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Clinical pharmacology > Substances with an effect on the digestive system > Flashcards

Substances with an effect on the digestive system Flashcards

1
Q

Sensory cells in the wall of the digestive tract react to: (5)

A

Wall stretch

Changes in nutrient concentration
Changes in osmolarity

pH
Irritation of the mucosal membrane

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2
Q

GI hormones are produced after stimulation of endocrine cells via

A

short or long reflexes

Produced after stimulation via luminal contents, or via degree of stretch of the tract wall.

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3
Q

Substances affecting the gastrointestinal tract are broadly divided into 5 categories:

A

1) Substances that increase and suppress appetite

2) Substances with an effect on the upper gastrointestinal tract

3) Substances affecting the stomach

4) Substances affecting the intestinal tract

5) Substances affecting the function of the liver and bile

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4
Q

define meteorism

A

also known as tympanites, bloat, is characterized by the accumulation of gas in the gastrointestinal (GI) tract.

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5
Q

2) Substances with an effect on the upper gastrointestinal tract can be: (3)

A

Substances increasing salivary secretion

Substances suppressing salivary secretion

Substances reducing irritation of mucous membrane

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6
Q

3) Substances affecting the stomach can be: (5)

A

Substances affecting gastric motility and secretion

Substances against meteorism (bloating)

Antacids, medicines for the treatment of ulcers

Emetics
Antiemetics

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7
Q

4) Substances affecting the intestinal tract can be: (3)

A

Laxatives

Substances affecting intestinal motility and secretion

Locally acting agents
(coatings, astringents, etc.)

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8
Q

Regulation of Eating behaviour is linked to

A

the satiety center

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9
Q

Substances increasing appetite (2)

A

Vitamin B (stimulates appetite mildly)

Glucocorticoids (they increase gluconeogenesis and thus improve the animal’s energy levels)

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10
Q

What drugs can increases the appetite in cattle and sheep through the suppression of the satiety center?

A

benzodiazepines

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11
Q

In humans, appetite is increased by (3)

A

cyproheptadine

antiserotonin substances, which include antihistamines with antiserotonin properties.
(Medications for depression)

Medication for psychosis (dopamine antagonists)

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12
Q

Appetite suppressants or anorexigenic substances. (3)

A

Desipramine,
amfepramone,
amphetamine

Note: In vet med substances suppressing appetite are not practically used.

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13
Q

Substances stimulating salivary secretion are

A

Cholinomimetic drugs - the flow of saliva increases via the activation of the parasympathetic nervous system.

It’s more like a side effect tho, not used as main effect.

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14
Q

Substances suppressing salivary secretion are primarily used for

A

premedication for anesthesia. Are anticholinergic agents.

ie. Atropine – in case of buccal surgery.

Neuroleptics, histamine blockers and other medicines also cause “dry mouth”.

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15
Q

Describe Substances reducing irritation of mucous membranes. Give examples.

A

Substances of high molecular weight, which oil and coat, and cover up the unpleasant taste of food, and aid in emulsifying food.

Ie. Honey, starch, glycerin, agar, mineral oils, gelatin, propylene glycol and others.

Also mouth and throat antiseptics typically.

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16
Q

Substances affecting the stomach can either (2)

A

affect gastric motility or gastric secretion.

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17
Q

Describe Substances affecting gastric motility

A

Remedies for rumination – increasing the intensity of the function of ruminants’ forestomach.

Cholinomimetic drugs, a mixture of lactic acid and other substances (reducing the generation of gases and foam).

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18
Q

Name 2 Substances to increase gastric secretion.

A

histamine,
pentagastrin (synthetic gastrin hormone).

They are primarily used for diagnostic purposes. Not used in vet practice.

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19
Q

Simethicone is an effective

A

antiflatulent, trade name Cuplaton (also used in dogs)

acts locally in the rumen of animal by changing the surface tension of small gas bubbles trapped in foam, causing them to coalesce and ultimately pass out.

(similar: dimethicone)

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20
Q

What species do not vomit? (5)

A

Species such as horses, ruminants, rodents, guinea pigs and rabbits do not vomit.

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21
Q

Name 3 emetics.

