Drugs acting on digestive system

Gut-Brain Axis stimulates the release of hormones acting on the whole GIT to get appetite from the brain

_________ stimulates the release of hormones acting on the whole GIT to get _______ from the brain

Orexigenic Hormones

Produce by the hypothalamus to increase appetite

Anorexigenic Hormones

Produce by the hypothalamus to decrease appetite (anorexia)

Lateral Hypothalamus

○ Hunger Center - Decreased food in the stomach leads to increased hunger

Lateral Hypothalamus

○ _______ Center

Hunger Center - Decreased food in the stomach leads to increased hunger

______ Center - ______ food in the stomach leads to _______ hunger

Ventromedial Hypothalamus

○ Satiety Center

Ventromedial Hypothalamus

○ ______ Center

Satiety Center - Just the right amount of food in the stomach but still craves food is due to this center which increases unsatisfied feeling; cells signals lack of energy, carbohydrate, protein, or fat, vitamin, or mineral in the body

______ Center - Just the right amount of food in the stomach but still craves food is due to this center which ________ _______ feeling; cells signals lack of energy, carbohydrate, protein, or fat, vitamin, or mineral in the body

1. Drugs Affecting Appetite

   • Appetite Stimulant

   • Appetite Suppressant

2. Drugs Affecting the Mouth, Pharynx, and Esophagus

   • Sialogogues

   • Anti-Sialogogues

   • Alimentary Demulcent

   • Buccopharyngeal Antiseptic

3. Drugs Affecting the Gastric Function (Stomach)

• Emetic

• Anti-Emetic

• Stomachics/Prokinetics

• Anti-Stomachics/Gastric Sedatives

• Antacid

• Carminatives

• Antizymotic Drug/ Anti-Foaming Agents

4. Drugs Affecting the Intestinal Function

• Laxative and Purgative

• Enema/Enemata

• Spasmolytic (Antispasmodic)

• GIT Protectant and Adsorbent

5. Drugs Affecting the Accessory Glands

   • Digestants

6. Drugs Affecting the Liver

   • Cholagogue

   • Choleretics

   • Liver Protectants

topic outline

1. Appetite stimulant

2. appetite suppressant

Drugs Affecting Appetite

Appetite Stimulant fucntion

• Given to animals that have inappetence.

• Provides small quantities of food

• Stimulates the hunger center

Appetite Stimulant fucntion

• Given to animals that have ______.

• Provides _____ quantities of ____

• Stimulates the _____ center

1. Vitamin B Complex

2. Glucocorticoids

3. Anabolic steroids

4. Benzodiazepines

5. Cyproheptadine

6. Minerals (Zinc)

   
   

Examples of appetite stimulant

VGABCM

Appetite stimulant

Vitamin B Complex - Anti-stress drug (e.g. overcrowding, temperature changes)

Appetite stimulant

Vitamin B Complex - Anti-____ drug (e.g. overcrowding, temperature changes)

Appetite stimulant

Glucocorticoids - Steroids coming from the adrenal gland to stimulate metabolism

• Cortisol and Cortisone

Appetite stimulant

Glucocorticoids - Steroids coming from the ____ gland to stimulate ______

• ___ and ____

Appetite stimulant

Anabolic steroids

• Testosterone’s primary function is to make male masculinizing (sperm production)

• Testosterone’s secondary function is to make nitrogen return in the body/retained for muscle buildup (protein)

• It is derived from testosterone but devoid of the primary function

• Nandrolone and Boldenone

Appetite stimulant

Anabolic steroids

• Testosterone’s primary function is to make male masculinizing (sperm production)

• Testosterone’s secondary function is to make nitrogen return in the body/retained for muscle buildup (protein)

• It is derived from ______ but devoid of the _____ function

• ______ and ______

Appetite stimulant

Benzodiazepines

• Diazepam (common) - an anti-anxiety drug

Appetite stimulant

Benzodiazepines

• ______ (common) - an anti-_____ drug

Appetite stimulant

Cyproheptadine

• Not commonly used since it stimulates the satiety center, which has addictive properties

Appetite stimulant

Cyproheptadine

• Not commonly used since it stimulates the _____ center, which has ______ properties

