Webb Lecture 2: Gastrointestinal Motility

Question 1

hunger hormone

Answer 1

ghrelin

Question 2

a ghrelin AGONIST/ANTAGONIST should increase appetite?

Answer 2

agonist

Question 3

first FDA-approved appetite stimulant

Answer 3

entyce: capromorelin, an orally active ghrelin agonist, caused sustained increases in IGF-1, increased food intake, and body weight in cats

Question 4

Elura

Answer 4

capromorelin oral solution for managing weight loss in cats with CKD: appetite stimulant

Question 5

loperamide

Answer 5

opioid-receptor agonist: binds mu (μ)-opioid receptor in the myenteric plexus of the large intestine

Question 6

common name for loperamide

Answer 6

imodium

Question 7

what is a likely side effect of imodium in cats and dogs?

Answer 7

constipation

Question 8

how does loperamide work?

Answer 8

like morphine, decreases activity of myenteric plexus; decreases longitudinal and circular intestinal smooth muscle

Question 9

why would you not want to use loperamide/imodium to treat parvo D+?

Answer 9

parvo attacks rapidly dividing cells; so the way to actually get rid of parvo is to have D+ and shed it out

Question 9

what medication might you give to stop D+?

Answer 9

loperamide/imodium

Question 10

opioid side effects

Answer 10

• Nausea and V+: GI motility inhibition, vestibular apparatus stimulation, CRTZ stim
• GI motility disturbances: decreased secretion, decreased propulsion, dysbiosis in microbiome
• disrupted gut homeostasis: GI motility inhibition, direct effects on cells

Question 10

peristalsis

Answer 10

propulsion

Question 11

segmentation

Answer 11

mixing

Question 12

2 types of small intestinal motility

Answer 12

peristalsis, segmentation

Question 13

what layer of the GI are the neuronal cell bodies in?

Answer 13

myenteric plexus

Question 14

how does cisapride affect GI motility?

Answer 14

stimulates 5HT4: serotonergic receptor

Question 15

drug of choice for moving a cat’s colon

Answer 15

CISAPRIDE

Question 15

what drives inflammatory bowel disease

Answer 15

driven by reaction of antigenic stimulus thru GI tract: food! need to go on hypoallergenic food or hydrolyzed food

Question 15

metoclopramide effect on GI tract

Answer 15

• increase tone and amplify GI contractions
• relax pyloric sphincter
• increase duodenal/jejunal peristalsis
• decrease time to empty stomach/GI transit time

Question 15

why would you not want to give metoclopramide to a constipated cat?

Answer 15

you get constipated in the COLON, but this drug only works on small intestine! won’t help at all with colonic motility

Question 15

how does cisapride work?

Answer 15

serotonin agonist on pre-synaptic neurons: enhances release of ACh to get colonic mm to contract

Question 15

what effects do glucocorticoids have

Answer 15

anti-inflammatory and immunosuppressive

Question 15

cisapride is

Answer 15

the drug of choice for moving a cat’s colon

Question 15

most common diagnoses in cats with GI signs

Answer 15

IBD or GI lymphoma

Question 16

most common cause of chronic GI disease in adult dogs and cats

Answer 16

IBD

Question 16

prednisone metabolism

Answer 16

gets changed in the liver to active form: prednisolone: safe for cats!

Question 16

what effects do prednisolone and budesonide have

Answer 16

anti-inflammatory and immunosuppressive

Question 17

budesonide

Answer 17

“supertopical” glucocorticoid
- first pass hepatic metabolism
- decrease systemic steroid effects
- no better than prednisone for clinical response
- reached for in GI cases

Question 18

cobalamin

Answer 18

Vit B12: low in cats and dogs with chronic GI problems

Question 19

low cobalamin tells you that what part of the GI is in trouble?

Answer 19

distal small intestine! it is absorbed in ileum

Question 19

EPI test

Answer 19

TLI

Question 20

low cobalamin means there’s a problem where

Answer 20

either pancreas or distal GI tract