Pharm T4
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- What are some problems associated with the GI tract?
- Regurgitation, vomiting, diarrhea, weight loss, colic, bloat and abnormal bowel movements.
- What does the Autonomic nervous system (ANS) do to regulate the GI tract?
- Increases intestinal motility, tone, increases secretions and stimulates relaxation of sphincter when the parasympathetic portion of the ANS is stimulated.
- What are cholinergic drugs?
- Drugs that minic the autonomic nervous system.
- What are anticholinergic drugs?
- Drugs that inhibit the reaction of the autonomic nervous system.
- What happens when the sympathetic brance of the ANS is stimulated?
- There will be decreased intestinal motility, tone, secretions and increased anal sphincter tone.
- What do hormones do to help regulate the GI tract?
- Gastrin, secretin and cholecystokinin are released from intestinal cells and control many functions such as gastric secretions, gastric and gall bladder emptying.
- What does histamine do to help regulate the GI tract?
- Histamine, serotinin and prostaglandins are released from specialized GI cells and histamine attaches to H2 receptors in gastric parietal cells and causes the release of hydrocholoric acid in the stomach.
- What is the definition of vomiting?
- Forced expulsion of stomach contents.
- Where is vomiting initiated from?
- From the stimulation or activation of the emectic (vomiting) center of the brain.
- Where is the emetic center located?
- In the medulla oblongata.
- What animals do not vomit?
- Horses, rabbits and rats.
- What is the definition of regurgitation?
- A normal process of ruminants in which semi-digested material from the rumen is "cast up" or chewing.
- What animals normally regurgitate "castings"?
- Many birds - owls and raptors.
- What do emetics do?
- They cause vomiting.
- Why would you use an emetic?
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To remove recently ingested poisons.
To empty stomach prios to anesthesia.
They can remove appoximately 80% of stomach contents. - Contraindication of emetics.
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Semi-conscious or seizuring animals.
Animals in shock or having difficulty breathing.
Ingestion of caustic substances (acidic or alkaline).
Animals that don't normally vomit. - What are the two types of emetics?
- Centrally acting emetics (CNS) and locally acting emetics.
- Types of centrally acting emetics.
- Morphine, apormorphine HCL, xylazine (Rompun (R)), syrup of ipecac.
- What is the centrally acting emetic drug of choice for dogs?
- apomorphine HCL
- How is apomorphine HCL administered?
- Topically in the conjunctival sac or given parenterally.
- What's the centrally acting emetic choice for cats?
- xylazine (Rompun(R))
- What centrally acting emetic is not classified as an emetic, but will produce vomiting?
- xylazine (Rompun(R))
- What's the trade name for xylazine?
- Rompum (R)
- How do locally acting emetics work?
- They irritate the gastric/pharyngeal mucosa, causing reflex vomiting.
- What are some locally acting emetics?
- Hydrogen peroxide, salt water (warm), syrup of ipecac.
- What are some side effects to syrup of ipecac?
- Lacrimation (tearing) and salivation and cardiotoxicity in high doses. Use with caution in animals with heart problems.
- What emetic is both centrally and locally acting?
- syrup of ipecac
- What are antiemetics?
- They prevent vomiting.
- What do you use antiemetics for?
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To prevent motion sickness.
to prevent vomiting while under anesthesia.
To prevent post-op vomiting.
To treat symptoms of persistant vomiting. - What are the two classifications of antiemetics?
- Centrally and locally acting.
- What are the different types of centrally acting antiemetics?
- Phenothiazine derivatives, procainimide derivatives, metoclopramide, antihistamines.
- What are phenothiazine derivative used for?
- Motion sickness.
- List the different types of phenothiazine derivatives.
-
tranquilizer (Acepromazine (R))
chlorpromazine (Thorazine (R))
prochlorperazine (Darbazine (R)) - Trade name for tranquilizer.
- Acepromazine (R)
- Trade name for chlorpromazine.
- Thorazine (R)
- Trade name for prochlorperazine.
- Darbazine (R)
- What are procainimide derivative used for?
- Parvovirus
- What is metoclopramide used for?
- The drug causes increase gastric contraction, emptying and strengthens cardia sphincter tone. It's a stomach dumper.
