GI session 9/10

Question 1

True or false: it is essential for the CRTZ to have a functional blood brain barrier

Answer 1

FALSE: The CRTZ is exposed to the blood, just like the rest of the areas of the CNS that DO have functional BBB. In fact, it is essential that CRTZ does not have a functional BBB or it would not be able to continuously ‘sample’ the chemical composition of blood

Question 2

Which drug has become a first-line antiemetic in dogs and cats, and has an injectable formulation that may cause less stinging when chilled before injection.

Answer 2

Maropitant

Question 3

Metoclopramide is used first as a prokinetic. Which of its side effects gives it a second use?

Answer 3

Antiemetic

Question 4

Diphenhydramine, a ‘first-generation’ antihistamine (H1 receptor antagonist), is typical of many first-generation antihistamines in that it has anticholinergic (muscarinic cholinergic antagonist) effects. Name some anticholinergic effects.

Answer 4

ileus
xerostoma (dry mouth)
urinary retention
dry eye

Question 5

What drug class is apomorphine?

Answer 5

Dopamine agonist

Question 6

What drug class is loperamide?

Answer 6

opioid

Question 7

What drug class is Diphenoxylate?

Answer 7

Opioid

Question 8

Is Diphenhydramine an effective antiemetic in cats?

Answer 8

ineffective in cats, inconsistant effectiveness in dogs

low bioavilability in dogs (<10%)

Question 9

Preciosa, an 8-year-old, 25-pound Minatare Poodle, is well-known at your clinic because she tolerates handling, even rough handling, anywhere on her body, EXCEPT anything involving opening her mouth, at which point she becomes completely unhinged. You are seeing Preciosa on emergency because she very recently consumed an unknown quantity of baker’s chocolate. If you choose to administer an emetic, which emetic would be the best choice?

Answer 9

Apomorphine - injectable!

Question 10

When oral antacids are co-administered to patients taking a fluoroquinolone antibacterial drug, what order should the drugs be given in?

Answer 10

Administer the fluoroquinolone, wait 2 hours, then give antacid

Question 11

Aluminum containing antacids and sucralfate can prevent oral absorption of drugs that chelate with aluminum. When given together, which drug classes should be given 2 hours prior to ensure absorption?

Answer 11

Fluoroquinolones
Digoxin
Tetracyclines

Question 12

Which drug class has an evidence-basis for being the most effective choice to attain a sustained gastric pH increase?

Answer 12

PPI

Omeprazole, Pantoprazole

Question 13

Which drug drug forms a polymeric barrier over the gastric mucosa

Answer 13

Sucralfate

Question 14

Sulfasalazine and 5-ASA are used to treat inflammatory bowel disease occurring in the

Answer 14

large intestine

Question 15

___________ is an appetite stimulant with documented effectiveness in cats, while _______ stimulates growth hormone release and is an FDA-approved appetite stimulant in dogs.

Answer 15

mirtazapine, capromorelin

Question 16

What is the treatment for Tritrchomonas?

Answer 16

Ronidazole

Question 17

What is Praziquantel used to treat?

Answer 17

Cestodes

Question 18

What condition should you rule out before prescribing Maropitant?

Answer 18

obstruction

Question 19

Are H2 antagonists such as Famotidine effective in the prevention of gastric ulceration associated with NSAID administration?

Answer 19

NO

used for treatment of ulcers, nor prevention

Question 20

Which GI protectant is effective at preventing ulcers when given with NSAIDs but not with glucocorticoids?

Answer 20

Misprostol

Question 21

What is an AE effect of metronidazole?

Answer 21

Neurotoxicity

Question 22

Which form of chronic enteropathy is most commonly diagnosed in young patients?

Answer 22

food responsive enteropathy

Question 23

Why would testing a blood cobalamin level be potentially indicated in patients presenting with chronic gastrointestinal signs?

Answer 23

Cobalamin deficiency can support a diagnosis of distal small intestinal enteropathy

• absorbed in the ileum
• most helpful in cats
• deficiency can cause anemia, weakness, and contribute to diarrhea
• vitamin B12
• water soluble therefore excess levels excreted by kidney

Question 24

What signalment indicates abdominal imaging may be helpful in cases of chronic enteropathy?

Answer 24

older patients with weight loss, palpable abnormalities (mass), progressive and severe clinical signs

Question 25

What are the 2 drugs prescribed to manage antibiotic-responsive enteropathy?

Answer 25

Metrondiazole and Tylosin

Question 26

What drug class is Budesonide?

Answer 26

Glucocorticoid

helpful in chronic inflammatory enteropathy

Question 27

Why quality of Budesonide makes it good for treating steroid responsive chronic enteropathy?

Answer 27

orally administered

high topical activity with low systemic bioavailability

Question 28

What is the recommended length for an elimination diet trial in a patient with suspected food responsive enteropathy?

Answer 28

2-4 weeks

Question 29

What is the recommended length for a patient with suspected food responsive enteropathy who is showing signs of cutaneous adverse food reaction?

Answer 29

8-12 weeks with cutaneous signs

Question 30

Name signs of GI adverse food reactions

Answer 30

• inc daily number of bowel movements
• cutaneous signs
• otitis externa
• pruritus