A

apomorphine (main in use in vet med)

narcotic analgesics (some opioids ie. morphine)

digitalis preparations

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22
Q

Peripherally acting emetics (2)

A

Hydrogen peroxide 3%, but can cause ulcers in esophagus, stomach, intestines – use as a last choice.

Salt & salt solutions – data in the literature, but not in use anymore, can cause serious dehydration/salt poisoning.

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23
Q

Centrally acting emetics (4)

A

Opiates,
apomorphine and
glycosides (ie. amygdalin)
Alfa2 agonists (have an emetic effect on cats)

24
Q

Apomorphine is a

A

synthetic derivative of morphine that is used as an emetic especially in dogs.

25
Q

Opioids have both

A

an emetic and antiemetic effect.

It is not exactly known which effect prevails in which case as there’s an individual dose-dependent relationship.

26
Q

Centrally acting antiemetics. (3+4)

A

More commonly:
Metoclopramide (primperan)
Maropitant
Antimuscarinic substances (ie. scopolamine)

Less commonly:
Phenothiazines
Derivatives of butyrophenones (haloperidol, antidopaminergic)

Barbiturates
benzodiazepines

27
Q

Describe Metoclopramide.

A

Is a dopamine antagonist, increases the tone of the lower esophageal sphincters, strengthens the contractility of the stomach, relaxes the pyloric sphincters, enhances peristalsis.

A potent antiemetic drug, acts on the vomiting center (centrally acting and peripherally acting antiemetic drug).

Metoclopramide is a more efficacious antiemetic drug in cats than in dogs.

28
Q

Describe Antimuscarinic substances:

A

belladonna (deadly nightshade) alkaloids (scopolamine) and their synthetic analogues

Cats experience dangerous side effects.

29
Q

Maropitant is a..?
Mechanism of action?

A

neurokinin 1(NK1) receptor antagonist

acts by inhibiting the binding of substance P, the tachykinins family of neuropeptides, in the CNS.

Substance P can be found in large quantities in nuclei that form the vomiting center and is considered the primary mediator-substance in vomiting.

Maropitant has an affinity to Ca and K ion channels thus careful use in case of heart diseases!

30
Q

Peripherally acting antiemetics do what broadly speaking (2).

A

Are typically substances that reduce gastric secretion and motility.

31
Q

Common Antacid substances (4)

A

Aluminium and magnesium salts, sodium bicarbonate and calcium carbonate.

32
Q

How does Lactulose act as a laxative?

A

synthetic sugar, pulls water to intestines, makes the stool softer.

33
Q

Laxatives do what?
Give examples.

A

Laxatives loosen the contents of the intestines, enhancing its excretion.

Purgatives or laxatives are substances that accelerate the emptying of the rectum and loosen stools.

Oils. Liquid paraffin, castor oil and others.

34
Q

Substances affecting both intestinal motility and secretion:

A

Laxatives: phenolphthalein and bisacodyl.

They inhibit the absorption of glucose (osmolar state in intestinal lumen) and strengthen intestinal motility. No vet products available.

35
Q

Antidiarrheal substances (4)

A

certain Opiates

Kaolin & pectin

Activated charcoal

Anticholinergic substances (but too many side effects so rarely used in practice)

36
Q

Give an opiate example of an antidiarrheal drug.

A

loperamide, brand name Imodium)

37
Q

Describe Kaolin & pectin.

A

Mucosal protectants used as antidiarrheal substances.

Kaolin: aluminum silicate
Pectin: carbohydrate, extracted from the rinds of citrus fruits.

Efficacy not proven, but used actively due to positive empirical evidence.

38
Q

The parasympatholytic agent hyoscine butylbromide (butylscopolamine) antagonizes…? By what mechanism?

A

the muscarinic actions of acetylcholine by competitive inhibition of acetylcholine at parasympathetic nerve endings.

Thus it inhibits the contraction of smooth muscles of the gastro-intestinal tract and urine and bile excretory organs.

Activity at the nicotinic receptors occurs only at high (toxic) doses.

39
Q

Classic drug used for Treatment of GI spasms (especially in horses).

A

butylscopolamine
(also known as hyoscine butylbromide)

Inhibits the contraction of smooth muscles of the gastro-intestinal tract and urine and bile excretory organs.

Species: horse, cattle, sheep, swine.