- Trade name for metoclopramid.
- Reglan (R)
- What are antihistamines used for (as an antiemetic)?
- When vomiting is due to motion sickness or inner ear problems.
- What are two antihistamines used as antiemetics?
- Benadryl (R), Dramamine (R)
- What do you use locally acting antiemetic used for?
- Vomiting caused by gastric irritation. It goes to the stomach to quiet it down.
- What do locally acting antiemetics contain?
- Local anesthetics, antacids and protectants.
- If a proctectant contains magnesium what should it not be given with?
- Tetracycline, dogoxin, corticosteroids and ketaconzole.
- List some examples of protectants.
- Maaloz (R), Mylanta (R), Milk of Magnesia (R), Pepto Bismol (R), Kaopectate (R).
- What are some things that can cause diarrhea?
- Parasites, viruses, bacteria, toxins, neoplasia.
- What supportive care would you give to an animal with diarrhea?
- A bland diet and fluid therapy if needed.
- What happens to the GI tract when diarrhea occcurs?
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Hypersecretion of intestinal fliud/exudates and increased permeability.
Osmotic retention of water and overload.
Intestional hypomotility. - What's one of the most common reasons for the occurance of diarrhea?
- Intestinal hypomotility.
- What is hypomotility?
- Fluid is not well absorbed. This is because hypomotility causes the lumen diameter to increase and allows for faster passage of contents.
- What two drugs should be used with caution for treating diarrhea?
- Anticholinergics and antispasmodics.
- What do most vets consider the drug of choice for the control of diarrhea in dogs?
- Opiates.
- What are the four types of antidiarrheal drugs?
- Narcotic analgesic, anticholinergics/antispasmodics, antibiotics, protectants.
- What do narcotic analgesic drugs do?
- They decrease intestinal secretions, motility and intestinal absorption. They take care of the cause of diarrhea.
- Two types of narcotic analgesics.
- Lomotil (R), Immodium (R)
- What is combined with Lomotil (R) and why?
- Atropine, to discourage abuse.
- Which antidiarrheal drugs should be used with caution?
- anticholinergics/antispasmodics. They may contain a CNS suppressant. You need to be sure of what is causing the diarrhea.
- List three antibiotics that are used as antidiarrheals.
- Aminiglycosides (Neomycin, kanamycin), cephalosporins, metronidazole (Flagyl (R)).
- When would you use an aminoglycoside as an antidiarrheal?
- When there is bloody diarrhea or signs of sepsis along with diarrhea. Problems is that they're not absorbed well in the GI tract (kills the good bacteria also).
- What are some side effects of metronidazole (Flagyl (R))?
- Anorexia, hepatotoxicity, neutropenia dn neurotoxocity.
- Trade name for metronidazole.
- Flagyl (R)
- What is metronidazole (Flagyl (R)) mainly used for?
- Treating giardia and anaerobic infections in dogs and cats.
- What is helocobacter?
- It causes gastric ulcers.
- What are two types of protectants?
- Kaopectate (R), Pepto-bismol (R).
- What protectant converts to aspirin in the body and should be used with caution in cats?
- Pepto-bismol (R).
- What drugs are used the alter the pH?
- antacids, acidifiers and cinetidine (Tagamet (R)).
- What do antacids do?
- They neutralize gastric HCL or increase the pH of the stomach.
- What do acidifiers do?
- They decrease the pH of gastric or rumen contents. Mostly used in LA, vinegar is used to treat urea and high protein toxicity in ruminants.
- What does cimetidine (Tagamet (R)) do?
- It's a H2 blocker (H2 receptors produce acid). It decreases acid production.
- Trade name for cimetidine.
- Tagamet (R)
- What are the two types of protectives?
- Demulcents and absorbents.
- What do demulcents do?
- They form a protective layer of the GI mucosa and protect inflamed mucosa from further irritation.
- List three types of demulcents.
- Pepto-bismol (R), Kaopectate (R), corrective mixture.
- What two categories do Pepto-bismol (R) and Kaopectate (R) fall into?
- Protectants and protectives (demulcents).
- What do absorbents do?
- They absorb or bind up harmful toxins or chemical and prevents absorption in the GI tract.
- List an absorbent.
