GI and Hepatobiliary drugs Flashcards
What drugs can be used to induce vomiting in dogs?
- Apomorphine
- Ropinirole
What drugs can be used to induce vomiting in cats?
- Dexmedetomidine
- Xylazine (unlikely to have in stock in SA clinic)
(A2 agonists)
What is the MOA of apomorphine?
central dopamine agonist in the CRTZ
What is the MOA of ropinirole?
central dopamine agonist in the CRTZ
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. Demedetomidine
What is the MOA of 3% Hydrogen peroxide?
direct irritation to the oropharynx and GIT lining
Inducing emesis with hydrogen peroxide is indicated in what species?
Dogs only
hemorrhagic gastroenteritis in cats
Contraindications of using hydrogen peroxide to induce emesis?
- Dont use in cats, hemorrhagic gastroenteritis
- Dont use with pre-existing GI ulcers or bleeding
What receptors stimulate appetite?
- Norepinephrine
- Dopamine
- GABA agonists (benzos, propofol)
- Ghrelin
- Serotonin antagonists
Which of the following drugs could be used to treat serotonin syndrome or serotonergic drug toxicity?
A. Propofol
B. Cyproheptadine
C. Capromorelin
D. Metoclopramide
B. Cyproheptadine
- serotonin receptor antagonist
What is the MOA of Mirtazapine?
A. Ghrelin agonist
B. Serotonin antagonist
C. GABA agonist
D. Dopamine agonist
B. Serotonin antagonist
What is the MOA of Cyproheptadine?
A. Ghrelin agonist
B. Serotonin antagonist
C. GABA agonist
D. Dopamine agonist
B. Serotonin antagonist
What is the MOA of Capromorelin?
A. Ghrelin agonist
B. Serotonin antagonist
C. GABA agonist
D. Dopamine agonist
A. Ghrelin agonist
What is the MOA of maropitant?
A. Serotonin antagonist
B. Dopamine antagonist
C. Neurokinin receptor antagonist
D. Ghrelin antagonist
C. Neurokinin receptor antagonist
(Cerenia, antiemetic)
What is the MOA metoclopramide?
A. Serotonin antagonist
B. Dopamine antagonist
C. Neurokinin receptor antagonist
D. Ghrelin antagonist
A. Serotonin antagonist (at higher doses)
B. Dopamine antagonist
(Dopamine antagonist gives antiemetic effects, Serotonin antagonist gives prokinetic effects)
What is the MOA of ondansetron?
A. Serotonin antagonist
B. Dopamine antagonist
C. Neurokinin receptor antagonist
D. Ghrelin antagonist
A. Serotonin antagonist
(antiemetic)
When is use of any antiemetic contraindicated?
Contraindicated if GI obstruction cannot be ruled out
Main uses of maropitant citrate?
(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)
List the drugs used to inhibit emesis
- Maropitant citrate (Cerenia)
- Metoclopramide
- Ondansetron, dolasetron
Others
1. Acepromazine
Which of the following antiemetics also blocks substance P and has a role in adjunct analgesia?
A. Metoclopramide
B. Ondansetron
C. Maropitant
D. Dolasetron
C. Maropitant (cerenia)
Which of the following has antiemetic and prokinetic activity?
A. Metoclopramide
B. Ondansetron
C. Maropitant
D. Dolasetron
A. Metoclopramide
Main uses of ondansetron?
- Antiemetic for irretractable vomiting (no prokinetic activity)
- Chemo related nausea
Precautions when using ondansetron?
- GI obstruction
- QT interval prolongation
- Extra-pyramidal signs
Main uses of metoclopramide?
- Anti emetic, prokinetic
- Tx of regurg and ileus
- Antagonist (Reversal) for apomorphine/Ropinirole induced vomiting
What animals are most at risk of extra-pyramidal signs when using metoclopramide?
- Brachycephalics