Appetite stimulant

Minerals (Zinc)

• Promotes taste acuity – to acquire the taste

Appetite stimulant

Minerals (Zinc)

• Promotes _____ ______ – to acquire the taste

1. Providing small quantities of food

2. Warm food > cold food

3. Wet food > dry food

Appetite stimulant

• Proper management

Given to animals that have inappetence; Stimulates the hunger center

1. Vitamin B Complex

2. Glucocorticoids

3. Anabolic steroids

4. Benzodiazepines

5. Cyproheptadine

6. Minerals (Zinc)

Appetite Stimulant

• give definition and examples

Appetite Suppressant

• Acts on the satiety center – has addictive properties (CNS function)

• seldom used

Appetite Suppressant

• Acts on the ______ center – has ______ properties (CNS function)

• _____ used

Appetite Suppressant

Too much appetite may cause obesity

• Higher risk of inability of anesthetics to work

• Reproductive failure

• Cardiovascular diseases

• Liver diseases

Appetite Suppressant

Too much appetite may cause ______

• Higher risk of inability of anesthetics to work

• Reproductive failure

• Cardiovascular diseases

• Liver diseases

because owners can control their pet’s diet

Reason why appetite suppressant have no particular effect or use in veterinary medicine

1. Amphetamine (metamphetamine)

2. Chlorphentermine

3. Phenmetrazine

   
   

Appetite Suppressant example

di ako kakain no, diet ako, ACo Pa?

1. Sialogogues

2. Anti-Sialogogues

3. Alimentary Demulcent

4. Buccopharyngeal Antiseptic

Drugs Affecting the Mouth, Pharynx, and Esophagus (Mechanical)

intro:

• Salivary glands – produce saliva

• Saliva produces enzymes such as ptyalin or salivary amylase; also contains natural anti-bacterial action

intro:

• _______ _____ – produce saliva

• Saliva produces enzymes such as _____ or salivary ______; also contains natural anti-bacterial action

• Increases the volume and fluidity of the saliva

• Contains salivary amylase, which helps break down carbohydrates

Sialogogues MOA

Sialogogues USES

• Treatment of hypoptyalism - Decreased salivary production

• Treatment of xerostomia - Dryness of the oral cavity

• Added in Tonic drink preparation

Sialogogues USES

• Treatment of ______ - Decreased salivary production

• Treatment of ______ - Dryness of the oral cavity

• Added in T_______ preparation (sting,cobra)

1. Alkaloids

2. cholinergic drugs

Drug examples

Sialogogues - Alkaloids

• Gentian

• Quassia

• Nux vomica (Strictus nux vomica)

Sialogogues - Alkaloids

• _____

• _______

• ____ ______ (Strictus nux vomica)

Sialogogues - Alkaloids

Nux vomica

• 1st alkaloid: Strychnine (CNS stimulant)

• 2nd alkaloid: Nux vomicsa

• ■ Used in fighting cocks to salivate more = when they salivate more, they drink more water (so add vitamins), then they eat more to condition their body

Sialogogues - Alkaloids

Nux vomica

• 1st alkaloid: ______ (CNS stimulant)

• 2nd alkaloid: ____ ______

• ■ Used in fighting cocks to salivate more = when they salivate more, they drink more water (so add vitamins), then they eat more to condition their body

Sialogogues - Alkaloids

• Bitter taste which are incorporate in tonic to produce more saliva

Sialogogues - Alkaloids

• _____ taste which are incorporate in tonic to produce more saliva

Sialogogues - Cholinergic drugs

• Bind with acetylcholine and parasympathetic nerves

• It increases the production of saliva for digestion, add fluid to the food and lubricates in deglutition

Sialogogues - Cholinergic drugs

• Bind with _______ and _____ nerves

• It increases the production of saliva for _____, add fluid to the food and lubricates in ______

