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130 Cards in this Set
- Front
- Back
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What are the four types of stomach animals can have? |
- monogastric (simple stomach, small cecum) - hind gut fermentors (large cecum) - Ruminants (4 chambers, rumen ferments/breaks down) - crop and gizzard (birds) |
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what are the functions of the GI tract? |
- to digest and absorb nutrients and water - provide initial immune protection - expel solid waste |
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What are the three types of smooth muscle contraction of the gI tract |
- segmental - peristalsis - mass action contraction |
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Explain segmental contraction |
the muscles in the GI tract contract in a kneading motion - mixing, not moving forward
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explain peristalsis |
a wave of motion propels the ingesta forward |
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explain mass action contraction |
contraction of a large section of intestine pushes items forward |
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physically, what is diarrhea |
there's no contraction and the tube is dilated |
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What is unique about the cat bile duct vs the dog |
The cat bile duct is combined with the pancreatic duct, in dogs they are separated |
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Which intestine has more risk of issues with foreign bodies and why? |
The small intestine, because it's diameter is so compact |
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What are the 6 GI issues in need of medical intervention? |
- ingestion of toxins - vomiting - ulcers - diarrhea - constipation - inflammation |
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What type of digestive system does not allow for vomiting? |
Hind gutt fermentors (horses and rabbits) |
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What are the 3 regulations of the GI tract |
- The autonomic nervous system - GI hormones - Bacterial endotoxins |
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What are the tree parts of the Autonomic nervous system that effect the GI tract, and how? |
- Parasympathetic (stimulation of parasympathomemetics and cholinergics causes secretion of gastric juices) - Sympathetic (stimulation slows down the secretion of gastric juices) - The intrinsic/ enteric (promotes peristalsis) |
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Name a few of the GI hormones involved in digestion |
- Hydrochloric Acid - Prostilandin - Seratonin
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What do bacterial endotoxins do to the GI tract? |
they increase the permiability of the GI vasculature. |
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Simply put, what are emetics |
drugs that make you vomit |
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When would you not want to use an emetic even if a toxin has been ingested? |
- if that toxin is caustic, it's just going to cause more damage on the way back up - the animal must be conscious - the animal must be healthy enough to withstand vomiting |
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What are the two types of emetics |
Centrally acting and locally acting |
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Name some centrally acting emetics, and who can they be used on |
- apomorphine (dogs) narcotic - Xylazine (cats) non narcotic (alpha 2 agonist) |
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What do we use Apomorphine for with the gI tract, and how is it administered? |
as an emetic in dogs. - can be used IV, IM, oral or conjunctiva |
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What do we use xylazine for with the gi tract? |
as an emetic in cats |
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Name some locally acting emetics |
- mustard and water or salt and water - syrup of ipecac - 3% hydrogen peroxide |
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why don't we really use syrup of ipecac on animals that often |
has many side effects |
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What do locally acting emetics do to the body to cause vomiting? |
work with the peripheral receptors |
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Simply put, what are antiemetics? |
drugs that stop vomiting |
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What are the two categories of vomiting that we use antiemetics for? |
chronic vomiting vomiting with behavioral changes |
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What are the five classes of drugs that are used as antiemetics? |
- phenothiazine derivatives - procainamide derivatives - antihistamines (H1 blockers) - serotonin receptor antagonists (5-HT3) - NK1 receptor antagonists |
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What is it important to remember about antiemetics when dosing them out? |
usually you can't give them orally until the vomiting is under control oral versions can be given before motion sickness |
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What do Phenothiazine derivatives do to stop vomiting? |
Block dopamine receptors in the CRTZ and inhibit the vomiting center - used primarily for motion sickness and nausea |
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List the Phenothiazine derivatives used as antiemetics |
- Chlorpromazine (thorazine) - Prochlorperazine (Darbazine- combined with an antcholinergic) |
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What are some side effects of phenothiazine derivatives |
- sedation - dilated pupils - hypotension - ataxia - drug interactions |
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How do procainamide derivatives stop vomiting |
Block dopamine in the CRTZ and act peripherally by increasing the rate of cardiac sphincter tone and gastric emptying |
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Name the procainamide derivatives |
- Metoclopramide (reglan) |
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How can meoclopramide (Reglan) be administered, and what are it's shortcomings? |
