GI drugs

Question 1

What are the main ways gastric ulceration can be prevented?

Answer 1

antacids: sodium bicarbonate
H2 inhibitors: ranitidine & famotidine
H:K ATPase proton pump inhibitors: omeprazole
mucosal coating chelating & complexing agents: sucralfate

Question 2

What drugs are contraindicated with antacids?

Answer 2

enrofloxacin & tetracyclines- chelate divalent ions suchs as antacids Calcium carbonate, aluminum hydroxide, magnesium oxide

Question 3

Name the H2 inhibitors?

Answer 3

ranitidine

famotidine

Question 4

Name two major differences between ranitidine and famotidine?

Answer 4

ranitidine- can interfere with liver CP450 and is a prokinetic

Question 5

Name the proton pump inhibitors?

Answer 5

omeprazole
pantoprazole
lansoprazole

Question 6

Which PPI is best for treating ulcers?

Answer 6

omeprazole (prilosec)

Question 7

Which PPI is given IV for anorexic patient that is expensive?

Answer 7

pantoprazole (protonix)

Question 8

Which PPI is formulated as a oral suspension with bicarbonate for small dogs?

Answer 8

lansoprazole (prevacid)

Question 9

What drugs can inhibit the absorption of enrofloxacin?

Answer 9

antacids & sulcralfate (carafate) (contains aluminum a divalent cation)

Question 10

Sulcralfate (carafate) MOA

Answer 10

prodrug is converted to a sugar polymer by acid in the stomach that coats the stomach lesions

Question 11

What are the two locations in the brain associated with emesis? What are the receptor associated with each?

Answer 11

chemoreceptor trigger zone (floor of ventricle in dorsal medulla): 7 R- D2, 5HT3, H1,2, M1, a2, ENK, NK1
vomiting center (reticular formation): 3R a2, 5HT1a, NK1

Question 12

What are two commonly used emetics?

Answer 12

apomorphine (dogs»cats)

dexmeditomidine /xylazine in cats

Question 13

What are the anti-emetics that act on the CRTZ

Answer 13

metoclopramide (D2), ondansetron (5HT3), maropitant (NK1)

Question 14

What are the anti-emetics that act on vomiting center?

Answer 14

chlorpromazine

maropitant

Question 15

What class of motion sickness drugs do not work in cats?

Answer 15

H1 inhibitors (diphenhydramine-benadryl)

Question 16

What drug acts on the vestibular apparatus to inhibit H1 R for motion-sickness tx?

Answer 16

diphenhydramine aka benadryl

Question 17

Which has a more potent prokinetic action in GI tract metoclopramide (reglan) or cisapride (propulsid) ? Why

Answer 17

more effective: cisapride- acts via release Ach from myenteric plexus through SM of SI
MCP: 5HT4 agonist- increase tone of LES and relax pylorus for more gastric emptying

Question 18

Which antibiotic has prokinetic effects?

Answer 18

erythromycin- motilin agonist

Question 19

What are two anti-diarrheals that promote segmental mixing via the mu receptor agonism?

Answer 19

loperamide

diphenoxalate

Question 20

What probiotic species does fortiflora have? Prostora max?

Answer 20

fortiflora- enterococcus faecium

prostora max-bifidobacterium animalis