• Choline esters

• Cholinomimetic alkaloids

• Cholinesterase inhibitor

Sialogogues - Cholinergic drugs

examples

Sialogogues - Cholinergic drugs

• Choline esters - Carbachol and Bethanechol

• Cholinomimetic alkaloids - Pilocarpine and Arecoline

• Cholinesterase inhibitor - Physostigmine and Neostigmine

Sialogogues - Cholinergic drugs

• Choline esters - ______ and ______

• Cholinomimetic alkaloids - ______ and ______

• Cholinesterase inhibitor - _______ and ______

MOA: Increases the volume and fluidity of the saliva

Tx: hypoptyalism, xerostomia, Added in Tonic drink

1. Alkaloids: gentian, quassia, nux vomica

2. Cholinergic drugs: choline esters, cholinomimetic alkaloids, cholinesterase inhibitor

Sialogogues definitions and example

Anti-Sialogogues

• Decreases the volume, flow and fluidity of the saliva

Anti-Sialogogues

• Decreases the ____, ____ and _____ of the saliva

1. Atropine

2. Glycopyrrolate

Anti-Sialogogues example

Anti-Sialogogues

Atropine and Glycopyrrolate

• Both decrease salivation during the administration of pre-anesthetic medication

Anti-Sialogogues

Atropine and Glycopyrrolate

• Both decrease salivation during the administration of ________ medication

Anti-Sialogogues

• used during surgery

○ Atropine first, then a sedative before anesthesia

○ Avoids choking due to the accumulation of saliva

○ Atropine balances the effects of anesthesia

Anti-Sialogogues

• used during ______

○ _______ first, then a ______ before anesthesia

○ Avoids ______ due to the _______ of saliva

○ Atropine balances the effects of anesthesia

Decreases the volume, flow and fluidity of the saliva

1. Atropine

2. Glycopyrrolate

Anti-Sialogogues

Defintion and examples?

Alimentary Demulcent

• Drugs that coat, lubricate, and mechanically protect the irritated and abraded mucous membrane of the pharynx and esophagus

• Specifically the upper digestive system

• Acts as a suspending agent

Alimentary Demulcent

• Drugs that ___, _____, and mechanically ____ the irritated and abraded _____ membrane of the pharynx and esophagus

• Specifically the _____ digestive system

• Acts as a _______ _____

Alimentary Demulcent

• Most often used as a lubricant for the stomach tube

• Masks the unpleasant taste of drugs

Alimentary Demulcent

• Most often used as a ____________

• Masks the __________

Alimentary Demulcent uses

• Application of stomach tubing

• Actually, not a drug; it is used as an excipient, mixed with drugs to become a suspending agent

Alimentary Demulcent uses

• _______ of stomach tubing

• Actually, _______; it is used as an ______, mixed with drugs to become a suspending agent

Alimentary Demulcent

• Calcium is naturally bitter

• ○ Addition of alimentary demulcent (sugar, sucrose)

Alimentary Demulcent

• ______ is naturally _____

• ○ Addition of alimentary demulcent (sugar, sucrose)

1. Syrup

2. Gums

3. Glycerol

4. Gelatin

5. Egg Albumin - used when ingested pyrotechnic chemical mixtures (during nye meron sa hospital)

6. Starch'

7. Mineral Oil

8. Honey

   
   

Alimentary Demulcent examples

Buccopharyngeal Antiseptic

• Drugs that mechanically cleanse and decrease bacterial growth in the oral

Buccopharyngeal Antiseptic

• Drugs that mechanically _____ and _____ bacterial growth in the ____ _____

Buccopharyngeal Antiseptic uses

• Treatment for periodontitis - Gum disease

• Treatment for stomatitis - Inflammation of the mucous membrane of the mouth

• Treatment for sore throat, gingivitis, and halitosis (bad breath)

Buccopharyngeal Antiseptic uses

• Treatment for ______ - Gum disease

• Treatment for ______ - Inflammation of the mucous membrane of the mouth

• Treatment for sore ____, _____, and ______ (bad breath)

1. Mouthwash

2. Lozenges

Buccopharyngeal Antiseptic example

Buccopharyngeal Antiseptic

• Mouthwash - Hexitidine (Bactidol), Phenol. Povidone iodine. Chlorhexidine

• Lozenges - Dequalinium (Dequadin)

Buccopharyngeal Antiseptic

• Mouthwash - _______ (Bactidol), _____. ________. ________

• Lozenges - _______ (Dequadin)

