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CLIN PHARM > II - GI Large Animal > Flashcards

II - GI Large Animal Flashcards

1
Q

What two drugs are used to treat esophageal obstruction in ruminants?

A

Acepromazine
Xylazine or detomidine

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2
Q

Name two ruminotorics

A

Mineral oil
Dicotyl sodium sulfosuccinate

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3
Q

Name two anti foaming agents.

A

Poloxalene
Polymerized methyl silicone

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4
Q

Neostigmine and bethanechol
N-butylscopolammonium bromide
Atropine
Xylazine
Metoclopramide
Erythromycin lactobionate

These are all:

A

Modulators of ruminoreticular motility

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5
Q

Species for which gastric ulceration tends to be more common

A

Horses, pigs, dogs, cats, zoo animals

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6
Q

NSAIDS, corticosteroids, stomach irritants, stress, disrupted mucosal blood supply, and inflammatory diseases are risk factors for ____.

A

Ulcers in veterinary patients

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7
Q

Gastric acid production is stimulated by these three things:

A

Histamine via H2 receptors
Vagal stimulation via ACh
Gastrin via CCK2 receptor

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8
Q

Mucosal protection is mediated primarily by ______ stimulation of:

Bicarbonate production
Mucus
Epithelial cell turnover and replacement
Adequate blood flow

A

PGE2

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9
Q

Drugs used for prevention and/or treatment of ulcers are divided into two categories:

Control _______
Promote ______

A

Gastric acidity
Mucosal protection

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10
Q

What do these kinds of drugs do?

Antacids
Anticholinergic agents
Antihistamines
Proton pump inhibitors

A

Control gastric acidity

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11
Q

Two common antihistamines (H2 receptor antagonists)

A

Ranitidine and Famotidine

Higher doses needed in horses because of limited oral absorption

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12
Q

H2 receptor antagonists block _________ stimulated by histamine as well as other stimuli of gastric acid secretion.

A

Gastric acid production

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13
Q

In horses, ______ are used to increase stomach pH and to improve or heal ulceration in foals or adult horses.

A

Antihistamines (H2 receptor agonists)

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14
Q

In calves, ______ is used to maintain the pH of the abomasum > 3.5.

A

Ranitidine (H2 receptor antagonist)

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15
Q

Drug interactions with antihistamines are due to ___.

A

Changes in pH

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16
Q

GastroGard and UlcerGard are FDA approved pastes for the treatment/prevention of ulcers in horses. These pastes are _______.

A

Proton pump inhibitors
- omeprazole

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17
Q

These drugs irreversibly bind to the H+,K+, ATPase proton pump, permanently inhibiting its action. The parietal cell must synthesize new enzyme in order to continue to secrete acid.

A

Proton pump inhibitors

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18
Q

___________ is superior to ____________ for healing ulcers.

A

omeprazole is superior to ranitidine for healing ulcers

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19
Q

_____ may occur when PPIs are discontinued.

Chronic administration can result in elevated levels of gastrin and ________.

A

Rebound hyperacidity

Bacterial overgrowth

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20
Q

PPIs are metabolized by _____

A

P450

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21
Q

Increment of pH can alter absorption of _____ and _____.

A

Antifungals and Mycophenolate

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22
Q

Three kinds of drugs that promote mucosal protection

A

Prostaglandin-analogues
Antacids (large volumes impractical in adult horses)
Sucralfate (no substantial efficacy in LA)

23
Q

In horses, Misoprostol has been proposed for treatment of _______.

A

NSAID-associated right dorsal colitis

24
Q

_____ is contraindicated in pregnant mares, because it can cause abortion. Pregnant women should handle it with extreme care.

A

Misoprostol (Cytotec)

25
Q

Name a prostaglandin analog used in LA medicine.

A

Misoprostol

26
Q

MOA: PGE series inhibit gastric acid secretion and promotes mucosal protection by enhanced bicarbonate secretion, enhanced mucus secretion, and enhanced mucosal blood flow

A

Misoprostol

27
Q

This prostaglandin analogue does not cause rebound secretion of gastric acid, but it can cause intestinal hypersecretion and hyper motility resulting in nausea, diarrhea, and abdominal cramping (colic).

