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pharm > GI Drugs (final exam) > Flashcards

GI Drugs (final exam) Flashcards

1
Q

Centrally-acting emetics control vomiting through what three structures?

A

Vomiting (emetic) center
Chemoreceptor Trigger Zone (CRTZ)
Vestibular apparatus

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2
Q

What is unique about feline emetic receptors?

A

Cats have more a2 and 5-HT receptors

Also fewer D2 and H1 than dogs

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3
Q

Apomorphine mechanism of action

A

D2 agonist in Chemoreceptor Trigger Zone

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4
Q

What is the emetic drug of choice in dogs?

A

Apomorphine

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5
Q

Apomorphine adverse effects

A

Respiratory depression on overdose

Reverse with naloxone (will not reverse emetic effect)

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6
Q

Xylazine mechanism of action

A

A2 agonist in vomiting center and Chemoreceptor Trigger Zone

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7
Q

What is the emetic drug of choice in cats?

A

Xylazine

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8
Q

Why is Xylazine more effective in cats?

A

Cats have more a2 receptors than D2 receptors.

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9
Q

3% hydrogen peroxide mechanism of action

A

Direct irritation of oropharynx and GI lining

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10
Q

Hydrogen peroxide uses

A

Emesis in dogs (NOT cats)

Owner can administer at home

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11
Q

Hydrogen peroxide contraindications

A

Cats, risk of hemorrhagic gastroenteritis

Pre-existing GI ulcers/bleeding

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12
Q

What are the physiological inhibitors of appetite?

A

Serotonin

Cortisol releasing hormone

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13
Q

What are the physiological stimulants of appetite?

A 
Norepinephrine
Dopamine
GABA agonists
Ghrelin
Serotonin antagonists
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14
Q

Mirtazapine mechanism of action

A

Serotonin antagonist

Inhibits satiety

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15
Q

Mirtazapine uses

A

Dogs > cats (both unreliably)

Variable onset

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16
Q

Cyproheptadine mechanism of action

A

Serotonin antagonist

Inhibits satiety

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17
Q

Cyproheptadine uses

A

Cats, more effective than dogs
Onset 2-3 days
Sedation is most common side effect

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18
Q

Capromorelin mechanism of action

A

Ghrelin receptor agonist (selective)

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19
Q

Capromorelin use

A

Increase ghrelin -> stimulate hypothalamus, increase appetite

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20
Q

Antiemetics

A

Maropitant citrate
Ondansetron
Dolasetron
Metoclopramide

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21
Q

Maropitant citrate mechanism of action

A

Blocks substance P
Neurokinin receptor antagonist (NK1)
Vomiting center and Chemoreceptor Trigger Zone

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22
Q

Maropitant citrate uses

A

Antiemetic in cats and dogs

Motion sickness in dogs

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23
Q

Maropitant citrate contraindications

A

GI obstruction

Exception if patient with obstruction is going into surgery

24
Q

Ondansetron and Dolasetron mechanism of action

A

Serotonin receptor antagonist

Central and peripheral 5-HT receptors

25
Q

Ondansetron and Dolasetron uses

A 
Chemotherapy related nausea
Severe vomiting (no prokinetic activity)
26
Q

Ondansetron and Dolasetron contraindications

A

May mask ileus

Potential GI obstruction

27
Q

Metoclopramide mechanism of action

A

Dopamine receptor antagonist (D2) in chemoreceptor trigger zone
5-HT3 antagonism at high dose
Prokinetic
Increase lower esophageal sphincter tone

28
Q

Metoclopramide uses

A

Antagonize apomorphine-induced emesis
Anti-emetic
Prokinetic

29
Q

Metoclopramide contraindications

A

Suspected GI obstruction

Immediately post-operative GI resection

30
Q

GI effects of autonomic and enteric nervous system

A

Increase activity via acetylcholine, serotonin, peptides.

Decrease activity via norepinephrine, dopamine, endorphins.

31
Q

Drugs used to increase GI motility

A 
Metoclopramide
Cisapride
Ranitidine
Erythromycin
Lidocaine
Neostigmine
32
Q

Antacids and GI protectants

A

Antihistamine H2 blockers
Proton pump inhibitors
Prostaglandin E analog
Sucralfate

33
Q

Antihistamine H2 blockers mechanism of action

A

H2 receptor inhibition

Inhibit HCl and pepsin secretion

34
Q

Antihistamine H2 blockers

A

Famotidine (most common)
Cimetidine
Ranitidine (prokinetic)

35
Q

Proton pump inhibitors mechanism of action

A

H+/K+/ATPase proton pump inhibition in GI
Decrease HCl production
Most effective antacid for pH increase

36
Q

Proton pump inhibitors

A

Omeprazole (oral)

Pantoprazole (injectable)

37
Q

Prostaglandin E analog mechanism of action

A

Increase mucous secretion in GI (ulcer healing)

38
Q

Prostaglandin E analog

A

Misoprostol

39
Q

Misoprostol contraindications

A

GI cramping
Diarrhea
Abortifacient

40
Q

Sucralfate mechanism of action

A

Binds directly to and protects ulcer site

Requires low pH to bind

41
Q

Sucralfate uses

A

Treat gastric ulcers

Poorly absorbed

42
Q

Pancrelipases

A

Viokase

Pancrezyme

43
Q

Pancrelipase mechanism of action

A

Supplemental exocrine pancreas enzymes

Viokase has high efficacy

44
Q

Pancrelipase uses

A

Exocrine pancreatic insufficiency

Lifelong treatment

45
Q

Hepatobiliary drugs

A

Lactulose
N-acetylcysteine
S-adenosyl-methionine
Urosdiol - synthetic ursodeoxycholic acid

46
Q

Lactulose mechanism of action

A

Enhances NH3 fecal excretion
Lowers systemic NH3
Lower colonic pH

47
Q

Lactulose uses

A

Manage hepatic encephalopathy
Stool softener (megacolon in cats)
Retention enema

48
Q

N-acetylcysteine mechanism of action

A

Replenishes tissue glutathione

49
Q

N-acetylcycteine uses

A

Hepatotoxic conditions with oxidative stress

Acetaminophen toxicity antidote

50
Q

S-adenosyl-methionine mechanism of action

A

Nutraceutical hepatoprotectant

Antioxidant

51
Q

S-adenosyl-methionine uses

A

Adjunct for hepatic disease and acute hepatotoxicity
Osteoarthritis
Cognitive dysfunction

52
Q

Urosdiol mechanism of action

A

Choleretic (increase bile flow)

Immune-modulating

53
Q

Urosdiol uses

A

Chronic inflammatory liver disease (small animals)

54
Q

Urosdiol contraindications

A

Biliary obstruction

Can interfere with bile acid tests

55
Q

Misoprostol treats _____

A

NSAID-induced gastric ulcers

pharm (6 decks)

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