1. Emetic

2. Anti-Emetic

3. Stomachics/Prokinetics

4. Anti-Stomachic/Gastric Sedatives

5. Antacid

6. Carminatives

7. Antizymotic Drug

Drugs Affecting the Stomach/Gastric Function (Chemical)

Emetic

• Drugs that induce vomiting

• Commonly employed in dogs and cats

• Rarely in pigs and exotic spp., Not in horses and cattle

• Indicated in non-corrosive poisoning and in case there is ingesta (foreign material) in the stomach which is needed to be regurgitated

  
  

Emetic

• Drugs that induce ______

• Commonly employed in _____ and ___

• Rarely in ____ and _____ spp., Not in horses and cattle

• Indicated in ___________and in case there is ______ (foreign material) in the stomach which is needed to be regurgitated

  
  

1. Emergency surgery

2. During anesthesia and recovery

   
   

Emetic uses

1. Peripherally Acting

2. Centrally Acting

   
   

Emetic examples

Emetic

Peripherally Acting

• Acts on the peripheral nerves (Autonomic drugs)

• Warm water saturated with these peripherally acting drugs

Emetic

Peripherally Acting

• Acts on the ________ nerves (Autonomic drugs)

• ________ saturated with these peripherally acting drugs

• NaCl (Sodium chloride)

• Copper sulfate (CuSO4)

• Zinc sulfate (ZnSO4)

• Ipecac (production of toxic emetine)

• Oil from Mustard seed

  
  

Emetic

Peripherally Acting

Examples

Emetic

Centrally Acting

• Drugs acting on the brain

Emetic

Centrally Acting

• Drugs acting on the _____

1. Apomorphine

2. Xylazine

3. Ipecac

   
   

Emetic

Centrally Acting examples

Emetic

Centrally Acting examples

1. Apomorphine - Good for dogs, do not use in cats

2. Xylazine - Less effective in dogs, faster effect in cats

3. Ipecac - Both peripheral and Centrally-acting emetics

   
   

Emetic

Centrally Acting examples

1. Apomorphine - Good for ____, do not use in ____

2. Xylazine - Less effective in ____, faster effect in ____

3. Ipecac - Both ______ and _________ emetics

   
   

Emetic

Centrally Acting examples

• increased dose xylazine - Muscle Relaxant (CNS)

• decreased dose xylazine - Emetics

Emetic

Centrally Acting examples

• increased dose xylazine -

• decreased dose xylazine -

induce vomition; common in dogs and cats; used in emergency surgery and during anesthesia and recovery

1. peripherally acting - NaCl, Copper sulfate, Zinc sulfate, ipecac, oil from mustard seed

2. centrally acting - apomorphine, xylazine, ipecac

Emetic definition and examples

Anti-Emetic

• Drugs that control or stop vomiting

Anti-Emetic

• Drugs that _____ or ____ vomiting

1. Peripherally Acting

2. Locally Acting

3. Centrally Acting

   
   

Anti-Emetic examples

Anti-Emetic

Peripherally Acting

• Reduce vomiting associated with pharyngitis, gastritis, esophagitis, gastric ulcer, and gastroenteritis

Anti-Emetic

Peripherally Acting

• _______ vomiting associated with ______, ______, ______, gastric ____, and _______

1. Glycopyrrolate

2. Scopolamine - Propantheline, Methscopolamine

3. Isopropamide

4. Metoclopramide (most common)

5. Domperidone - Motilium – most common brand

Anti-Emetic

Peripherally Acting example

Gagging Stomach instantly Meet Drug

Anti-Emetic

Locally Acting

• Mucous membrane of the stomach

• Provide protective coating on the inflamed mucosal surface

Anti-Emetic

Locally Acting

• ________ of the stomach

• Provide _________ on the inflamed mucosal surface

1. Treatment for gastritis, Hyperacidity, Irritation

Anti-Emetic

Locally Acting uses

1. Antacids

2. Kaopectate (Kaolin, pectin)

3. Bismuth Subsalicylate

   
   

Anti-Emetic

Locally Acting examples

1. Metoclopramide (Plasil)

2. Meclizine (Bonamine)

3. Dimenhydramine

4. Diphenhydamine (Benadryl-AH)

5. Maropitant (Cerenia)

6. Cyclizine

7. Promethazine

8. Labyrinthine

   
   

