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Pharmacology > Vomiting and Diarrhea > Flashcards

Vomiting and Diarrhea Flashcards

1
Q

Purpose of vomiting

A
  1. Removal or toxic/irritant material
  2. Prevention of gastric rupture with obstruction
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2
Q

Vomiting control

A

-Triggered by brain= emetic center in the medulla

Can be affected by:
-pharyngeal stimulation (H2O2),
-cerebral cortex (fright, pain)
- vestibular system (motion),
-chemoreceptor trigger zone (monitors blood for toxins, alpha2s, apomorphine)

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3
Q

Emetics

A

-commonly used after ingestion of toxins
*avoid vomiting back up oils or tissue damaging substances

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4
Q

Emetic examples

A

-Includes apomorphone, hydromorphone, alpha 2 agonists, syrup of Ipecac, Hydrogen peroxide, saturated salt solution

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5
Q

Apomorphine

A

Dopamine agonist in CRTZ
-90% effective as emetic for dogs but less effective for cats
-administered in eye or IV
-no analgesic or high like other opioids

**other opioids can also induce vomiting- hydromorphone (anesthesia pre med)

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6
Q

alpha 2 agonist as emetic

A

-emetic for cats
-Xylazine (~50% effective)
-Dexmedetomidine (>50% effective)

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7
Q

Syrup of Ipecac

A

-GI irritation leading to vomiting
-acts on pharynx receptors
-used in kids, not much in vet med

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8
Q

Hydrogen peroxide

A

-dogs
-not very effective but clients can do it at home
-acts on pharynx receptors

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9
Q

Saturated salt solution

A

-used in dogs to make them vomiting
-acts on pharynx receptors

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10
Q

Situations where you want to stop vomiting

A

-motion sickness
-parvovirus
-gastroenteritis
-chemotherapy
-uremia
-hair balls

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11
Q

Acepromazine

A

Antagonizes dopamine which inhibits CTZ, other causes

Can also help reduce motion sickness:
-antihistaminic for dogs
-weak anticholinergic in cats

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12
Q

Side effects from Phenothiazine= acepromazine

A

-hypotension
-sedation
-extrapyramidal signs (aggression)
-lower seizure threshold in epileptics
-prolapsed 3rd eyelid, CYP mediated drug

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13
Q

Extrapyramidal signs

A

Occurs if excessive inhibition of dopamine receptors
=involuntary movements

**Treat with IV diphenhydramine

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14
Q

Metroclopramide

A

-injectable
-was popular in small animals but variable PK
-extrapyramidal effects

Results in:
-at low dose= inhibits dopamine in CNS
-increases gastric and upper duodenal emptying
-high dose: inhibits serotonin in CRTZ

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15
Q

Ondansetron (Zofran)

A

-expensive
-inhibits 5-HT3 (serotonin) receptors on vagal nerve and CRTZ

-used for chemotherapy emesis (cytotoxic and radiation release of serotonin in small intestines)
-not effective for motion sickness induced vomiting

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16
Q

Maropitant

A

-Cerenia, Emavert
-oral or injectable
-cats and dogs

-Neurokinin (NK1) receptor antagonist= clocks binding of substance P at emetic center

*can block Apomorphine, and syrup of ipecac vomiting

17
Q

What is Maropitant labelled for?

A

Acute vomiting (2mg/kg)

Motion sickness (8mg/kg)
*acepromazine probably still best choice

18
Q

Adverse effects of cerenia (maropitant)

A

-can cause bone marrow hypoplasia in young puppies
**be careful with parvovirus

-contraindicated in GI obstructions

19
Q

Anti emetics for Parvo vomiting

A

**argue that may not want to stop parvo puppies from vomiting

-can use metoclopramide, ondansetron, maropitant

20
Q

Maropitant effects other than emetic

A

-analgesic and anti inflammatory effects
*blocks binding of substance P

21
Q

Treatment of diarrhea

A

-fluid therapy
-electrolytes
-acid/base treatment

22
Q

Fluid therapy for diarrhea

A

-most important treatment
-used for dehydration and acidosis
-given oral, intravenous, SQ

23
Q

Electrolyte use for diarrhea

A

-Replace Na, Cl, and K

24
Q

Acid/base treatment for diarrhea

A

Supply animal with bicarbonate to treat acidosis
-metabolize substrates (citrate, propionate, acetate) that produce bicarb

25
Q

Steps of Oral therapy

A

Fluids need H2O, Na, and cotransport (glucose or amino acids)!!

-Na transported into mucosa call by Na channels, Na-glucose co transport, Na-amino acid co transport, Na-H exchanger
>Na absorbed and water and Cl will follow

26
Q

Anti-diarrheal drugs

A

Protectants and adsorbents
-Kaolin-Pectin (used to have morphine)
-Activated charcoal (absorbs toxins)
-Bismuth subalicylate (pepto-bismol)= Bismuth (coating), aspirin (anti-PGE)

27
Q

Anticholinergic drugs

A

Decrease intestinal motility and secretions
BUT few cases of diarrhea are hypermotile. Usually diarrhea is due to slow guts
>systemic side effects and may worsen diarrhea

28
Q

Hyoscine butylbromide (Buscopan)

A

-antispasmodic and anticholinergic for horses
-Rapid onset: 5-10mins, duration 3-4hrs
-can cause tachycardia and decreased gut sounds

-Used on label for intestinal pain in non surgical colic
-not very effective

29
Q

Opioids

A

-antisecretory and antimotility effects by acting on mu receptors in GI tract

-decreased propulsive intestinal contractions, and increased segmentation= overall constipating effect (COMMON ADR)

-increase GI sphincters tone

-Stimulate absorption of fluid and electrolytes

30
Q

Loperamine (Imodium)

A

-opioid with no function on central NS, stays in guts and will bind guts

-used for traveller’s diarrhea

-not really used in vet med. Can’t be used with infectious diarrhea or ABC-B1 deletion dogs

31
Q

Antimicrobial therapy for diarrhea

A

Only used for known bacterial causes
**antimicrobials can also cause diarrhea (change in normal flora)

-breakdown of gut can lead to damage and secondary infection/septicemia= antibiotics to help this
**often using antibiotics for the septicemia and not the diarrhea

-use of antimicrobials may result in carrier animals (salmonella and campybacter)

-OTC calf scour boluses= beware! Because they don’t supply fluids, likely won’t work on the actual issue (viral vs. bacteria), will stay in gut and won’t treat septicemia

32
Q

NSAIDs for diarrhea

A

-Meloxicam has label claim for calf diarrhea (WITH ORAL FLUIDS)

-Some evidence for use of Ketoprofen (would need higher dose) and Flunixin (only when blood present)

**There is a risk of renal adverse effects with concurrent dehydration

33
Q

Meloxicam in calves

A

-increased appetite
-some weight gain
-Therefore helps the animal feel a bit better but no long term effects

Pharmacology (41 decks)

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