- activated charcoal (SuperChar (R)).
- Trade name for activated charcoal.
- SuperChar (R)
- What do digestive enzymes do?
- They aid digestion and absorption.
- What would you use digestive enzymes for?
- To treat pancreatic exocrine insufficiency.
- What should you be careful about when using disgestive enzymes (powdered form)?
- Remove from skin immediates (it will breakdown proteins on the skin) and it can cause nasal irritation and possibly an asthma attack if inhaled.
- Two types of pancreatic products.
- Viokase-V (R), Pancreatin (R).
- What are rumen function drugs used for?
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To treat rumen atony.
To restore normal rumen flora.
To treat bloat. - What is neostigmine used for?
- To stimulate peristalsis. (to treat rumen atony)
- What is Probiocin (R) used for?
- In calved that are on antibiotic treatment.
- What is Therabloat (R) used for?
- To treat frothy bloat. Cause the tiny bubbles in the rumen to break down and allow the gas to be excreted.
- What is eructation?
- burping
- What are cathartics used for?
- To stimulate or foster defecation/assist defecation.
- What's another word for cathartic?
- Laxative.
- When would you use a cathartic?
- 1.certain oral poisonings. 2.emptying the colon prior to x-ray or surgery. 3.remove fecal impactions. 4.certain cases of equine colic. 5.used with certain anthelmintics
- What are the three types of cathartics?
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Bulk.
Lubricant.
Stool softeners. - What do bulk cathartics do?
- They stimulate defecation by increasing the volume of the colon contents.
- What make up bulk cathartics?
- They are usually forms of indigestible plant material. They absorb water and swell in the colon.
- What are some examples of bulk cathartics?
- Equine psyllium, Metamucil (R), bran mash (often used in horses).
- What do lubricant cathartics do?
- They are typically oil products that soften the fecal material and make it easier to move through the GI tract.
- What are lubricant cathartics used for?
- For constipation and fecal impactions. Used on cats alot.
- List some examples of lubricant cathartics.
- Laxatone (R), Kat-a-lax (R), Felaxin (R).
- What are stool softeners used for?
- For the treatment of hard, dry feces in small animals, impactions in horses and digestive upsets in cattle. Surfactant allows water to penetrate impacted stool.
- List some examples of stool softeners.
- Colase (R), Surfak (R).
- List some drugs that are used as appetite stimulants.
- Diazepam/oxazepam (Valium (R)) and B-vitamins.
- What appetite stimulant works well, almost immediately, in cats?
- Diazepam
- Stimulation os which part of the automomic nervous sytem would increase GI motility, tone, scretion, and relax sphincters?
- Parasympathetic
- What family of drugs inhibit the stimulation of the parasympathetic part of the autonomic nervous system?
- Anticolergenic
- What centrally actin emetic has a unique route of administration?
- apormorphine - topical, subconjunctival sac.
- What are some locally acting emetics you may have at home?
- Hydrogen peroxide, warm salt water, syrup of Ipecac.
- What centrally acting antiemetic should not be used in the case of GI obstruction?
- metoclopramide (Reglan (R)).
- What is the advantage of ranitidine ove cimetidine?
- BID vs. 3-4 times a day - less side effects.
- What pH altering durgs have the side effect of constipation and ileus?
- Omethazol
- What drug works in an acid environment and forma a "gastric bandaid" over the surface of an ulcer?
- Sucrofate
- What GI drugs would be used for colitis?
- Prednisolone
- What protectant is used to bind harmful toxins?
- Activated charcoal.
- What's the difference between a demulcent and an adsorbent?
- Adsorbents absorb and a demulcent makes a patch/cover.
- What is viokase?
- A pancreatic enzyme.
- What drugs empties the stomach?
- Reglan (R)
- What type of laxative is Metamucil (R)?
- Bulk
- What type of laxative is Laxatone (R)?
- Lubricant
- What type of laxative is Lactulose (R)?
- Hyperosmotic
- What type of laxative is DSS?
- Surfactant
- What GI prokinetic or stimulant is only available through a compounding pharmacy?
- cisapride
- What GI prokinetic or stimulant is also an antiemetic?
- Metocolpromide
- What antibiotic is also used as an antidiarrheal?
- Aminoglycocides