GI therapy Flashcards

Question

Omeprazole

Answer 1

Gastroguard, ulcerguard - proton pump inhibitor approved for use in horses - human form Prilosec used in dogs - inhibits H+/K+ proton pump at the luminal surface of the parietal cell that secretes hydrogen ions into the gastric lumen - ulcers tend to come back after therapy

Answer 2

Cytotec - synthetic prostaglandin E1 analogue that inhibits gastric acid secretion by direct action on the parietal cells (inhibits activation of histamine sensitive adenylate cyclase thus inhibiting GA secretion) - mainly used as preventative - during NSAID therapy for ex.

Answer 3

-causes increase motility in upper GI by increasing sensitivity of Ach receptors and increasing amt of Ach release in upper GI and antagonizing dopamine (which inhibits GI motility) -works from esophagus to small intestine -readily crosses BBB- giving dopamine antagonism at CRTZ --> anti emetic BUT get extrapyramidal signs too (bad)

Answer 4

Motilium - peripheral dopamine receptor antagonist (dopamine inhibits GI motility) - esophageal, gastric and SI effects - No CNS rxns! (effects of metoclopramide without

Answer 5

Propulsid - chemically related to metoclopramide (w/o crossing BBB or having anti dope effects) - it enhances the release of Ach from postganglionic nerve endings of myenteric plexus and antagonized inhibitory actions of serotonin on myenteric plexus ---->increased GI motility and increase HR - most pro kinetic and broader activity than metoclopramide (does colon motility too)

Answer 6

Resotran - potent partial benzamide agonist at 5-HT4 receptors - increases colonic motility - and gastric, pyloric and duodenal motility - increased freq of defecation in dogs and cats (not diarrhea)

Answer 7

- macrolide antibiotics are motilin receptor agonists (incl. erythromycin and clarithromycin) - also stimulate cholinergic and noncholinergic neural pathways to stimulate motility

Answer 8

- acetylcholinesterase inhbition causes prokinetic action (mostly proximal GI tract) - Ranitidine and nizatidine are two H2 receptor antagonists that inhibit gastric secretion (via H2 antagonism) but are prokinetic due to Achesterase inhibition.

Answer 9

- suppression of inhibitory GI reflexes by reduction of postoperative peritoneal irritation is mech of action - also suppresses primary afferent neurons from firing and anti-inflam properties and direct stimulatory effects on sm. muscle.

Answer 10

- role in regulating gastric tone and Ach release through presynaptic mech in enteric NS. - adrenergic antagonists prevent the effects of NE on intrinsic neurons and stimulate sm. muscle - treatment for ileus

Answer 11

- stimulant (irritant) laxative - potent stimulator of bowel. - hydrolysed to ricinoleic acid in bowel ---> increase h20 secretion in SI

Answer 12

- stimulant (irritant) laxative - similar action to castor oil --> increase h20 secretion in SI - feed daily in horses to supply FAs and mild laxative effect

Answer 13

- stimulant (irritant) laxative - increases gastric fluid secretion and bowel motility---> laxative action - Secokot and Exlax (OTC)

Answer 14

- stimulates enteric nerves to cause colonic mass mvmts. | - also increases fluid and NaCl secretion

Answer 15

- laxative - draw fluid into the bowel by osmosis-->increased fluid content of feces -->intestinal distension --> promotes peristalsis. - ex. Mg salts (epsom salts, milk of magnesia, citro-mag), Na bisphosphate/phosphate (fleet enema)(Don't use in cats), lactulose (Lactulax), polyethylene glycol

Answer 16

- hyperosmotic cathartic laxative - organic acids produced from lactulose fermentation stimulate colonic fluid secretion and propulsive motility. - can alter bowel flora = farts and bloating

Answer 17

- hyperosmotic cathartic - large MW, water soluble polymer used as bulking and softening agent from tx of constipation - not metabolized and minimally absorbed in the intestines - forms Hbonds with water-->high osmotic pressure in bowel lumen-->prevents absorption of h20 out of lumen (powder or soln form0

Answer 18

- "bulk laxatives" - composed of non absorbed PSC cellulose derivatives - drugs absorb h20 and increase mass of non digestible material in the bowel ex. methylcellulose, pysillium (metamucil), prunes, wheat bran and canned pumpkin. - FIBER

Answer 19

- act by coating the surface of the stool with h20 immiscible film and increase h20 content of feces - also lubricant action - usually contain mineral oil or white petroleum - min oil in horses and cattle, Kat-Lax in cats (hairball passage)

Answer 20

- decrease surface tension and allow h20 to accumulate in the feces - occasionally in horses (nasogastric tube) - ex. dioctyl sodium, sulfosuccinate (DSS), dioctyl calcium sulfosuccinate(surfak, doxidan)

Answer 21

-acts as a demulcent (substance forming soothing, protective film over mm) and adsorbent in tx of diarrhea. -action like bacterial toxins binding to GI (not Kaopectate anymore which now = bismuth subsalicylate)

Answer 22

- derived from wood, peat, coconut or pecan shells - very effective for adsorbing bacterial enterotoxins that cause some types of diarrhea. Also adsorb many drugs and toxins and prevent GI absorption

Answer 23

PeptoBismol, Kaopectate, Corrective Mixture - tx of choice for acute diarrhea (proven efficacy) - Bismuth part may adsorb bacterial enterotoxins and produce gastric/intestinal protective effect - Salicylate part is anti inflammatory action - get black feces - can get toxicity, esp in cats

Answer 24

- they signif decrease intestinal motility and secretions - decrease segmental and propulsive intestinal sm muscle contractions - decrease urgency with diarrhea in small animals, decrease fluid secreted in bowel and decrease abdominal cramps seen with hyper motility. - can only be used in hyper motile forms of diarrhea tho or could make worse (stove pipe effect)(limited use in vet med)

