A

C. Omeprazole

antacid that irreversibly inhibits H+/K+ proton pump in stomach

27
Q

What is the MOA of famotidine?

A. Binds directly to the ulcer site
B. Increases mucus and bicarb secretion
C. Irreversibly inhibits H+/K+ proton pump in stomach
D. Competitive inhibition of histamine receptors

A

D. Competitive inhibition of histamine receptors

(antacid and GI protector)

28
Q

What is the MOA of Omeprazole?

A. Binds directly to the ulcer site
B. Increases mucus and bicarb secretion
C. Irreversibly inhibits H+/K+ proton pump in stomach
D. Competitive inhibition of histamine receptors

A

C. Irreversibly inhibits H+/K+ proton pump in stomach

(antacid and GI protector)

29
Q

What is the MOA of Pantoprazole?

A. Binds directly to the ulcer site
B. Increases mucus and bicarb secretion
C. Irreversibly inhibits H+/K+ proton pump in stomach
D. Competitive inhibition of histamine receptors

A

C. Irreversibly inhibits H+/K+ proton pump in stomach

(antacid and GI protector)

30
Q

What is the MOA of Cimetidine?

A. Binds directly to the ulcer site
B. Increases mucus and bicarb secretion
C. Irreversibly inhibits H+/K+ proton pump in stomach
D. Competitive inhibition of histamine receptors

A

D. Competitive inhibition of histamine receptors

(antacid and GI protector)

31
Q

What is the MOA of Ranitidine?

A. Binds directly to the ulcer site
B. Increases mucus and bicarb secretion
C. Irreversibly inhibits H+/K+ proton pump in stomach
D. Competitive inhibition of histamine receptors

A

D. Competitive inhibition of histamine receptors

(antacid and GI protector)

32
Q

Which of the following is a prostaglandin analog that increases mucus and sodium bicarb secretion?

A. Famotidine
B. Cimetidine
C. Omeprazole
D. Misoprostol

A

D. Misoprostol

33
Q

Which of the following antacids can be given PO to treat NSAID induced gastric ulcers?

A

Misoprostol (prostaglandin analog)

34
Q

What is not true about Cimetidine?

A. Used for treatment of melanoma in grey horses
B. Antacid with prokinetic activity
C. Hepatic enzyme inhibitor
D. Inhibits gastric acid and pepsin secretion

A

B. Antacid with prokinetic activity

The only antacid with prokinetic activity is Ranitidine

35
Q

Adverse effects of misoprostol?

A
  • GI cramping
  • Diarrhea
  • Colic
  • Abortifacient (stimulates uterine contractions)
36
Q

All of the following have prokinetic effects on the GI tract except?

A. Cisapride
B. Ranitidine
C. Metoclopramide
D. Ondansetron

A

D. Ondansetron

antiemetic only through serotonin antagonism

37
Q

The emetic effects of ropinirole can be reversed with ___________

A

Metoclopramide

38
Q

Apomorphine can be reversed with?

A
  • Naloxone
    -Metoclopramide
39
Q

Which drugs stimulate appetite by blocking serotonin receptors and inhibiting satiety?

A
  1. Mirtazapine
  2. Cyproheptadine
40
Q

Which of the following appetite stimulants is contraindicated in feline acromegaly (excess growth hormone)?

A

Capromorelin (ghrelin agonist)

41
Q

Which antacids work by competitive inhibition of histamine?

A
  1. Famotidine
  2. Cimetidine
  3. Ranitidine
42
Q

Main use of cimetidine?

A
  • Antacid and GI protector by blocking histamine
  • Tx of melanoma in grey horses

-

43
Q

What drug can be used to treat melanoma in grey horses?

A

Cimetidine

(Histamine antagonist, GI protector and antacid)

44
Q

What is the most potent histamine inhibitor?

A

Famotidine

45
Q

Which antacid is a hepatic enzyme inhibitor?

A

Cimetidine

46
Q

List the proton pump inhibitors

A
  1. Omeprazole
  2. Pantoprazole
47
Q

Adverse effects of misoprostol?

A
  • GI cramping
  • Diarrhea
  • Colic in horses
  • Abortifacient (uterine stimulation)
48
Q

What is the main use of di-tri-octahedral smectite (DTO)?

A
  • Toxin neutralization
  • Binds to clostridium perfringens enterotoxins
  • Tx of colitis in LA
49
Q

Which drug is used to treat clostridium perfringens enterotoxemia?

A

di-tri-octahedral smectite (DTO)

(Toxin neutralization)

50
Q

What drug is used for treatment of EPI?

A

Pancrelipase

51
Q

What drug is used to treat hyperphosphotemia due to CKD?

A

Ammonium hydroxide (oral antacid and phosphate binder)

52
Q

MOA of fuzapladib (Panoquell)?

A

Inhibits LFA-1 (leukocyte function-associated antigen inhibitor)

53
Q

Main use of fuzapladib (Panoquell)?

A

Acute pancreatitis in dogs

54
Q

Precautions when using fuzapladib (Panoquell)?

A

Cardiac, renal, hepatic dz

  • not used in dogs < 6 months or pregnant/nursing
  • GI signs
55
Q

List the drugs used to treat liver disease

A
  1. Lactulose
  2. N-Acetylcysteine (NAC)
  3. S-Adenosyl-Methionine (SAMe)
  4. Ursodiol
56
Q

MOA of lactulose?

A
  • Reduces systemic ammonia levels, enhances excretion of ammonia in feces
57
Q

Main use of lactulose?

A
  • Management of hepatic encephalopathy
  • Retention enema
  • Stool softener (Megacolon in cats)
58
Q

Which drug is used as a specific antidote for acetaminophen toxicity?

A

N-Acetylcysteine (NAC)

59
Q

MOA of N-Acetylcysteine?

A

Replenishes tissue glutathione

60
Q

MOA of S-Adenosyl-Methionine (SAMe)?

A

Nutraceutical hepatoprotectant and antioxidant

61
Q

Main uses of S-Adenosyl-Methionine (SAMe)?

A
  • Adjunct tx for hepatic dz and acute hepatotoxicity
62
Q

What is the MOA of Ursodiol?

A
  • Choleretic, increases bile flow
  • Immune-modulating properties
63
Q

When is use of Ursodiol contraindicated?

A

Biliary obstruction

pharm II (23 decks)

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