Anti-Emetic

Centrally Acting examples

MM DD MC PL

Anti-Emetic

Centrally Acting examples

Metoclopramide (Plasil)

• Sedative (barbiturate)

• A faster way of inhibiting

• Both peripheral-acting and centrally acting anti-emetic drugs

• Advocated for the control of chronic, Persistent vomiting caused by parvoviral infection

Anti-Emetic

Centrally Acting examples

Metoclopramide (Plasil)

• _____ (barbiturate)

• A faster way of ______

• Both ______-acting and ______ acting anti-emetic drugs

• Advocated for the _____ of chronic, _________ caused by parvoviral infection

Anti-Emetic

Centrally Acting examples

Meclizine (Bonamine)

• Affects the chemoreceptor trigger zone/ CRTZ (vomiting center of the brain) from the ear labyrinth

• Teratogenic

• Do not give to pregnant animals

Anti-Emetic

Centrally Acting examples

Meclizine (Bonamine)

• Affects the __________/ CRTZ (vomiting center of the brain) from the ear labyrinth

• _______

• Do not give to ______ animals

Anti-Emetic

Centrally Acting examples

Diphenhydamine (Benadryl-AH)

• Histamine 1 Receptor - Allergic Reaction

• Histamine 2 Receptor - Stomach Acid

Anti-Emetic

Centrally Acting examples

Diphenhydamine (Benadryl-AH)

• Histamine 1 Receptor - ____ Reaction

• Histamine 2 Receptor - _________

Anti-Emetic

Centrally Acting examples

Maropitant (Cerenia)

• Expensive new drug

Anti-Emetic

Centrally Acting examples

Maropitant (Cerenia)

• ______ new drug

Anti-Emetic

Centrally Acting examples

Cyclizine

• Teratogenic

Anti-Emetic

Centrally Acting examples

Cyclizine

• _______

Anti-Emetic

Centrally Acting examples

Labyrinthine (Motion Sickness)

• Anxiolytics

• Diazepam

Anti-Emetic

Centrally Acting examples

Labyrinthine (Motion Sickness)

• ________

• ________

Drugs that control or stop vomiting

1. Peripherally Acting

2. Locally Acting

3. Centrally Acting

Anti emetic definition and examples

Stomachics/Prokinetics

• Promote the functional activity of the stomach by increasing motility and secretion

• Promotes peristalsis for the movement of food into the intestines

• Hydrochloric acid and enzymes are secreted

Stomachics/Prokinetics

• Promote the functional activity of the stomach by increasing _____ and _____

• Promotes ______ for the movement of food into the intestines

• ________ and ________ are secreted

• treatment for indigestion

Stomachics/Prokinetics uses

1. Metoclopramide - prokinetic and antiemetic (reverse peristalsis and peristalsis)

2. Bethanecol

3. Neostigmine

4. Bicarbonate

5. Pentagastrin

6. Betazole

7. Histamine Acid Phosphate

8. Domperidone

9. Cisapride

10. Tegaserod

Stomachics/Prokinetics examples

Anti-Stomachic/Gastric Sedative

• Slows down the motility and secretion of the stomach

• Fast intake of food to the point where digestion is slow or impossible

• Protein digestion does not commence in the stomach and will go straight into the intestine

• Rarely used in animals

Anti-Stomachic/Gastric Sedative

• _____ down the ______ and ______ of the stomach

• Fast intake of food to the point where ______ is ____ or _______

• Protein digestion does not commence in the stomach and will go straight into the ______

• _____ used in animals

mas mabilis kumain > animal will grow > mas mabilis makakatay pang consumption

Anti-Stomachic/Gastric Sedative

• ● Rarely used in animals why?

