Podcast
Questions and Answers
In managing gastrointestinal (GI) patients, which therapeutic intervention is often considered the MOST crucial?
In managing gastrointestinal (GI) patients, which therapeutic intervention is often considered the MOST crucial?
- Providing nutritional support
- Fluid therapy (correct)
- Administering anti-emetics
- Administering antibiotics
What is the primary difference between replacement fluids and maintenance fluids in treating GI patients?
What is the primary difference between replacement fluids and maintenance fluids in treating GI patients?
- Maintenance fluids are designed to correct dehydration and electrolyte imbalances, while replacement fluids are for ongoing daily needs.
- Replacement fluids contain a lower concentration of electrolytes than maintenance fluids.
- Replacement fluids are typically administered intravenously, while maintenance fluids are given subcutaneously.
- Maintenance fluids are designed for ongoing daily needs, while replacement fluids correct dehydration and electrolyte imbalances. (correct)
When administering intravenous potassium to a patient with hypokalemia, what is the MOST critical precaution to take?
When administering intravenous potassium to a patient with hypokalemia, what is the MOST critical precaution to take?
- Monitor the patient's heart rate for signs of bradycardia, which indicates potassium is infusing too quickly.
- Administer potassium as a rapid bolus to quickly correct the deficiency.
- Ensure the fluid bag is thoroughly mixed to avoid concentrated delivery of potassium. (correct)
- Use a high concentration of potassium in the IV fluid to achieve a faster correction.
Which clinical finding would indicate that a patient is approximately 6-7% dehydrated?
Which clinical finding would indicate that a patient is approximately 6-7% dehydrated?
A 7-week-old puppy is vomiting due to parvovirus. Considering the patient's age, which anti-emetic should be avoided?
A 7-week-old puppy is vomiting due to parvovirus. Considering the patient's age, which anti-emetic should be avoided?
A dog with a history of ingesting foreign objects presents with vomiting. Radiographs do not reveal an obstruction. Which anti-emetic would be LEAST appropriate?
A dog with a history of ingesting foreign objects presents with vomiting. Radiographs do not reveal an obstruction. Which anti-emetic would be LEAST appropriate?
What is the MOST important consideration when prescribing anti-emetics, especially in cases where the underlying cause of vomiting is not immediately clear?
What is the MOST important consideration when prescribing anti-emetics, especially in cases where the underlying cause of vomiting is not immediately clear?
Why is famotidine considered more potent than cimetidine as an H2 blocker?
Why is famotidine considered more potent than cimetidine as an H2 blocker?
What is the MOST significant consideration when administering H2 blockers like famotidine or cimetidine to patients with GI issues?
What is the MOST significant consideration when administering H2 blockers like famotidine or cimetidine to patients with GI issues?
In what scenario is misoprostol primarily indicated as a gastroprotectant?
In what scenario is misoprostol primarily indicated as a gastroprotectant?
What class of medication does Chlorpromazine belong to and what receptors does it antagonize to prevent vomiting?
What class of medication does Chlorpromazine belong to and what receptors does it antagonize to prevent vomiting?
Why are Tetracyclines and Fluoroquinolones like Doxycycline and Ciprofloxacin, administered with caution with Sucralfate?
Why are Tetracyclines and Fluoroquinolones like Doxycycline and Ciprofloxacin, administered with caution with Sucralfate?
In the context of acute hemorrhagic diarrhea syndrome (AHDS), what is the MOST critical consideration when deciding whether to use antibiotics?
In the context of acute hemorrhagic diarrhea syndrome (AHDS), what is the MOST critical consideration when deciding whether to use antibiotics?
What potential effect does misoprostol have that warrants caution in women who are handling the medication?
What potential effect does misoprostol have that warrants caution in women who are handling the medication?
Which of the following appetite stimulants is safe to use in cats with chronic kidney disease?
Which of the following appetite stimulants is safe to use in cats with chronic kidney disease?
What distinguishes capromorelin from mirtazapine in terms of their mechanisms as appetite stimulants?
What distinguishes capromorelin from mirtazapine in terms of their mechanisms as appetite stimulants?
When should you use caution with compounded products?
When should you use caution with compounded products?
What would MOST warrant the use of intravenous fluids?
What would MOST warrant the use of intravenous fluids?
What do high levels of potassium potentially indicate?
What do high levels of potassium potentially indicate?
What amount should insensible (feces, respiratory) losses be accounted for when calculating the amount of fluids that should be given to a patient?
What amount should insensible (feces, respiratory) losses be accounted for when calculating the amount of fluids that should be given to a patient?
Why is Ondansetron a consideration as an anti-emetic?
Why is Ondansetron a consideration as an anti-emetic?
What property of Metoclopramide warrants caution in pancreatitis patients?