- injectable oral and CRI - short acting - not good for GI obstruction because it increases gastric movement |
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What does CRTZ stand for |
chemo receptor trigger zone |
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How do antihistamine (H1 blockers) work as an antiemetic |
- Block H1 receptors in the CRTZ - cause sedation used mainly for motion sickness |
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List the Antihistamine antiemetics |
- Dimenhydrinate (dramamine) - Diphenhydramine (benadryl) - Meclizine (Antivert) - Promethazine (Phenergan) |
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How do seratonin receptor antagonists (5-HT3 receptor antagonists) prevent vomiting? |
- bind to seratonin receptors in the CRTZ and on the vagal nerve |
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list some seratonin receptor antagonists |
- Ondanestron (zofran) - Dolaestron (anzemet) |
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How do NK1 receptor agonists prevent vomiting? |
block the binding of substance P to NK1 receptors in the CRTZ |
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What is the difference between the dosing of Maropitant (cerenia) for motion sickness and for other types of vomiting? |
dose is higher for motion sickness vs. other acute vomiting |
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Name the NK1 receptor antagonists |
Maropitant (cerenia) |
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What is important to remember about the time frame for cerenia (maropitant) |
can't be used for more than five days in a row, can cause muscle tremmors That's why it's dispensed in a four pack. |
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Who is cerenia (maropitant) labeled for?
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Dogs, it's used off label in cats
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List the H2 Receptor Antagonists that are used as anti ulcer medications.
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- cimetadine (tagamet)
- Ranitidine (Zantac) - Famotidine (Pepcid) |
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Why isn't Cimetadine often used?
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It's short acting, has to be administered 3-4x daily.
It has lots of drug interactions. |
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Which of the H2 receptor agonist antiulcer medications has the fewest side effects?
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famotidine (Pepcid)
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Which of the H2 Receptor Antagonist Antiulcer medications promotes gastric emptying?
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Ranitidine (Zantac)
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How are antiulcer H2 Receptor Antagonists dispensed? Administered?
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All can be found as oral and injectable.
All are over the counter medications. |
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What are the five types of antiulcer medications?
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- H2 Receptor Antagonists
- Proton Pump Inhibitors - Antacids - Gastromucosal Protectants - Prostaglandin E1 Analogues |
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List the Proton pump inhibitor antiulcer medications
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- omeprazole (prilosec/gastrogard)
- lansopazole (prevacid) |
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How do proton pump inhibitors work?
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they bind irreversibly to S-P Enzyme, preventing the secretion of hydrogen ions into the stomach.
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What are some of the side effects of Proton pump inhibitors?
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- constipation
- sedation - ileus - pancreatitis - CNS effects |
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What can cause ulcers?
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- stress
- excess of gastric acid - metablolic disease - reaction from drugs |
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What are the effects of ulcers?
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- pain
- anorexia - melena - hematoemesis |
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How do antacids work?
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They get rid of the acid once it's in the stomach.
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List the antacids used as antiulcer medications.
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- Aluminum Hydroxide (Amphojel)
- Aluminum Carbonate (Basaljel) - Aluminum/Magnesium Hydroxide (mylanta/Maalox) - Magnesium Hydroxide (Milk of Magnesia) |
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What type of antacids should't be used with kidney disease?
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anything with magnesium
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What is important to remember when administering antacid medications?
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They can decrease the absorption rate of other drugs. Give sperately.
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List the gastromucosal protectants
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- Sucralfate (Carafate)
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How do gastromucosal protectants work?
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- Adheres to the gastric mucosa
*needs an acidic environment* |
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How should you give gastromucosal Protectants?
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- works best if ground up and given as a slurry (more surface area)
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List the Prostaglandin E1 analogues Antiulcer medications
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- Misoprostol (Cytotec)
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How do the Prostaglandin E1 Analogues work?
