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39 Cards in this Set
- Front
- Back
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What are some life-threatening complications that can result from lack of GI mucosal protection?
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GI bleeding
GI perforation |
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What are the 3 pharmacological modes of GI mucosal protection?
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Gastric acid neutralization
Mucosal protectantants Inhibition of acid production |
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What is an example of a drug that neutralizes gastric acid?
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Tums (bicarb salts)
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What are examples of drugs involved in mucosal protection? Which provides direct protection?
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Misoprostol
Sucralfate (direct) |
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Which drug increases gastric mucus production?
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Misoprostol
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Which drug is a synthetic PGE1 analog?
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Misoprostol
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What are the gastric effects of PGE2?
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Increase mucus secretion
Increase pancreatic bicarb secretion Increase gastric blood flow |
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Which gastric drug can cause abortions?
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Misoprostol
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Which drug is important in combating the effects of NSAID overdose?
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Misoprostol - stimulates gastric mucus production even in the presence of NSAIDs
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Which drug is the "mucosal bandage"?
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Sucralfate
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What are the components of Sucralfate?
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Sucrose sulfate + Al(OH)3 copolymer
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What are the two main indications where Sucralfate should be used?
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Iatrogenic GI bleeding
Esophogeal, gastric, or duodenal ulceration |
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Which of the following are shortcomings/side effects for Sucralfate?
May reduce drug absorption Expensive Large/frequent dosages requires presence of anaerobic bacteria for efficacy |
May reduce drug absorption
Expensive Large/frequent dosages |
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T or F:
Most manipulation of gastric activity is done at the level of the parietal cells. |
True!
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T or F:
Both PPIs and histimine blockers can be effective at increasing pH. |
True! PPIs are more effective though.
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What is the preferred drug therapy in cases of gastric disease?
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1) try H2 blocker
2) if fails, use PPI |
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What is the preferred drug therapy in cases of esophageal or gastroesophageal disease?
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1) use PPI first
2) if fails, use alternate PPI (H2 blockers won't work!!) |
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What are the three main H2 blockers? Which is most effective?
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Cimetidine
Ranitidine Famotidine (most effective) |
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Choose Cimetidine, Ranitidine, or Famotidine...
...inhibitor of cytochrome p450 enzymes. |
Cimetidine and Ranitidine
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Choose Cimetidine, Ranitidine, or Famotidine...
...most rapid clearance and shortest half-life. |
Cimetidine
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Choose Cimetidine, Famotidine, or Ranitidine...
...no cytochrome p450 inhibition. |
Famotidine
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Choose Ranitidine, Famotidine, or Cimetidine...
...interferes with the metabolism of many drugs. |
Cimetidine
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What is the main PPI used in vet med?
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Omeprazole
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Which of the drugs used in manipulation of gastric activity (Cimetidine, Omeprazole, Famotidine, or Ranitidine) has absolutely no cytochrome p450 inhibition?
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Famotidine
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What are three major drugs used in vomiting control in veterinary medicine?
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Ondansetron
Maropitant Metaclopramide |
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T or F:
Due to toxicity issues, no more than four doses of maropitant should be given to a vomiting dog. |
False!
There is no toxicity issue with maropitant; if 4 doses doesn't fix the problem, then there is something else going on. |
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What peripheral GI effects lead to the anti-emetic properties of metaclopramide?
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Increased lower esophageal sphincter tone.
Decreased pyloric tone. Increased gastric, duodenal, and jejunal motility. |
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Which antiemetic blocks dopamine in the chemoreceptor trigger zone of the brain?
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Metaclopramide
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Which antiemetic is the least effective in controlling nausea?
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Metaclopramide.
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Which antiemetic is a 5-HT3 receptor antagonist?
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Ondansetron
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Why are German Shepherds predisposed to chronic enteropathies? What is the general treatment for this?
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Why? sIgA deficiency leads to bacterial overgrowth;
Treat w/antibiotics |
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What is the preferred antibiotic treatment for chronic enteropathy? What class of antibiotic is it?
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Tylosin; macrolide antibiotic (interferes w/bacterial ribosomes)
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T or F:
Off-label use of Tylosin in small animals provides for bacteriocidal activity quelling chronic enteropathy. |
False.
Tylosin is BACTERIOSTATIC |
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This drug has antibiotic and antiprotozoal properties and is frequently underdosed.
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Metronidazole
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Which is the best choice for protozoal disease?
Metronidazole Tylosin Fenbendazole Sulfasalazine |
Fenbendazole
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Which two components comprise sulfasalazine? What is the mechanism of action for each?
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Sulfapyridine (antibacterial)
5-aminosalycylic acid (anti-inflammatory) |
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What drug is used to combat hepatic encephalopathy? How does it work?
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Lactulose is broken down into fructose and galactose then fermented to organic acids by intestinal bacteria. This acidifies the gut and converts NH3 to NH4.
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Which antibiotics are commonly combined with Lactulose? Which one is arguably superior to the other two?
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Neomycin, Ampicillin, and Metronidazole
Neomycin is best since it isn't absorbed orally and doesn't increase hepatic workload. |
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What drug is used to treat cholistasis? What is its mechanism of action?
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Ursodeoxycholic acid is water soluble and increases the size of the circulating bile acid pool leading to decreased bile acid synthesis and dissolution of existing bile acids.
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