What property of Metoclopramide warrants caution in pancreatitis patients?
When should you avoid using Maropitant?
When should you avoid using Maropitant?
Which antiemetic requires the administration to be intravenous slowly?
Which antiemetic requires the administration to be intravenous slowly?
Why is it important to use caution when administering Omeprazole?
Why is it important to use caution when administering Omeprazole?
What are some adverse effects of Mirtazapine?
What are some adverse effects of Mirtazapine?
What effects warrant use for Sucralfate for healing GI tract?
What effects warrant use for Sucralfate for healing GI tract?
What does Mirtazapine do to help stimulate appetite?
What does Mirtazapine do to help stimulate appetite?
What is NOT a sign or symptom of dehydration?
What is NOT a sign or symptom of dehydration?
What is a major contraindication for Metoclopramide?
What is a major contraindication for Metoclopramide?
What does the fluid replacement formula Body weight (kgs) x percent dehydrated/100 tell you?
What does the fluid replacement formula Body weight (kgs) x percent dehydrated/100 tell you?
Why should you monitor a patients body weight during fluid monitoring?
Why should you monitor a patients body weight during fluid monitoring?
In dogs, what is the oral dosage for Maropitant PO daily for motion sickness?
In dogs, what is the oral dosage for Maropitant PO daily for motion sickness?
What medication should be given with Piroxicam?
What medication should be given with Piroxicam?
What does fluid bolus refer to?
What does fluid bolus refer to?
Which of the following can happen if you mix Ondansetron with metoclopramide?
Which of the following can happen if you mix Ondansetron with metoclopramide?
A patient presents with signs of hypovolemic shock and requires immediate fluid resuscitation. Considering the principles of fluid therapy in gastrointestinal patients, which of the following crystalloid fluid types would be the MOST appropriate initial choice for a rapid bolus?
A patient presents with signs of hypovolemic shock and requires immediate fluid resuscitation. Considering the principles of fluid therapy in gastrointestinal patients, which of the following crystalloid fluid types would be the MOST appropriate initial choice for a rapid bolus?
A 9-year-old cat with chronic kidney disease and concurrent gastritis is prescribed famotidine. Which of the following adjustments to the standard famotidine administration should be considered in this patient?
A 9-year-old cat with chronic kidney disease and concurrent gastritis is prescribed famotidine. Which of the following adjustments to the standard famotidine administration should be considered in this patient?
In a canine patient diagnosed with acute pancreatitis and persistent vomiting, metoclopramide is being considered as an anti-emetic. What is the PRIMARY pharmacological concern regarding the use of metoclopramide in this specific clinical scenario?
In a canine patient diagnosed with acute pancreatitis and persistent vomiting, metoclopramide is being considered as an anti-emetic. What is the PRIMARY pharmacological concern regarding the use of metoclopramide in this specific clinical scenario?
A client is prescribed misoprostol for their dog receiving long-term piroxicam therapy. Which of the following instructions is MOST critical to convey to the client regarding the safe handling and administration of misoprostol?
A client is prescribed misoprostol for their dog receiving long-term piroxicam therapy. Which of the following instructions is MOST critical to convey to the client regarding the safe handling and administration of misoprostol?
A 14-year-old cat with a history of chronic kidney disease and inappetence is being considered for appetite stimulant therapy. Considering the patient's comorbidities, which of the following appetite stimulants would be the SAFEST initial choice?
A 14-year-old cat with a history of chronic kidney disease and inappetence is being considered for appetite stimulant therapy. Considering the patient's comorbidities, which of the following appetite stimulants would be the SAFEST initial choice?
A dog is diagnosed with parvoviral enteritis and is experiencing severe, intractable vomiting. While maropitant and ondansetron are both effective anti-emetics, what is a potential ADVANTAGE of choosing maropitant over ondansetron in this specific case?
A dog is diagnosed with parvoviral enteritis and is experiencing severe, intractable vomiting. While maropitant and ondansetron are both effective anti-emetics, what is a potential ADVANTAGE of choosing maropitant over ondansetron in this specific case?
A veterinarian is formulating a fluid therapy plan for a dehydrated dog. They have calculated the replacement fluid volume and the maintenance fluid rate. To ensure accurate fluid administration and monitoring, what is the MOST critical next step in refining this fluid plan?
A veterinarian is formulating a fluid therapy plan for a dehydrated dog. They have calculated the replacement fluid volume and the maintenance fluid rate. To ensure accurate fluid administration and monitoring, what is the MOST critical next step in refining this fluid plan?
When considering the use of sucralfate in a patient receiving oral doxycycline for a concurrent condition, what is the PRIMARY rationale for staggering the administration of these two medications?
When considering the use of sucralfate in a patient receiving oral doxycycline for a concurrent condition, what is the PRIMARY rationale for staggering the administration of these two medications?
