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Pharmacology II > GI system > Flashcards

GI system Flashcards

1
Q

what is the GI system and its functions?

A

the GI system is a long tube responsible for digestion and absorption of nutrients, movement of substances (motility), elimination of waste as feces

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2
Q

what are common CS related to GI?

A

vomiting, diarrhea, abdominal pain

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3
Q

anatomic GI structures

A

oral cavity, pharynx, esophagus, stomach, small intestine, large intestine

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4
Q

accessory GI organs

A

liver, gallbladder, salivary glands, pancreas

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5
Q

what are the 3 types of digestive systems?

A

monogastric = single simple stomach
ruminant = multichambered forestomach, fermentation breaks down ingested feed before it travels to the true stomach
hindgut fermenters = fermentation in large intestine

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6
Q

peristalisis

A

wavelike contraction of the longitudinal and circular smooth muscle fibers in the intestinal walls that move food through the gut

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7
Q

segmental contraction

A

periodic, repeating intestinal constrictions that cause churning of intestinal contents to increase digestion and absorption of nutrients through the intestinal walls

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8
Q

which nervous system controls GI tract activity?

A

autonomic nervous system (ANS)

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9
Q

what are the two branches of the ANS and what happens if the activity of one branch is blocked?

A

sympathetic and parasympathetic
blocking activity of 1 branch increases activity of the other branch

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10
Q

cholinergic drugs

A

parasympathetic drugs

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11
Q

anticholinergic drugs

A

parasympathetic drugs that inhibit parasympathetic actions

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12
Q

sympathomimetic drugs

A

stimulate sympathetic branch

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13
Q

other GI helpers

A

chemical secretions, hormones, digestive enzymes, histamine

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14
Q

antisialogues

A

saliva stopping drugs
decrease salivary flow
administer IV, IM, SQ to limit excess saliva production during anesthesia

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15
Q

atropine

A

anticholinergic antisialogue
decreases GI motility and secretions
quick onset and short acting

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16
Q

glycopyrrolate (Robinal)

A

FDA approved in dogs and cats
doesn’t cross into CNS or placenta
anticholinergic, decreases GI motility and secretions
longer onset and longer acting

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17
Q

antidiarrheals

A

diarrhea stopping
diarrhea is a symptom of a disease
decrease liquidity of stool, decrease peristalsis, decrease inflammation, improve fecal consistency

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18
Q

what are the causes of diarrhea?

A

parasitic disease, bacterial infection, viral infection, dietary indiscretion, systemic non-gastrointestinal disease, dehydration, electrolyte imbalance, decreased nutrition uptake

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19
Q

what are the long term effects of diarrhea?

A

muscle weakness, acid-base disturbance, anorexia

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20
Q

anticholinergic antidiarrheals

A

treat diarrhea and tenesmus (straining to defecate)
use with caution since they can cause a wide variety of systemic effects

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21
Q

atropine

A

anticholinergic antidiarrheal
injectable
decreases GI motility

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22
Q

aminopentamide

A

anticholinergic antidiarrheal
oral, injectable forms
treats acute GI spasms

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23
Q

propantheline

A

anticholinergic antidiarrheal
tablet form
treats GI spasms and hypersecretion, decreases rectal contractions in horses

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24
Q

N-Butylscopolammonium bromide

A

IV form
relieves horses of pain due to spasmodic colic, flatulent colic, and simple impactions

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25
Q

adverse effects of anticholinergic antidiarrheals

A

dry mm, urine retention, tachycardia, constipation

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26
Q

protectant antidiarrheals

A

coats inflamed intestinal mucosa with a protective layer

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27
Q

adsorbent antidiarrheals

A

binds to bacteria and/or digestive enzymes and/or toxins to protect intestinal mucosa from their damaging effects

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28
Q

Bismuth subsalicylate

A

protectant/adsorbent antidiarrheal
coats intestinal mucosa, anti-inflammatory, minor antibacterial effects
don’t use in cats
is a type of subsalicylate (aspirin-like drug, anti-inflammatory)

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29
Q

Kaolin/pectin

A

protectant/adsorbant antidiarrheal
generic OTC
absorbent and protectant, doesn’t decrease fluid loss, not FDA approved, some can contain bismuth subsalicylate

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30
Q

activated charcoal

A

protectant/adsorbent antidiarrheal
brand names: Liqui-Char, SuperChar, Actidose-Aqua
powder and liquid forms
absorbs chemicals and drugs in GI tract, not absorbed or metabolized in GI, toxins bind to it and are carried out of GI tract
administered through stomach tube, dosing gun, or syringe
give right after toxin ingestion

