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68 Cards in this Set

  • Front
  • Back
gastric ulcers often develop during ________ as a co-morbidity
the stomach produces ____ and ___ which are potentially damaging to the gastric mucosa
acid and proteolytic enzymes
the three main modes of mucosal protection include:
1. gastric acid neutralization
2. mucosal protectants
3. inhibition of gastric acid secretion
Misoprostol is a ________ and the MOA of Misoprostol is:
A synthetic prostaglandin E1 analog.

To decrease parietal cell acid secretion
NSAIDs interfere with ______ synthesis which results in _______, ________ and _______.
prostaglandin synthesis, mucus secretion, blood flow and bicarbonate production
T of F The better an NSAID is at blocking nociceptors the more severe the effect is on the gastric mucosa.
What are the indications for misoprostol administration? (2)
NSAID induced gastric ulceration (overdoses/accidental consumption) or as preemptive with high doses of glucocorticoids
Typically you would like to take a patient off NSAIDs for at least __ weeks before starting them on steroids
What are the adverse effects associated with misoprostol? What animals should you avoid them in?
diarrhea, gastric upset

Pregnant animals- causes smooth muscle contraction
Sucralfate reacts with gastric to form a ____ which then _____to the exposed submucosa.
gel, adheres
Sucralfate acts as a mucosal protectant by forming a direct ______ _______.
physical barrier
Sucralfate also has some minor _____ properties and there is some evidence for stimulation of ______ (which would increase mucus production and bicarbonate secretion)
antacid, PGE2 and PGI2
When is use of sucralfate indicated?
and if a lesion is in this section of the GIT ________ this drug would no longer be beneficial to the patient.
esophageal, gastric or duodenal ulceration (gastric reflux, severe gastritis) or iatrogenic mucosal bleeding (NSAID gastritis, steroid induced lesions, surgical complications)

not indicated if the lesion is past the duodenum because it gets broken down
you should administer sucralfate at least ___ min before antacids.
what is the easiest and cheapest way to administer sucralfate
you make crush and suspend the sucralfate in tap water or feed them the tablet if they will eat a horse pill
what important medications will sucralfate inhibit the absorption of?
flurorquinolones, digoxin (and cimetidine but its not really considered an impt one)
it is ______ expensive and is used for ____term treatment in patients
moderately (25 cents per tablet), short
Gastric acid is produced by the ____ cells in the stomach and the pH can reach as low as _____ in a carnivore stomach
parietal, 1
blocking of the histamine receptors is a type of ______ antagonism and hence relies on the relative __________ of histamine and antagonist
competitive, concentrations
proton pump blockers bind ______ and hence are considered ______ blockers of gastric acid secretion
covalently, absolute
T or F

H2 receptor blockers can completely abolish gastric acid production and can lower pH to below 5
F that would be the PPIs
which are more expensive proton pump inhibitors or H2 receptor blockers?
proton pump inhibitors
what protective mechanisms does the esophageal mucosa employ?
not many! it will not heal easily in adverse conditions
If you only have a gastric disease which antacid might you select?
H2 receptor blockers
if you have concurrent gastric and esophageal disease which type of antacid might you select
a proton pump inhibitor
list the three commonly used H2 blockers
cimetiine, ranitidine, famotidine
what is one of the major adverse effects of cimiedtidine? what is the outcome of this adverse effect?
significant inhibitor of cytochrome P450. it interferes with drug metabolism
how often must cimetidine be dosed?
every 6-8 hours
Ranitidine is known as _____ over the counter and has to be dosed _______.
zantac, 2 x daily
Famotidine has the least effect on this enzyme ______ but is the most ________
cytochrome p450, expensive
what is the MOA of omeprazole and what is its adverse effects
MOA- irreversible inhibitor of parietal cell proton pumps. it mildly inhibits cytochrome p450.
vomition is a ______ process and is controlled centrally by the _____ and ______.
complex, chemoreceptor trigger zone, vomition center
Maropitant is a ______ receptor antagonist which blocks the action of _____ in a common pathway to the vomition center
NK1, substance P
Maripotant needs to be dosed ___ x daily by _____ or per os.
1, subcutaneous
Maripotent is dispensed by the manufacturer in packages of 4 tablets because ____________.
if the animal is still vomiting after this time it requires further work up
The anitemetic effect of metoclopramide is predominantly _______. This is achieved by increasing ____ tone, decreasing ____ tone, increasing ________ and _______ motility.
increasing LES tone
decreasing pyloric tone
increasing gastric and duodenal/jejunal motility
Metoclopramide also has some ____ activity which can lead to ____ side effects. it is a _____ antagonist
central, neurological, dopamine
Metoclopramide has a prokinetic effect but is not particularly good at preventing ____.
Metoclopramide can be given as a _____ (dose form) and is not cost prohbitive.
how common are side effects of metoclopramide and what are they?

