Gastrointestinal Therapeutics - Part 1

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Questions and Answers

What is a major contraindication for inducing vomiting after poisoning?

  • The poison contains antioxidants
  • The patient exhibits severe CNS depression (correct)
  • The poison was ingested over 2-3 hours ago
  • The patient is conscious and alert

What is the primary use of emetics?

  • To enhance appetite in anorexic patients
  • To induce vomiting following poisoning (correct)
  • To treat motion sickness in cats
  • To prevent bradycardia in dogs

Which drug stimulates the emetic center in cats?

  • Ropinirole
  • Apomorphine
  • Xylazine (correct)
  • Hydrogen peroxide

Which of the following is NOT a target for drug therapy in treating gastric ulceration?

<p>Serotonin receptors (C)</p> Signup and view all the answers

Which emetic is administered orally to stimulate vomiting?

<p>Hydrogen peroxide (A)</p> Signup and view all the answers

What is the primary action of proton pump inhibitors like omeprazole?

<p>Suppress stomach acid secretion (A)</p> Signup and view all the answers

What role do histamine H2 receptor antagonists serve in drug therapy?

<p>They decrease stomach acid production. (A)</p> Signup and view all the answers

Which drug is specifically used for ulcers caused by NSAIDs?

<p>Misoprostol (D)</p> Signup and view all the answers

What is a common disadvantage of antacids such as aluminium hydroxide and magnesium hydroxide?

<p>They require frequent administration. (D)</p> Signup and view all the answers

What is the mechanism of action of sucralfate in the treatment of ulcers?

<p>Binds to proteins in ulcers to form a protective paste (A)</p> Signup and view all the answers

What is the primary function of emesis in animals?

<p>To protect from ingested toxins (B)</p> Signup and view all the answers

Which receptor is targeted by antiemetics specifically in dogs?

<p>Dopamine receptors (D2) (D)</p> Signup and view all the answers

Which of the following antiemetics is known to be a serotonin antagonist?

<p>Ondansetron (A)</p> Signup and view all the answers

The action duration of maropitant as an NK1 receptor antagonist is approximately how long?

<p>24 hours (D)</p> Signup and view all the answers

Which receptor is specifically associated with sympathomimetic effects in cats?

<p>α2 adrenergic receptors (A)</p> Signup and view all the answers

What should be excluded before administering metoclopramide?

<p>GI obstruction (B)</p> Signup and view all the answers

Which of the following receptors is NOT mentioned as a target for emetics/antiemetics in dogs and cats?

<p>Histamine-2 receptors (H2) (A)</p> Signup and view all the answers

Which of the following correctly pairs an animal with its primary emetic target?

<p>Dogs - Dopamine receptors (D2) (D)</p> Signup and view all the answers

What is the primary mechanism by which anti-diarrhoeals reduce diarrhea?

<p>Enhancing water reabsorption (A)</p> Signup and view all the answers

Which of the following drugs is an opioid agonist used as an anti-diarrhoeal?

<p>Loperamide (A)</p> Signup and view all the answers

What receptor does maropitant primarily antagonize in veterinary medicine?

<p>NK1 receptor (A)</p> Signup and view all the answers

What is the role of prokinetic medications in gastrointestinal treatment?

<p>Increase gastrointestinal motility (D)</p> Signup and view all the answers

Which of the following agents is used as an emetic in cats?

<p>Xylazine (A)</p> Signup and view all the answers

Which drug functions as a motilin receptor agonist?

<p>Erythromycin (B)</p> Signup and view all the answers

What distinguishes the action of metoclopramide as an antiemetic?

<p>It is a D2 receptor antagonist (C)</p> Signup and view all the answers

Which drug has an unknown mechanism of action as a prokinetic?

<p>Lidocaine (D)</p> Signup and view all the answers

What is the primary function of emetics?

<p>To induce vomiting as a protective response (B)</p> Signup and view all the answers

Which type of receptor is primarily targeted by antiemetics in cats?

<p>Sympathomimetic (α2) (B)</p> Signup and view all the answers

Which of the following is not a class of drugs used in gastrointestinal therapeutics?

<p>Bronchodilators (B)</p> Signup and view all the answers

What is the role of acid blockers in gastrointestinal therapeutics?