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31
Q

toxiban

A

protectant/adsorbent antidiarrheal
contains activated charcoal and kaolin

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32
Q

di-tri-octahedral smectite (DTO-smectite) (Bio-sponge)

A

protectant/adsorbent antidiarrheal
not FDA approved, natural clay mineral, used in horses and foals (for diarrhea, colic, antibiotic colic)
binds to toxins produced by bacterial overgrowth
also used in small animal for endotoxemia, enteritis, small intestinal bacteria overgrowth, acute and chronic diarrhea, parvo, food allergies
can be given with Metronidazole

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33
Q

Diphenoxylate

A

motility reducer antidiarrheal
opioid
C-V controlled with atropine added
decreases intestinal secretions, peristalsis, increases segmental contractions

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34
Q

Loperamide

A

motility reducer antidiarrheal
opioid
OTC
decreases intestinal secretions, peristalsis, increases segmental contractions, less CNS depression

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35
Q

probiotics

A

seed the GI tract with beneficial bacteria (such as Lactobacillus spp, enterococcus faecium, Bifidobacterium spp)
mechanisms of action: decreases pathogenic

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36
Q

probiotics mechanisms of action

A

decreases pathogenic bacteria survival by competing for nutrients and colonizing sites, produces antimicrobial factors, alters microenvironment, decreases local inflammation, alters immune responses

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37
Q

Metronidazole

A

antibiotic antidiarrheal
effective against anaerobic bacteria, effective against protozoa, has anti-inflammatory effects

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38
Q

constipation

A

passage of feces is slowed producing infrequent stool that is often dry and hard

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39
Q

obstipation

A

difficult to manage constipation often leading to the inability to evacuate an impacted mass of dry hard feces

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40
Q

colic

A

in horses
abdominal pain that may be caused by a number of underlying gut problems such as intestinal distention due to gas, constipation, bowel obstruction with sand or feed, or torsion of intestines

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41
Q

laxative

A

medicine that loosens the bowel contents and encourages evacuation of stool

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42
Q

cathartics

A

harsher laxatives that result in a soft to watery stool and abdominal cramping

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43
Q

how do osmotic laxatives work?

A

aka hyperosmolar
work by pulling water into the colon by osmosis
composed of salts or saline, lactulose, and glycerin

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44
Q

Lactulose

A

osmotic laxative
oral syrup
treats hepatic encephalopathy
metabolized by bacteria in the colon to form low osmotic acids that pull fluid into the colon

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45
Q

sodium phosphate with sodium biphosphate

A

osmotic laxative
used for enemas
not for cats, causes hyperphosphatemia and hypocalcemia

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46
Q

Magnesium sulfate

A

osmotic laxative
contain epsom salts
used for enemas

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47
Q

Magnesium hydroxide

A

osmotic laxative
Carmilax-powder, Magnalax, Poly Ox II Bolus
oral

48
Q

Polyethylene glycol (PEG)

A

electrolyte solution
used for enemas

49
Q

stimulant laxatives

A

stimulant = irritant or contact
increases peristalsis by chemically irritating sensory nerve endings in the intestinal mucosa
not approved for vet

50
Q

Castor oil

A

stimulant laxative
ricinoleic acid, inhibits water and electrolyte absorption causing fluid accumulation in GI tract, increases peristalsis

51
Q

Bisacodyl

A

stimulant laxative
cathartic
enteric coated tablets, suppository, don’t give within an hour of milk or antacids

52
Q

Senna, Senokot

A

stimulant laxative
similar to other drugs in this group

53
Q

bulk forming laxatives

A

natural fibrous substances or semisynthetic compounds
added to diet, absorbs water into intestine, increases fecal bulk, stimulates peristalsis

54
Q

examples of bulk-forming laxatives

A

psyllium hydrophilic mucilloid (equine psyllium), calcium polycarbophil, Bran

55
Q

emollient laxatives

A

stool softeners, lubricants, fecal wetting agents

56
Q

Docusate calcium

A

emollient laxative
regular and soft gel capsules

57
Q

Docusate sodium, docusate sodium sulfasuccinate (DSS) (Pet-Ema, Docu-soft)

A

emollient laxative

58
Q

petroleum white petrolatum, mineral oil (CatLax, Laxatone)