Answer 25

- anticholergic drug | - not usually used for tx diarrhea because of systemic effects

Answer 26

- antispasmodic and anticholingeric drug that relaxes the smooth muscle of GI tract - tx of uncomplicated colic - decreases gut sounds - beneficial in choke cases

Answer 27

- can have anti-secretory and anti-motility actions ( mu and delta receptors of the GI tract) - decrease propulsive intestinal contractions and increase segmentation--> constipating effect - increase tone if GI sphincters - opiates also stimulate absorption of fluid, electrolytes and glucose (inhibition of Ca influx and decrease calmodulin activity) - mostly used in dogs (less cats) - dont use in infectious diarrhea (may increase absorption of bacterial toxins when slow GI transit time)

Answer 28

- synthetic opiate that has specific action on GI tract (no system effects) - used to tx diarrhea - used in small animals and large neonates - controlled substance

Answer 29

Imodium (OTC) - synthetic opiate with specific action on the GI tract (no systemic effects) - used for diarrhea tx in small animals and neonate large animals - dont use in "ivermectin sensitive" breeds (ABCB1 gene deletion dogs)

Answer 30

- tincture of opium found in many antidiarrheal products | - controlled substance (corresponds to morphine)

Answer 31

- may be beneficial for diarrhea tx, and very impt in tx of septicaemia/ endotoxemia - action may be anti inflam effect - Anti-PG drugs may directly inhibit fluid and electrolyte hypersecretion by intestinal cells (increased cAMP) - meloxicam calve diarrhea over a week old - ketoprofen reduces fecal output in enterotoxigenic E. coli diarrhea - use with caution

Answer 32

- tx of equine and canine endotoxemia - diarrhea tx? - available for parvovirus enteritis in horses and clostridial diseases in ruminants

Answer 33

- 5-aminosalicylic acid product - treatment of chronic colitis - salicylic acid component is active in the GI- causes anti inflammatory effect - anti-lipoxygenase activity, decreased IL-1, decreased PG synthesis and oxygen radical scavenging activity. - commonly used in SAs for ulcer therapy or idiopathic colitis or plasmacytic/lymphocytic colitis after dietary causes ruled out

Answer 34

- antimicrobial used for colitis - often given on chronic basis as alternative to sulfasalazine therapy - may have activity against mycoplasma, spirochetes and chlamydia - powdered form for swine given in food

Answer 35

- fair efficacy against Giardia - given to dogs, cats and horses with IBD - also good some other diarrhea cases due to activity against anaerobes prob. - may be immunosuppressive on GI mucosa too - has neuro effects tho - ANTIDOTE = diazepam

Answer 36

- tx colitis because anti inflam and immunosuppressive effects (colitis due to autoantibodies and T-cells directed against colonic epithelial cells or colitis due to lymphocytic/plasmacytic colitis) - dogs, cats and horses - prednisone or oral dexamethasone - budesonide (Entocort-crohns disease)-dogs with IBD possibly. (HPA suppression tho)

Answer 37

- addn of N 3 FA to the diet makes fewer n-6 FA available for AA cascade (reduce inflame?) - derm caps for SA and raw linseed for horses

Answer 38

- immunosuppressive drug used for colitis - metabolized to 6-mercaptopurine which causes immunosuppression by interfering with nucleic acid synthesis and impairing lymphocyte proliferation - monitor cats closely for SEs

Answer 39

- for hepatitis therapy - naturally occurring hydrophilic bile acid that displaces the more hydrophobic bile acid pool in cholestatic liver disease - suppresses hepatic synthesis and secretion of CHO and decreases intestinal absorption of CHO (allows solubilization of CHO containing gallstones) - also increases bile flow and reduces hepatotoxic effect of bile salts by decreasing their detergent action - uses: tx of CHO containing gallstones, idiopathic hepatic lipidosis and chronic active hepatitis.

Answer 40

- used for hepatitis therapy - increases levels of hepatic glutathione which is a potent antioxidant that protects hepatic cells from toxins and death. - used in compromised patients to maintain and protect liver fxn - also used in other cdns of tissue oxidant injury and of RBC fragility caused by toxins or drugs (ones related to low glutathione levels)

Answer 41

- used in hepatitis therapy (chronic with fibrosis, biliary cirrhosis) - anti-fibroic properties (inhibits microtubular mediated transcellular mvmt of pro collagen into the ECM) and increases collegenase activity (increasing collagen degradation) - anti inflam activity too

Answer 42

- hepatitis therapy - frequent copper chelator used in dogs - vomiting SE

Answer 43

- hepatitis therapy - copper chelating agent - less adverse effects than penicillamine

Answer 44

-anti inflammatory effects beneficial in tx of chronic hepatitis in Bedlington terriers and west highland white terriers

Answer 45

- essential cofactor for reducing hepatic copper []s - Zinc leads to intestinal metallothionein (MT) production --> MT induction prevents serosal transfer of copper into blood - zinc good follow up therapy after chelator therapy - zinc shows reduced hepatic copper []s, decrease hepatic enz activity and improved hepatic histologic features after long term therapy - SEs : nausea, vomiting and anorexia

Answer 46

- free radicals may play a role in initiating and perpetuating damage to liver in chronic active hepatitis - therapy with vit E reduces oxidant damage to hepatic tissue - NOT VIT C

Answer 47

-natural remedy for hepatitis therapy used for diseases of the liver and biliary tract -Silymarin is active extract and contain flavonignans (antioxidants) which scavenge free radicals and inhibit lipid per oxidation (APPARENTLY)