<p>To reduce stomach acid production (A)</p> Signup and view all the answers

What type of drug is used to decrease the frequency of bowel movements?

<p>Antidiarrhoeals (B)</p> Signup and view all the answers

In dogs, which receptor is targeted by antiemetic drugs?

<p>Dopamine receptors (D2) (C)</p> Signup and view all the answers

What is a common use for laxatives in veterinary medicine?

<p>To alleviate constipation (D)</p> Signup and view all the answers

Which of these drugs would be classified as a gastro-protectant?

<p>Acid blockers (D)</p> Signup and view all the answers

What is the primary mechanism of action for metoclopramide in the gastrointestinal tract?

<p>Increases acetylcholine release (C)</p> Signup and view all the answers

Which of the following laxatives promotes peristalsis by increasing stool bulk?

<p>Bulk forming laxatives (B)</p> Signup and view all the answers

Which prokinetic agent has been withdrawn from human medicine due to safety concerns?

<p>Cisapride (A)</p> Signup and view all the answers

What is the role of lubrication in the context of laxatives?

<p>Prevents water loss from the stool (D)</p> Signup and view all the answers

Which substance is known to have a dual effect as both an antibiotic and a motilin receptor agonist?

<p>Erythromycin (B)</p> Signup and view all the answers

What effect do prokinetics generally have on gastrointestinal motility?

<p>They increase motility (C)</p> Signup and view all the answers

Lactulose acts primarily through which mechanism to relieve constipation?

<p>Fermenting in the large intestine (C)</p> Signup and view all the answers

What is the secondary action of ranitidine that contributes to its prokinetic effect?

<p>Inhibition of acetylcholinesterase (D)</p> Signup and view all the answers

Flashcards

Vomiting (Emesis)

The reflex action of expelling stomach contents. It's a defense mechanism against toxins, but also associated with various medical conditions.

Emetics

Medications that induce vomiting.

Antiemetics

Medications that prevent or stop vomiting.

Neurokinin-1 receptors (NK1)

Receptors in the brain that play a role in vomiting, particularly in cats and dogs.

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Serotonin receptors (5-HT)

Receptors in the brain that play a role in vomiting, particularly in cats and dogs.

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Histamine-1 receptors (H1)

Receptors in the brain that play a role in vomiting, particularly in cats and dogs.

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Sympathomimetic

A type of medication that affects the nervous system, particularly in cats, and can be used to treat vomiting.

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Dopamine receptors (D2)

Receptors in the brain that play a role in vomiting, particularly in dogs.

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Apomorphine

This medication is a dopamine (D2) agonist, meaning it stimulates the chemoreceptor trigger zone (CTZ) in dogs. It's used as an emetic to induce vomiting.

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Xylazine

This medication is an α2-adrenergic agonist, meaning it stimulates the emetic centre in cats. It's used as an emetic to induce vomiting.

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Xylazine

This medication is an α2-adrenergic agonist, meaning it stimulates the emetic centre in cats. It's used as an emetic to induce vomiting. It is not used in dogs because it can cause cardiac problems.

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H2 Receptor Antagonists

Medications that reduce stomach acid production by blocking histamine H2 receptors.

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Proton Pump Inhibitors (PPIs)

Drugs that suppress stomach acid secretion by inhibiting the proton pump, a key enzyme in acid production.

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Sucralfate

A protective barrier formed in the stomach by reacting with stomach acid. Helps soothe and heal ulcers.

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Antacids

Medications used to neutralize excess stomach acid. Examples include aluminum hydroxide, magnesium hydroxide, and calcium carbonate.

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Misoprostol

A synthetic analogue of prostaglandin E1. Helps protect the stomach lining and is used for ulcers caused by NSAIDs.

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Sympathomimetic (α2 )

A type of medication that affects the nervous system, commonly used to treat vomiting in cats. It works by stimulating the sympathetic nervous system.

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Anti-diarrhoeals

Drugs that reduce bowel movement frequency by slowing down intestinal contractions, increasing water reabsorption, or protecting the intestinal lining.

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Opioid agonists

A class of anti-diarrheal drugs that work by mimicking the effects of opioids, reducing intestinal contractions and increasing water absorption.