A

Misoprostol

28
Q

______ is a neuropeptide that stimulates contraction of GI smooth muscle throughout most segments of the gut.

A

Motilin

29
Q

The regulation of GI smooth muscle is complex, and involves these three influences:

A

Extrinsic influence - vagal and sympathetic nerves
Enteric nervous system
Receptors on smooth muscle cells

30
Q

Name a condition in LA medicine that might require prokinetic drugs.

A

Post-operative ileus (POI)

31
Q

Cholinergics, Metoclopramide, Erythromycin, and lidocaine are all ______.

A

Prokinetics - gastric motility modulators

32
Q

_______ is the cholinergic agonist most used clinically for stimulating motility. It acts on the myenteric plexus and muscarinic receptor on smooth muscle cells.

A

Bethanechol

33
Q

___________ is used primarily for treating delayed gastric emptying; also increases contraction of cecum and right ventral colon.

A

Bethanechol - cholinergic

34
Q

This cholinergic is a cholinesterase inhibitor.

A

Neostigmine

35
Q

Adverse effects of the cholinergic ______ include SLUD, bradycardia, colic (esp LA), and potential for increased gastric acid secretion.

A

Bethanechol

36
Q

This drug is used to enhance cecal emptying in healthy ponies. It can also promote passage of gas in foals that have severe abdominal distention but no displacement or obstruction of colon.

A

Cholinergic
- Neostigmine

37
Q

Horses usually get mild colic signs after administration of this drug.

A

Cholinergic
- Neostigmine

38
Q

MOA: 5-HT4 agonist, 5HT3 antagonist, enhances ACh release

A

Prokinetic
- Metoclopramide

39
Q

Metoclopramide’ s prokinetic effects are limited to the _____. It relaxes the ______ making it useful for promoting gastric emptying.

A

Proximal GI tract
Pyloric sphincter

40
Q

_______ is contraindicated in patients with gastrointestinal obstruction or perforation.

It may cause CNS excitation, particularly in _____, or CNS depression.

Some sources list ____ as a contraindication as well.

A

Metoclopramide
Horses
Epilepsy

41
Q

_____ promotes gastric and proximal intestinal motility. This has been attributed to stimulation of the motilin receptor.

A

Erythromycin

42
Q

_______ is the second choice prokinetic after lidocaine used primarily for cecal impactions to improve gastric emptying.

A

Erythromycin

43
Q

It has been suggested that _______ exerts its effects not by directly stimulating GI motility, but by preventing the inhibition of bowel motility.

A

Lidocaine

44
Q

Potential adverse effects of ______ infusion include cardiac arrhythmias, muscle fasciculations, ataxia, and seizures.

A

Lidocaine

45
Q

Prophylactic lidocaine treatment was associated with a significantly reduced incidence of ________ in horses undergoing small intestinal surgery for colic.

A

Post operative ileus

46
Q

_________ is labeled for use in cases of equine colic and calf scours.

A

Anticholinergic
- hyoscine butylbromide (Buscopan)

47
Q

Side effects of ________ include dry mouth, constipation, urinary retention, and tachycardia.

A

Anticholinergic
- hyoscine butylbromide (Buscopan)

48
Q

Opioids used to treat diarrhea

A

Loperamide (Imodium - anecdotal use)
Butorphanol (used in combination with xylazine works even better)

49
Q

Alpha 2 agonists used to treat diarrhea

A

Xylazine
Detomidine

50
Q

______ was found to be effective in the treatment of severe non responsive diarrhea in adult horses.

A

Phenoxybenzamine

51
Q

Magnesium sulfate, bismuth, and activated charcoal:

A

Either line the mucosal surface or absorb potential toxicants in the intestinal lumen.

52
Q

This protectant/absorbent should be avoided in patients receiving glucocorticoids or NSAIDs.

A

Bismuth subsalicylate

53
Q

Cathartics are agents that stimulate ____.

A

Defecation

CLIN PHARM (13 decks)

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