A

prevents and treats hairballs, mineral oil for colic in horses

59
Q

antiemetics

A

control vomiting
commonly used with other treatment to help alleviate discomfort and control electrolyte balance

60
Q

phenothiazine derivative antiemetics

A

antiemetic group
decreases the stimulation to vomit
thought to lower seizure threshold
causes vasodilation and hypotension
don’t use in abnormal GI motility patients

61
Q

Acepromazine (PromAce and generic)

A

phenothiazine derivative antiemetic
injectable and oral tablets
FDA approved for motion sickness

62
Q

Prochlorperazine

A

phenothiazine derivative antiemetic
injectable, tablet, suppository

63
Q

Chlorpromazine

A

phenothiazine derivative antiemetic
injectable, tablet

64
Q

antihistamines

A

antiemetic group
controls vomiting due to motion sickness, vaccine reaction, inner ear problems
doesn’t work for vomiting cats
ex: Diphenhydramine, Dimenhydrinate, Meclizine

65
Q

Metoclopramide

A

antiemetic
works centrally by blocking CRTZ (vomiting zone)
and works peripherally by speeding gastric emptying and strengthening sphincter tone
oral, SQ, IV, IM
most effective as CRI
not used in animals with GI obstructions, GI perforation, hemorrhage

66
Q

serotonin receptor antagonist

A

antiemetic group
blocks serotonin receptors that cause vomiting

67
Q

Ondansetron

A

serotonin receptor antagonist antiemetic
oral dissolving tablet, injectable, oral solution

68
Q

Dolasetron

A

serotonin receptor antagonist
IV, tablet

69
Q

Granisetron

A

serotonin receptor antagonist
oral tablet and solution, transdermal patch, SQ

70
Q

Maropitant

A

antiemetic group
inhibits neurotransmitter involved in vomiting

71
Q

Maropitant citrate (Cerenia)

A

Maropitant anitemetic
vet approved for dogs and cats
suppresses peripherally and centrally induced vomiting
oral, IV, SQ

72
Q

emetics

A

induce vomiting
used for poisonings or drug overdoses

73
Q

Apomorphine

A

centrally acting emetic
dopamine agonist
directly stimulates CRTZ
very effective in dogs, not very effective in cats
SQ, IV, topical
works in 5-10 minutes

74
Q

Xylazine (Rompun, AnaSed)

A

centrally acting emetic
vomiting inducer in cats as a side effect

75
Q

do we usually use peripherally acting emetics?

A

no they’re not usually used or recommended because they aren’t reliable

76
Q

Hydrogen peroxide (3%)

A

peripherally acting emetic
gastric irritant
apply to back of pharynx to stimulate nerve that induces vomiting
give 5-10 mL orally by syringe
can cause aspiration pneumonia
don’t use for cats because it can cause hemorrhagic gastritis

77
Q

salt

A

peripherally acting emetic
be careful of sodium overdose
used for cerebral enema
can be fatal

78
Q

powdered mustard

A

peripherally acting emetic
not effective
inhaled and can cause lung damage

79
Q

how do gastric ulcers develop?

A

when there is an excess of harmful substances which lead to erosions in the stomach/small intestine lining

80
Q

antiulcer drugs

A

help treat/prevent ulcer formation

81
Q

antacids

A

antiulcer group
promote ulcer healing by neutralizing HCl and pepsin activity
can bind to other drugs or increase stomach pH
types: systemic or local

82
Q

Magnesium hydroxide (Magnalax)

A

antacid antiulcers
treats rumen acidosis

83
Q

Aluminum hydroxide/magnesium hydroxide

A

antacid antiulcers
adjunctive treatment for gastric ulcers in dogs and foals

84
Q

histamine-2 receptor antagonists

A

antiulcer group
inhibits acid production
take with or without food
extra-label

85
Q

Cimetidine

A

histamine-2 receptor antagonist antiulcer
decreases gastric acid secretion
tablet, oral solution, injectable
given every 8 hours

86
Q

Ranitidine

A

histamine-2 receptor antagonist antiulcer
more potent, longer duration, stimulates gastric emptying and intestinal motility
given 12 hours

87
Q

Famotidine

A

histamine-2 receptor antagonist antiulcer
more potent, fewer AE
coated tablets, oral powder, injectable
given every 24 hours

88
Q

Nizatidine

A

histamine-2 receptor antagonist antiulcer
increased GI motility
tablet, capsule, solution
given every 24 hours

