Lecture 5: drugs for treatment of GI disorders-3

Question 1

What is lactulose indicated for

Answer 1

1. Hepatic encephalopathy- reduce ammonia levels
2. Osmotic agent

Question 2

What are the pharmacodynamics of lactulose

Answer 2

1. Sugars—> acids—> reduce gastric pH—> protonate NH3+—> NH4+—> can’t cross BBB
2. Sugars are osmotic agents

Question 3

What are some adverse effects and contraindications of lactulose

Answer 3

Flatulence, cramping, GI distention

***free galactose and fructose may alter insulin requirements in diabetics

Question 4

What is ursodiol indicated for

Answer 4

1. Chronic hepatitis in dogs and cats
2. Gallbladder mucoceles in dogs
3. Cholangiohepatitis in horses
4. Feline triad it is (cholangiohepatitis, pancreatitis, IBD)

Question 5

What is the PD of ursodiol

Answer 5

1. Solubilizes gall bladder stones by reducing hepatic secretion and cholesterol absoprtion
2. Increases bile flow
3. Reduces hepatocellular inflammatory change and fibrosis

Question 6

What are some adverse effects and contraindications of ursodiol

Answer 6

Hindgut fermenters and rabbits produce larger amounts of lithocolate from bile acid. Efficacy is anecdotal

Question 7

What is fuzapladib indicated for

Answer 7

Acute pancreatitis in dogs

Question 8

T or F: it is illegal to use fuzapladib extra label

Answer 8

True

Question 9

What are the PD of fuzapladib

Answer 9

leukocyte function associated antigen 1 (LFA-1) inhibitor and blocks neutrophil extravasation to prevent systemic inflamamtion

Question 10

What are nutraceuticals

Answer 10

Food or parts of food that provide health benefits including prevention and treatment of disease

Question 11

The FDA does not regulate dietary supplements for ____

Answer 11

Efficacy

Question 12

What is silymarin indicated for

Answer 12

Chronic hepatitis in dogs and cats

Question 13

What are the PD of silymarin

Answer 13

1. Antioxidant: scavenges free radical and inhibits lipid peroxidation
2. TNFalpha inhibition- reduce cytotoxic/apoptotic inflammatory effects
3. Alters hepatocyte membrane permeability to toxic agents

Question 14

What are some side effects and contraindications for silymarin

Answer 14

Allergy to plant

Question 15

What is S-adenosyl methionine indicated for

Answer 15

Liver disease of any form

Question 16

What are the PD of S-adenosyl-methionine

Answer 16

1. Transmethylation which is involved in phospholipid synthesis
2. Aminopropylation which produces anti-inflammatory molecules
3. Transsulfuration which is necessary for glutathione production

Question 17

What is pancrelipase indicated for

Answer 17

Exocrine pancreas deficiency

Question 18

What is the PD of pancrelipase

Answer 18

Combination of lipase, amylase, and protease that promote digestion of nutrients

Question 19

What are some adverse reactions and contraindications for pancrelipase

Answer 19

1. Pork hypersensitivity
2. High dose can cause GI distress, oral ulceration and ulceration

Question 20

What is Bismuth subsalicyclate indicated for

Answer 20

1. Helicobacter associated gastritis in dogs, cats and ferrets
2. Diarrhea in cats, pigs, horses, cattle

Question 21

What is the PD for bismuth subsalicylate

Answer 21

Bismuth and salicylate cleaved
Bismuth is anti-endotoxin and antibiotic
Salicylate is a non-specific cox inhibitor

Question 22

What are some adverse effects and contraindications of bismuth subsalicyclate

Answer 22

Cats due to hemolysis