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Hyoscine

A medication that reduces muscle spasms in the gut, often used to treat equine colic (severe abdominal pain in horses).

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Prokinetics

A class of medications that enhance the movement of food through the digestive tract, often used to treat slow digestion or constipation.

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Metoclopramide

A medication that stimulates the release of acetylcholine, a neurotransmitter that increases gut muscle contractions. It can also increase the release of gastric emptying.

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Erythromycin

A medication that stimulates motilin receptors, leading to increased gut motility.

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Acid-reducing medications

Drugs that act by inhibiting the release of stomach acid, effectively reducing the amount of acid produced by the stomach.

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Enteric Nervous System (ENS)

The enteric nervous system (ENS) governs gut function independently of the central nervous system. It controls motility, secretions and sensing of the environment.

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Acetylcholine (ACh)

Acetylcholine (ACh) is a neurotransmitter that increases gut motility, relaxes sphincters, boosts blood flow, and stimulates secretions.

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Norepinephrine (NE)

Norepinephrine (NE) is a neurotransmitter that slows down gut activity, constricts sphincters, reduces blood flow, and inhibits secretions.

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Cisapride

Cisapride was a highly effective prokinetic, but it was withdrawn from human medicine due to risks of heart rhythm problems.

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Laxatives

Laxatives promote bowel movements or increase stool fluid content. They are used for constipation or bowel preparation for procedures.

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Bulk-forming laxatives

Bulk-forming laxatives, mainly plant fibers like bran, absorb water in the gut and stimulate peristalsis, helping with constipation.

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Study Notes

Gastrointestinal Therapeutics - Part 1

  • The lecture covers gastrointestinal therapeutics, specifically focusing on the pharmacological principles of treating various gastrointestinal conditions in domestic animals.
  • The learning outcomes include: identifying drugs affecting gastrointestinal function, identifying drugs for treating gastrointestinal disease, examples for treating common diseases in domestic animals, and understanding the pharmacology of antiparasitic treatments.
  • The equine digestive system diagram illustrates the esophagus, cecum, large colon, stomach, small intestines, small colon, and rectum.

Learning Outcomes

  • State functional problems caused by gastrointestinal diseases.
  • Identify drugs to modify gastrointestinal function.
  • Identify drugs to treat gastrointestinal disease.
  • Illustrate possible uses of drugs to treat common domestic animal diseases.
  • Explain the pharmacological principles of antiparasitic treatments.

Emetics and Anti-emetics

  • Vomiting (emesis) is a reflex pathway protecting animals from ingested toxins, but also linked to various medical conditions.
  • The main targets for emetics/antiemetics include neurokinin-1 receptors (NK₁), serotonin receptors (5-HT), histamine-1 receptors (H₁), sympathomimetic (α₂), and dopamine receptors (D₂).
  • Species differences are significant in selecting treatment agents.
  • Metoclopramide, maropitant, and ondansetron are key veterinary antiemetics.
  • Apomorphine and xylazine are used as emetics in dogs and cats.

Acid Blockers and Mucosal-Protectants

  • Acid blockade is essential for treating esophageal and gastric ulceration and gastritis.
  • Main therapeutic targets are histamine H₂ receptors and H+K+-ATPase proton pumps.
  • Mucosal protectants enhance GI barrier function by creating a barrier, neutralizing acid, and boosting prostaglandin E production.
  • Antacids, sucralfate, and misoprostol are frequently used.

Prokinetics and Anti-diarrhoeals

  • Prokinetics increase gastrointestinal motility.
  • Anti-diarrhoeals decrease motility.
  • Metoclopramide, cisapride, ranitidine, erythromycin, and lidocaine are significant prokinetics.
  • Loperamide and diphenoxylate are opioid antagonists reducing peristalsis.
  • Hyoscine acts as an antispasmodic for equine colic.
  • Kaolin-pectin formulations offer demulcent and adsorbent properties.

Laxatives

  • Laxatives promote elimination or increase stool fluid content.
  • They are used for constipation or before radiographic/surgical procedures.
  •  Bulk-forming laxatives (e.g., bran) are hydrophilic plant fibers stimulating peristalsis.
  • Lubricant laxatives (e.g., liquid paraffin) coat stool, improving passage.
  • Lactulose ferments in the large intestine to create an osmotic effect.

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