1. Atropine

2. Glycopyrrolate

3. Cimetidine

4. Ranitidine

Anti-Stomachic/Gastric Sedative examples

Antacid

• Decreases and controls hydrochloric acid

Antacid

• _______ and _______ hydrochloric acid

Antacid uses

• Treatment for hyperacidity

• Treatment for acute and uremic gastritis

• Treatment for gastric/peptic and duodenal ulcer

• Treatment for uremia

• This effect is useful in preventing acetaminophen intoxication

Antacid uses

• Treatment for ______

• Treatment for _____ and _____ gastritis

• Treatment for ________ and _____ ulcer

• Treatment for _____

• This effect is useful in preventing ________ intoxication

1. Alkalinizers

2. Histamine (H2) Blockers

3. Proton Pump Inhibitor

Antacid examples

Antacid examples

Alkalinizers

• Neutralizes the HCl acid (alkaline or base)

• Decrease and control HCl

Antacid examples

Alkalinizers

• ______ the HCl acid (alkaline or base)

• _____ and ______ HCl

1. Sodium Bicarbonate (Kremil-S)

2. Sodium Citrate

3. Calcium Carbonate

4. Aluminum Hydroxide

5. Magnesium Hydroxide

6. Magnesium Carbonate

Antacid examples

Alkalinizers examples

Antacid examples

Alkalinizers examples

• Sodium Bicarbonate: Most frequently employed systemic antacid (parenteral); If give PO causes acid rebound

Antacid examples

Alkalinizers examples

• Sodium Bicarbonate: __________________ systemic antacid (______); If give PO (per orem) causes __________

Antacid examples

Alkalinizers examples

• Calcium Carbonate: Chronic administration causes calciuria with metastatic calcification and urolitheiasis

Antacid examples

Alkalinizers examples

• Calcium Carbonate: ______________ causes ______ with metastatic calcification and urolitheiasis

Antacid examples

Alkalinizers examples

• Aluminum Hydroxide: Impairs the absorption of phosphate which may lead to phosphate depletion and osteomalacia

Antacid examples

Alkalinizers examples

• Aluminum Hydroxide: Impairs the _____________ which may lead to phosphate depletion and _________

AlOH, MgOH, simethicone

Kremil S contain?

Antacid examples

Histamine (H2) Blockers

• When histamine is released, there is an allergic reaction

• Used when neutralizing the hydrochloric acid is not enough as treatment

• Blocks the Histamine 2 receptor to decrease HCl acid production in the stomach.

Antacid examples

Histamine (H2) Blockers

• When histamine is released, there is an ____________

• Used when _________________ is not enough as treatment

• Blocks the Histamine 2 receptor to__________________ in the stomach.

• For an antihistamine: H1 blocker

• For hydrochloric acid: H2 blocker

  
  

Antacid examples

Histamine (H2) Blockers

• Histamine has 2 receptors:

1. Cimetidine

2. Ranitidine

3. Famotidine

4. Nizatidine

   
   

Antacid examples

Histamine (H2) Blockers examples

Antacid examples

Histamine (H2) Blockers examples

• Cimetidine - It is a microsomal inhibitor which impair the metabolism of concurrently administered drugs

Antacid examples

Histamine (H2) Blockers examples

• Cimetidine - It is a microsomal inhibitor which ________________________________________

Antacid examples

Proton Pump Inhibitor

• Presence of blood in feces

• Inhibit the release of hydrogen ion or protons

• The highest form of antacids

• Secretes hydrogen ions into the stomach

Antacid examples

Proton Pump Inhibitor

• Presence of _________

• _____ the release of hydrogen ion or protons

• The ________ of antacids

• __________ ions into the stomach

1. Dexlansoprazole

2. Esomeprazole magnesium

3. Lansoprazole

4. Omeprazole (commonly used)

• Omeprazole magnesium

• Omeprazole and sodium bicarbonate

5. Pantoprazole sodium

6. Rabeprazole sodium

Antacid examples

Proton Pump Inhibitor examples

Carminatives

• Drugs that cause expulsion of gas from the stomach due to indigestion

Carminatives

• Drugs that cause__________________ due to indigestion

Carminatives

• Antiflatulence: Avoids bloating/tympany in animals

• Promote expulsion of gas from the stomach due to fermentation

Carminatives

• ________: Avoids bloating/tympany in animals

• Promote ___________ from the stomach due to fermentation

Carminatives

• Carminatives are given in the presence of frothy bloat (Pops the bubble in frothy bloat)

Carminatives

• Carminatives are given in the _____________ (____ the bubble in frothy bloat)