restless, circling, whining, disorientation, seizures and frenzied behaviour
Ondansetron/Dolasetron are available in ___ and ___ forms for about ___ dollars a dose. they should be adminstered ___ x daily
IV and tablets

10 dollars

ondansetron and dolasetron are ______ acting and are _____ receptor antagonists.
centrally, serotonin/5HT3
What is your first line choice when selecting an anti-emetic?
many hospitalized patients are given _____ and _____ as single daily injections which is easy to maintain
maropitant and 5HT3 antagonist
What are some examples where it would be indicated to combine 3 antemetics?
severe acute pancreatitis, gastric carcinoma, severe uremic gastropathy, chemotherapy related nausea and vomiting
chronic GI enteroptathies include:
chronic small intestinal diarrhea, weight loss, failure to thrive, vitamin malabsorption, steathorrea
chronic enteropathies are most common in which if the companion animal species and in particular which breed
large breed dogs, the german shepard
which antibiotic has a good track record for the treatment of chronic enteropathies?
What type of antibiotic is tylosin and what is its MOA
macrolide, it inhibits protein synthesis
Would tylosin be considered bactericidal or bacteriostatic? Which species is it marketed and labeled for use in?

cattle, swine, poultry
the beneficial effect of tylosin is through the promotion of which microbe in the GIT
the optimum dose of tylosin is not clear but recently they have been recommending ___ mg/kg ___ x daily. patients need at least how many weeks therapy
25, 2

which drug is known as the great white hope of chronic GI disease?
patients on metronidazole often see a clinical response but with rapid _______
metronidazole is effective against _________ and ______ and in particular for diarrhea related to this parasite_______
bacteria, protozoa

You can see clinical benefits at a dose of ___mg/kg of metronidazole but to clear an infection of giardia completely you need to prescribe a dose of _____mg/kg BID for _____days

25 mg/kg 10 days
Protozoal infections are better treated with _______ because of lower likelihood of toxicity and increased efficacy.
Sulfasalazine is effective at treating conditions in this region of the GIT
the colon
In the colon, _______ is cleaved by the bacteria into sulfapyridine and 5-aminosalycylic acid.
What are the 3 general mechanisms behind diarrhea
secretory type diarrhea is often associated with _____ and _____
bacterial toxins, some viruses
osmotic type diarrhea is often associated with ________
fat and carbohydrates not being absorbed
motility type diarrhea is associated with ____, _____ and _______
inflammation, drugs, some toxins
The MOA of Loperamide is:
motility modifier
Opiate anitdiarrheals work by;
1. reducing longitudinal colonic motility and increasing circumferential contractions
thereby increasing the duration of passage of ingesta
When are opiate antidiarrheals contraindicated? (3)
1.when the patient has bacterial infections or has consumed any other toxins
2. in cats
3. collie breeds
Bismuth subsalicylate exerts its effects by being ______ protective
salicyclate is an _________ so take care when dosing
NSAID (aspirin)