40
Q

Why does butylscopolamine not produce CNS effects like atropine? Since both are parasympatholytic.

A

Due to its quaternary ammonium structure it cannot cross the blood-brain-barrier and therefore does not produce the central nervous effects of atropine.

41
Q

What non-drug substance is used for weaning piglets to prevent diarrhea?

A

zinc oxide but the mechanism of action is not completely understood, it may improve the barrier function of gastrointestinal tract.

After large doses there can be changes in gastrointestinal microflora of piglets.

May even cause antimicrobial resistance similarly to antibiotics!

42
Q

For fattening pigs what is sometimes given as a treatment or metaphylactic substance toward diarrhea caused by Brachyspira hyodysenteriae.

A

EDTA zinc disodium

43
Q

A drug that stimulates bile secretion (injectable product).

A

Menbutone – choleretic action, stimulates bile secretion, trypsinogen and pepsinogen.

After injection the secretion of bile and stomach acid increases 2-5 times. Enhances digestion.

Injectable solution for cattle, pigs, horses, sheep, coats.

44
Q

What is Hepagen?

A

2-methyl-2-phenoxypropionic acid

Supportive treatment with antioxidants and nutrients that support the liver’s normal detoxification processes, used in case of liver diseases and gastrointestinal disorders, increases production of bile.

Species: horse, cattle, swine, goat, dog.

45
Q

Antiulcer agents can be (name some broad classifications) (4)

A

Proton pump inhibitors

Anticholinergic substances

H2 antagonists

Prostaglandins: some investigation confirm the efficacy (in horses).

46
Q

Name two common proton pump inhibitors

A

omeprazole
esomeprazole (nexium)

reduction in the secretion of gastric acid. Usage has been researched in dogs and horses.

47
Q

nexium active ingredient

A

esomeprazole

48
Q

Why do Anticholinergic substances work as antiulcer drugs?

A

primarily used in human medicine, they reduce the secretion of hydrochloric acid and function as H2 receptor antagonists.

They are of low efficacy in animals.

49
Q

Name 3 H2-antagonists

A

cimetidine
ranitidine (zantac)
famotidine (pepcid, zantac)

reduction in the secretion of gastric acid.

50
Q

Antacids do what exactly

A

Antacids neutralize hydrochloric acid chemically.

51
Q

Give some antacid examples.

A

Sodium bicarbonate (a systemic antacid)

Aluminium, magnesium and calcium salts (nonsystemic antacids) (product Maalox)

52
Q

Drugs for the treatment of obesity

A

Mitratapide

The brand name is Yarvitan, but there is no longer a marketing authorization.

Treatment of overweight and obese dogs.

Peripherally acting anti-obesity substance.
Its mechanism of action blocks the absorption of dietary lipids and slightly reduces appetite. There is no central effect.

53
Q

Difference between pre and probiotics.

A

Prebiotics are foods (typically high-fiber foods) that act as food forgut microflora.

Probiotics are foods or supplements that contain live microorganisms intended to maintain or improve the “good” bacteria (normal microflora) in the body.

54
Q

Intraruminal AB preparation for cattle.

A

Monensin, (Rumensin), is an ionophore.

Slow release capsule lasts 90 days.

The effect is primarily directed against Gram-pos bacteria.

Gram-negative bacteria have complex external cell membranes that resist mechanisms of action of ionophores.

Despite technically being an AB, is used for the treatment of ketosis and for the reduction in the incidence of ketosis in the period after giving birth.

55
Q

monensin mechanism of action for use against ketosis

A

against gram pos., not effective against gram neg.

the primary intraruminal effect of monensin is to change the microbial population, the number of bacteria that produce acetate and butyrate will decrease and the number of bacteria that produce propionate - a gluconeogenic precursor - will increase.

56
Q

Bovine concentrated lactoserum is an

A

Oral solution for newborn calves
containing specific immunoglobulins G against E. coli F5 (K99) adhesin.

Product name: Locatim

Locatim is used to reduce death in newborn calves caused by enterotoxicosis associated with the bacterium E. coli F5 (K99) adhesin during the first days of life as a supplement to colostrum from the dam.

57
Q

Treatment of Exocrine pancreatic insufficiency.

A

oral enzyme replacement products made from animal pancreas

Clinical pharmacology (21 decks)

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