In the context of acute hemorrhagic diarrhea syndrome (AHDS) in dogs, a study demonstrated 'no significant difference between treatment groups concerning mortality rate, dropout rate, duration of hospitalization, or severity of clinical signs' when comparing antibiotics to placebo. Based on this evidence, what is the MOST appropriate clinical implication for antibiotic use in typical AHDS cases?
In the context of acute hemorrhagic diarrhea syndrome (AHDS) in dogs, a study demonstrated 'no significant difference between treatment groups concerning mortality rate, dropout rate, duration of hospitalization, or severity of clinical signs' when comparing antibiotics to placebo. Based on this evidence, what is the MOST appropriate clinical implication for antibiotic use in typical AHDS cases?
A dog presents with motion sickness, and maropitant is chosen for oral administration. To optimize the efficacy of maropitant for motion sickness prevention, what is the MOST important instruction to provide to the owner regarding administration timing?
A dog presents with motion sickness, and maropitant is chosen for oral administration. To optimize the efficacy of maropitant for motion sickness prevention, what is the MOST important instruction to provide to the owner regarding administration timing?
When comparing omeprazole and famotidine for the treatment of gastric ulceration, which statement accurately reflects a key pharmacological difference that influences clinical decision-making?
When comparing omeprazole and famotidine for the treatment of gastric ulceration, which statement accurately reflects a key pharmacological difference that influences clinical decision-making?
A patient receiving pantoprazole intravenously for severe gastritis develops diarrhea. What is the MOST likely mechanism by which pantoprazole could contribute to this adverse effect?
A patient receiving pantoprazole intravenously for severe gastritis develops diarrhea. What is the MOST likely mechanism by which pantoprazole could contribute to this adverse effect?
In a dog with suspected gastrointestinal obstruction, radiographs are inconclusive, and further diagnostics are pending. Considering anti-emetic therapy, which of the following anti-emetics would be LEAST appropriate to administer at this stage?
In a dog with suspected gastrointestinal obstruction, radiographs are inconclusive, and further diagnostics are pending. Considering anti-emetic therapy, which of the following anti-emetics would be LEAST appropriate to administer at this stage?
When calculating fluid replacement for a 10 kg dog estimated to be 7% dehydrated using the formula 'Body weight (kgs) x percent dehydration / 100', the result is 0.7. What is the CLINICAL INTERPRETATION of this value in the context of fluid therapy?
When calculating fluid replacement for a 10 kg dog estimated to be 7% dehydrated using the formula 'Body weight (kgs) x percent dehydration / 100', the result is 0.7. What is the CLINICAL INTERPRETATION of this value in the context of fluid therapy?
A veterinary nurse is administering intravenous potassium chloride (KCl) supplementation to a hypokalemic patient. Which of the following administration techniques is MOST critical to prevent potential life-threatening complications?
A veterinary nurse is administering intravenous potassium chloride (KCl) supplementation to a hypokalemic patient. Which of the following administration techniques is MOST critical to prevent potential life-threatening complications?
A dog receiving piroxicam for transitional cell carcinoma is prescribed misoprostol as a gastroprotectant. What is the PRIMARY mechanism by which misoprostol provides gastroprotection in this scenario?
A dog receiving piroxicam for transitional cell carcinoma is prescribed misoprostol as a gastroprotectant. What is the PRIMARY mechanism by which misoprostol provides gastroprotection in this scenario?
When considering the use of compounded medications in veterinary practice, especially for gastrointestinal drugs, what is the MOST significant concern regarding their use compared to commercially available, FDA-approved products?
When considering the use of compounded medications in veterinary practice, especially for gastrointestinal drugs, what is the MOST significant concern regarding their use compared to commercially available, FDA-approved products?
In a patient exhibiting clinical signs consistent with 6-7% dehydration, which combination of physical examination findings would be MOST indicative of this dehydration level?
In a patient exhibiting clinical signs consistent with 6-7% dehydration, which combination of physical examination findings would be MOST indicative of this dehydration level?
A client reports that their cat, recently started on mirtazapine transdermal ointment for appetite stimulation, is exhibiting increased vocalization and agitation. What is the MOST appropriate initial recommendation to manage these adverse effects?
A client reports that their cat, recently started on mirtazapine transdermal ointment for appetite stimulation, is exhibiting increased vocalization and agitation. What is the MOST appropriate initial recommendation to manage these adverse effects?
Flashcards
Why fluids are crucial for GI patients?
Why fluids are crucial for GI patients?
Fluids are often the most important therapy for GI patients, providing rehydration, electrolyte balance, and maintenance.
Common replacement fluids
Common replacement fluids
LRS, 0.9% NaCl and Normosol-R are replacement fluids. 0.45% NaCl and Normosol-M are maintenance fluids.