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- increase mucous and bicarbonate production in the stomach
- Inhibits parietal cells from secreting hydrogen ions into the stomach |
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When should you not use Prostaglandin E1 Analogues?
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With pregnant animals (can contribute to abortions)
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What are the two types of antidiarrheal agents?
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- Narcotics and Anticholinergics
- Protectants and Adsorbents |
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List the Narcotic analgesics used as antidiarrheals
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- Diphenoxylate C5 (lomotil)
- Loperamide (Immodium) |
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List the Anticholinergics used as antidiarrheals
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- centrine
- buscopen - probantheline |
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Why don't we often use anticholinergics as a treatment for diarrhea.
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Because they slow down peristalsis, we want to promote slow but steady movement.
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What is ileus
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dilation to the intestine with no movement
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Which narcotic analgesic is okay to use in cats?
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- Loperamide (immodium)
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List the Antidiarrhea Protectants and adsorents
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- Kaolin (Pectin)
- bismuth Susalicylate - Activated charcoal |
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How does bismuth subsalicylate work?
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The Bismuth coats and salicylate is an antiinflammatory
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Which protectant/adsorbent cannot be used in cats?
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Bismuth susalicylate
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What other remedies can be used as anti diarrheals?
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- bland high fiber diet
- metronidazole - probiotics |
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What are Cathartics/purgatives
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harsh laxatives
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List five types of laxatives
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- saline/hyperosmotic agents
- bulk (fiber) - lubricants - surfactants/softeners - irritants |
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List the hyperosmotic laxatives
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- Lactulose (enulose/milk sugar)
- Polyethylene glycol (Miralax) - Magnesium Hydroxide (Milk of Magnesia) |
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How does Polyethylene glycol (Miralax) work
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acts in the colon to balance the water content of stool
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How do hyperosmotics work
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- holds water in the intestinal lumen
- softens stool - encourages peristalsis (increases volume) |
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Why is lactulose so hard to administer
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it's a sticky liquid, tastes terrible and is very messy.
It must be given several times daily |
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List some of the bulk producing agents
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- psyllium fiber (vatasil/metamucil)
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how do fiber/bulk producing agents act as laxatives
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- indigestible plant fiber absorbs water
- swelling increases peristalsis |
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What is sand impaction
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ingestion of sand
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List the lubricants/oil laxatives
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- Mineral oil (great for horses)
- Petroleum Jelly (Laxatone, Petromalt)- great for hairballs in cats (breaks them up before they irritate to force them up) |
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List the surfactants/stool softeners
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- Dioctyl Sodium Sulfo Succinate (docusate sodium)
- Sodium Phosphate (FLEET enema) |
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How do surfactants/ stool softeners work?
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reduces surface tension and allows water to penetrate fecal masses
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what is obstipation
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bowel impaction
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What are the digestive enzymes/pancreatic enzymes
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- Amylase/lipase (viokase/ pancreazyme)
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What is the difference between constipation and obstipation
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constipation is difficulty moving stool, obstipation means the stoppage of stool
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List the Hepatoprotectants
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- Ursodiol
- S-adenosylmethionine (SAME-E) - Silymarin (milk thistle extract) - Lactulose |
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How can antibiotics be used in the gut
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- for infection
- overgrowth of normal bacteria in the gut |
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List the antibiotics used for GI treatment
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- Metronidazole (Flagyl) - Amoxycilin- Clavamox - Tylosin (Tylan Powder) |
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List the appetite stimulants
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- Diazepam (valium)
- Cyproheptadine (periactin) - Mirtazapine (Remeron) tetracyclic antidepressant |
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What is Dirlotapine
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also known as Slentrol
Weightloss drug many side effects |
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What is forti flora?
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a probiotic
- good microbes that inhibit the growth of bad gi pathogens |
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When can we use probiotics
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- allergies
- antibiotic therapy - non specific diarrhea caused by: stress, viruses, etc. - It has been shown to help treat giardia |
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What is Prostera
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a probiotic that can only be used in dogs, not cats.