89
Q

Sucralfate

A

mucosal protective antiulcer
stomach mucosal protectant
covers and protects ulcers
1g tablets (give as a slurry)
don’t give with other drugs
treats esophagitis, gastric/duodenal ulcers, uremic gastritis

90
Q

Misoprotal

A

protaglandin analog antiulcer
suppresses gastric acid production, increases mucous production, protects gastric ulcers from NSAIDs
tablet
not used in pregnant animals

91
Q

proton pump inhibitors

A

antiulcer group
binds to proton pumps and inhibits gastric acid production
most effective 30 minutes before a meal

92
Q

Omeprazole (Gastrogard, Ulcergard)

A

proton pump inhibitor antiulcer
only PPI that is FDA approved for dogs and cats
safe for horses and foals over 4 weeks
prevents and heals gastric ulcers

93
Q

Lansoprazole

A

proton pump inhibitor antiulcer
oral or IV
treats gastric reflux, heals ulcers, less likely to react to other drugs

94
Q

Esomeprazole

A

proton pump inhibitor antiulcer
oral or IV
treats gastroduodenal ulcers, prevents and treats gastric erosions from ulcer-producing drugs

95
Q

antifoaming agents

A

surfactants = decreases or prevents formation of foam
used in ruminants with frothy bloat
breaks down foam which allows gas release through belching

96
Q

Poloxalene and polymerized methyl silicone

A

antifoaming agent
administered as a solution through a stomach tube

97
Q

prokinetic agents (motility enhancing)

A

increases GI motility, enhances movement of material through GIT, treats gastric paresis, treats megacolon

98
Q

parasympathetic (cholinergics) prokinetic agents

A

increase motility and secretions, relaxes sphincters

99
Q

Neostigmine

A

cholinergic prokinetic agents
treats rumen atony in ruminants, increases motility in horses, diagnoses myasthenia gravis in dogs

100
Q

Dexpanthenol (d-panthenol injectable)

A

cholinergic prokinetic agent
treats intestinal distention or atony, paralytic ileus, colic

101
Q

dopaminergic antagonists

A

prokinetic agent group
increases tissue sensitivity to acetylcholine
stimulates gastroesophageal sphincter tone, stomach motility, intestinal motility

102
Q

Metoclopramide

A

dopaminergic antagonist prokinetic agent
antiemetic

103
Q

Domperidone (Equidone gel)

A

dopaminergic antagonist prokinetic agent
less neurologic effects, doesn’t cross blood brain barrier
FDA approved for treatment of fescue toxicosis in periparturient mares

104
Q

Cisapride

A

prokinetic agent group
serotonergic agent
stimulates motility of the stomach, small intestine, and colon
treats constipation, gastroesophageal reflux, ileus

105
Q

pancrelipase (Viokase-V powder, Pancrezyme)

A

enzyme supplements
tablet or powder mixed with food
lipase digests fats
amylase digests starches
protease digests proteins
treats exocrine pancreatic insufficiency (EPI)

106
Q

exocrine pancreatic insufficiency (EPI)

A

pancreas doesn’t produce sufficient enzymes
symptoms: fatty/greasy diarrhea, weight loss, vomiting

107
Q

Orexigenic drugs

A

appetite stimulants

108
Q

Capromorelin (Entyce)

A

orexigenic
FDA approved for dogs, extra-label for cats
stimulates receptors in the hypothalamus to induce hunger
oral solution which is shaken

109
Q

Elura (Capromorelin)

A

orexigenic
version of Capromorelin that is FDA approved for cats

110
Q

Mirtazapine (Mirataz)

A

orexigenic
antidepressant that causes appetite stimulation and antiemetic properties
human approved tablets used extra-label for dogs and cats
Mirtazapine ointment is FDA approved for cat transdermal
caution with severe liver or kidney disease patients

111
Q

Cyproheptadine

A

orexigenic
human approved phenothiazine
inhibits “feeling full” receptors

112
Q

Benzodiazepines

A

orexigenic
cats
induces GABA, inhibits satiety center in hypothalamus

113
Q

Diazepam

A

Benzodiazepine orexigenic
used most often
IV, IM, oral
avoid in liver disease cats

114
Q

Oxazepam

A

Benzodiazepine orexigenic
oral
not metabolized in the liver

115
Q

Glucocorticoids

A

orexigenics
Prednisolone: causes euphoria that increases appetite, not for long term use
Propofol: hypnotic drug, stimulates appetite in dogs at low doses

Pharmacology II (14 decks)

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