How to calculate replacement fluids?
How to calculate replacement fluids?
Estimate dehydration (5-10%), multiply body weight (kgs) by the % dehydrated/100 to find liters needed for rehydration
Signs of dehydration in animals
Signs of dehydration in animals
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Potassium fluid supplementation
Potassium fluid supplementation
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How to monitor fluid therapy?
How to monitor fluid therapy?
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What triggers the vomiting reflex?
What triggers the vomiting reflex?
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Maropitant's mechanism of action
Maropitant's mechanism of action
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Doses for Maropitant (Cerenia)
Doses for Maropitant (Cerenia)
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How does Metoclopramide prevent vomiting?
How does Metoclopramide prevent vomiting?
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Metoclopramide safety and dosing
Metoclopramide safety and dosing
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How Zofran works in humans
How Zofran works in humans
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H2 Blockers
H2 Blockers
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H2 Blocker, Famotidine
H2 Blocker, Famotidine
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Cimetidine
Cimetidine
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Omeprazole, a PPI
Omeprazole, a PPI
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Sucralfate
Sucralfate
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Sucralfate indications
Sucralfate indications
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How does Misoprostol work?
How does Misoprostol work?
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Misoprostol indications and safety
Misoprostol indications and safety
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Mirtazapine
Mirtazapine
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Capromorelin
Capromorelin
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AHDS: acute hemoragic diarrhea syndrome:
AHDS: acute hemoragic diarrhea syndrome:
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Antibiotics (Metronidazole, Unasyn, Clavamox)
Antibiotics (Metronidazole, Unasyn, Clavamox)
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Study Notes
- Fluids are often the most important therapy GI patients require.
Indications for Fluid Therapy
- Rehydration
- Replacing ongoing losses
- Maintenance
Routes of Administration
- Intravenous
- Subcutaneous
- Oral
Types of Fluids
- Crystalloid therapy is a common fluid type.
- Replacement fluids include LRS, 0.9% NaCl, and Normosol-R; balanced fluids are typically used.
- Maintenance fluids include 0.45% NaCl and Normosol-M.
- Electrolyte information (mEq) is available on fluid bags.
- In practice, only a couple of fluid types are usually needed.
Fluid Dosage
- Maintenance fluid dosage is 60ml/kg/day.
- Sensible losses (urine) account for 40ml/kg/day of maintenance fluid needs.
- Insensible losses (feces, respiratory) account for 20ml/kg/day of maintenance fluid needs.
Replace Dehydration
- Estimate dehydration percentage from 5-10%.
- The Liters of fluid needed to rehydrate equals body weight (kgs) x percent dehydrated/100.
- Rehydration is typically done over 12 hours.
- Some patients require a bolus or faster rehydration, while others need slower rehydration.
Potassium Considerations
- If potassium is high, use fluid without any (0.9% NaCl).
- If potassium is low, add up to 0.5mEq/kg/hour, intravenously.
- Intravenous potassium can be fatal if given as a bolus; always mix well.
- Follow the target mEq KCl per Liter fluids, which are based on serum potassium levels.
- Target is 20 mEq KCl per Liter of fluid for 3.5-4.0 serum potassium levels.
- Target is 30 mEq KCl per Liter of fluid for 3.0-3.5 serum potassium levels.
- Target is 40 mEq KCl per Liter of fluid for 2.5-3.0 serum potassium levels.
- Target is 60 mEq KCl per Liter of fluid for 2.0-2.5 serum potassium levels.
- Target is 80 mEq KCl per Liter of fluid for less than 2.0 serum potassium levels.
Anti-Emetics
- Maropitant (Cerenia), metoclopramide, and ondansetron are examples of commonly used medications.
Maropitant (Cerenia)
- Neurokinin-1 (NK-1) antagonist is used to prevent vomiting at the vomiting center.
- Broad-spectrum anti-emetic
- It Is very effective
- For acute vomiting:
- Administer subcutaneously at 1mg/kg daily for dogs >2 months and cats >4 months old.
- Administer intravenously at 1mg/kg daily slowly for dogs and cats >4 months old.
- Administer orally at 2mg/kg PO daily; this is labeled for dogs >2 months old (not cats).
Maropitant for Motion Sickness
- Administer 8mg/kg PO once daily for up to 2 days for dogs.
- Administer 2 hours prior to the trip on an empty stomach.
- It Is only labeled for dogs >4 months old.
- It Is not labeled for cats.
Maropitant Safety Precautions
- Metabolized by the liver, so exercise caution in patients with liver dysfunction.
- Rarely reported adverse effects include pain on injection, lethargy, diarrhea, and bone marrow suppression in puppies less than 11 weeks.
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