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List the GI prokinetics/stimulants
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- Metoclopramide (dopaminergic antagonist) increases cardiac sphincter tone
- Seroteonergic (Cisapride) - Erythromycin (Motilin like) small doses with few antibiotic effects - Ranitidine (H2 receptor antagonists) the only H2 that can be used for this |
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What products can be used for IBD
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- Prednisone/Prednisolone
- Azathioprine (Imuran) - Sulfasalazine (Azulfadine) - Olsalazine (Dipentum) |
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Why must Sulfasalazine/olsalazine be used carefully in cats?
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Because it is metabolized as asprin
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Which is easier to use prednisone or prednisolone?
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Prednisolone.
Prednisone has to be metabolized by the body to become prednisolone. Prednisolone has fewer side effects. |
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What are the major control Systems of the body? |
The endocrine system And the nervous system |
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How are the endocrine and nervous systems coordinated? |
By the hypothalamus |
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What is the master gland of the endocrine system? |
The pituitary gland |
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What does the anterior pituitary do? |
Indirect Secretes hormones to trigger other hormones to secrete hormones |
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What does the posterior pituitary do?
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Direct
hormones secreted directly to their target zones |
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What do the Thyroid hormones regulate/do in the body
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- regulate metabolic rate
- regulate growth and development - regulate body temperature - regulate heart rate - metabolism of nutrients - regulate skin condition - resistance to infection |
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What do we check in blood when we suspect a thyroid disorder?
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- Free T4 and TSH levels
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What will the blood analysis look like if the animal has hypothyroidism
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low free T4 and possibly high TSH
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What is the goal of treatment for hypothyroidism
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- to provide supplementary thyroid hormones
- life long therapy |
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List the drugs for hypothyroidism
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- Levothyroxine Sodium (T4 supplement)
Tablet form: Soloxine, Thyromed, Thyro tabs Liquid: Leventa |
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How often do we check T4 with animals on thyroid medication?
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at first every 3-4 weeks, then once it's evened out every 6 months
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What is the goal of drug therapy for Hyperthyroidism?
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- lowering the levels of T3 and T4 in the blood
BY: - to destroy or remove the overproductive thyroid hormone - blocking hormone production - Life long therapy |
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What are the options for an animal with hyperthyroidism?
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- Drugs: life long therapy
- Surgery (out of favor) - Radioactive iodine treatment - Diet: Y/D (not great) |
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List the Hyperthyroid drugs
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- Methimazole (interferes with the iodine which creates T3 and T4)
Also known as: - Felimazone - Tapazole (human) Carbimazole (precursor to methimazole) |
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How can methimazole be administered
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- trans dermal
- liquid - pills - treats |
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What animals can we see Hyperadrenocorticism in?
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Dogs and Horses
rarely cats |
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List the hyperadrenocorticism drugs
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- Trilostane (Vetoryl)
- Mitotane (Lysodren) - Selegiline (Anipryl) (not great) - Ketoconazole (not great) |
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What are the common side effects of drugs used for hyperadrenocorticism
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- Loss of appetite
- lethargy - weakness - diarrhea/vomiting |
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What are the drugs used for Hypoadrenocorticism
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- Desoxycorticosterone Pivalate (DOCP) Percorten (must combine w/ pred)
- Fludrocortisone (mineralo + glucocorticoid) - Prednisone |
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How is insulin classified?
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- regular, intermediate and long acting
- units per mL (U40 and U100) |
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List the regular (short) insulins
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- Humulin R
- Novolin R - Humalog |
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List the intermediate insulins
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- Humulin N
- Novolin N - Lente (Vetsulin) U40 - Protamine zinc (PZI) U40 - glargine (lantus) |
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List the long insulins
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- Glargine (lantus)
- Detemir (levemir) |
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When do we see side effects of insulin?
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with overdose of the medication, not with proper use
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How is insulin stored/prepared
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- refrigerated
- gently rolling the vial to mix - feed prior to injections |
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What can be given to an animal that is experiencing an overdose of insulin?
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karo syrup
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What is it important to remember about the expiration dates for insulin
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animals can use the human insulins up to six months after the expiration date
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What is Glipizide?
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An oral medication used to regulate Type 2 diabetes. (Non insulin dependent)
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