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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
Ondansetron and Dolasetron uses
``` Chemotherapy related nausea Severe vomiting (no prokinetic activity) ```
26
Ondansetron and Dolasetron contraindications
May mask ileus | Potential GI obstruction
27
Metoclopramide mechanism of action
Dopamine receptor antagonist (D2) in chemoreceptor trigger zone 5-HT3 antagonism at high dose Prokinetic Increase lower esophageal sphincter tone
28
Metoclopramide uses
Antagonize apomorphine-induced emesis Anti-emetic Prokinetic
29
Metoclopramide contraindications
Suspected GI obstruction | Immediately post-operative GI resection
30
GI effects of autonomic and enteric nervous system
Increase activity via acetylcholine, serotonin, peptides. | Decrease activity via norepinephrine, dopamine, endorphins.
31
Drugs used to increase GI motility
``` Metoclopramide Cisapride Ranitidine Erythromycin Lidocaine Neostigmine ```
32
Antacids and GI protectants
Antihistamine H2 blockers Proton pump inhibitors Prostaglandin E analog Sucralfate
33
Antihistamine H2 blockers mechanism of action
H2 receptor inhibition | Inhibit HCl and pepsin secretion
34
Antihistamine H2 blockers
Famotidine (most common) Cimetidine Ranitidine (prokinetic)
35
Proton pump inhibitors mechanism of action
H+/K+/ATPase proton pump inhibition in GI Decrease HCl production Most effective antacid for pH increase
36
Proton pump inhibitors
Omeprazole (oral) | Pantoprazole (injectable)
37
Prostaglandin E analog mechanism of action
Increase mucous secretion in GI (ulcer healing)
38
Prostaglandin E analog
Misoprostol
39
Misoprostol contraindications
GI cramping Diarrhea Abortifacient
40
Sucralfate mechanism of action
Binds directly to and protects ulcer site | Requires low pH to bind
41
Sucralfate uses
Treat gastric ulcers | Poorly absorbed
42
Pancrelipases
Viokase | Pancrezyme
43
Pancrelipase mechanism of action
Supplemental exocrine pancreas enzymes | Viokase has high efficacy
44
Pancrelipase uses
Exocrine pancreatic insufficiency | Lifelong treatment
45
Hepatobiliary drugs
Lactulose N-acetylcysteine S-adenosyl-methionine Urosdiol - synthetic ursodeoxycholic acid
46
Lactulose mechanism of action
Enhances NH3 fecal excretion Lowers systemic NH3 Lower colonic pH
47
Lactulose uses
Manage hepatic encephalopathy Stool softener (megacolon in cats) Retention enema
48
N-acetylcysteine mechanism of action
Replenishes tissue glutathione
49
N-acetylcycteine uses
Hepatotoxic conditions with oxidative stress | Acetaminophen toxicity antidote
50
S-adenosyl-methionine mechanism of action
Nutraceutical hepatoprotectant | Antioxidant
51
S-adenosyl-methionine uses
Adjunct for hepatic disease and acute hepatotoxicity Osteoarthritis Cognitive dysfunction
52
Urosdiol mechanism of action
Choleretic (increase bile flow) | Immune-modulating
53
Urosdiol uses
Chronic inflammatory liver disease (small animals)
54
Urosdiol contraindications
Biliary obstruction | Can interfere with bile acid tests
55
Misoprostol treats _____
NSAID-induced gastric ulcers

pharm (6 decks)

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