Anti-Ulcer, Anti-Diarrheal, Laxatives, Etc. (Cram)

What are the five categories of anti–ulcer medications?

1. H2 receptor antagonists
2. Antacids
3. H+,K+ ATPase Inhibitors
4. Sucralfate
5. Ruminatorics

Fill in the blank: ______ activates H2 receptors which stimulates secretion of ______ acid. H2 antagonists block the ______ receptors and therefore reduce gastric acid secretion.

Histamine, hydrochloric, histamine

What are the three H2 receptor antagonist drugs?

1. Cimetidine (Tagamet®)
2. Ranitidine (Xantac®)
3. Famotidine (Pepcid ®)

Which H2 receptor antagonistdrug inhibits liver metabolism of other drugs (which can prolong and/or increase their effects)?

Cimetidine

Note: It also has to be given more frequently than ranitidine

Which category of anti–ulcer drugs are relatively non–absorbable salts of aluminum, calcium, or magnesium? They are used to decrease the acid levels in the stomach

Antacids

Note: Veterinary product is magnesium hydroxide (Oxamin®)

What condition in cattle are antacids used to treat?

Grain overload

Antacids comprised of aluminum or calcium have which side effect?

Constipation

Antacids comprised of magnesium have which side effect?

Diarrhea

Why shouldn't you give antacids within 1-2 hours of other oral medication?

They can bind to other drugs and restrict their absorption

Which category of antiulcer drugs are mostly human drugs which block gastric acid secretion and are used to treat gastric pain and ulcers?

H+, K+ ATPase Inhibitors

What is an H+, K+ ATPase Inhibitor that is a human drug used in animals? It is also available as an oral paste for horses

Omeprazole

Which category of antiulcer drugs is a gastric mucosal protectant? It forms a paste–like substance in the stomach which binds to the surface of ulcers which protects the ulcers and allows them to heal

Sucralfate

Note: Like antacids, this will bind to some drugs, and may cause constipation. Administered orally

Which category of antiulcer drugs are products designed to normalize the rumen environment?

Ruminatorics

Example: Peptonic®

What are the three categories of antidiarrheal medications?

1. Narcotics
2. Anticholinergics/antispasmodics
3. Protectants/absorbents

Which category of antidiarrheal drugs increases contractions, decrease secretions, and increase absorption in the intestine?

Narcotics

Which two species should you NOT give antidiarrheal narcotics to?

1. Cats
2. Horses

Note: This is because they may cause CNS stimulation

What are the three antidiarrheal narcotics?

1. Diphenoxylate (Lomotil®)
2. Loperamide (Imodium®)
3. Paregoric

Which category of antidiarrheal drugs may be used to treat diarrhea or colic, but they must be used with caution?

Anticholinergics/antispasmodics

What is the anticholinergic drug used to treat horses with symptoms of colic?

Hyoscine butylbromide (Buscopan®)

Which category of antidiarrheal drugs tend to coat the mucosa in the intestine and protect it from irritation? They may also bind bacteria and toxins to protect against their harmful effects

Protectants/absorbents

Which protectant/absorbent drug has a coating, antibacterial effect, and also acts as an anti–inflammatory?

Bismuth salicylate (Pepto–Bismol®)

Note: The salicylates make this drug unsafe for cats

Which protectant/absorbent drugs are two drugs often combined and are not only protectants but also absorbs water and hardens stool?

1. Kaolin
2. Pectin

Note: Brand name is Kaopectate®

What is an important client communication when dispensing bismuth salicylate?

It can cause black stools

What are the five categories of laxatives?

Remember: I Love Big Soft Stools

1. Irritants

2. Lubricants

3. Bulk–producing agents

4. Saline/hyperosmotic agents

5. Surfactants/stool softeners/anti–bloat agents

Which category of laxative contains magnesium or phosphate ions that attract and hold water in the intestine and thus soften stool?

Saline/hyperosmotic agents

Note: Include lactulose, magnesium hydroxide which is also an antacid, magnesium sulfate (Epsom salts), and sodium phosphate

What kind of enema should never be used in cats? It can cause electrolyte imbalances

Sodium phosphate (fleet enemas)

Which category of laxative drugs are often indigestible plant material (cellulose) that absorbs water and swells which increases the bulk of the intestinal contents, stimulating peristalsis?

Bulk-producing agents

What is a commonly used material used in bulk producing agents? Provide examples.

Psyllium

Examples: Metamucil®, Vetasyl®. Another material is good ol' bran

Which category of laxative is usually indigestible oils or petrolatum that soften the feces and lubricates them?

Lubricants

What condition in cats can lubricants be used to treat?

Hairballs

Which lubricant is used in large animals mostly, but sometimes in small for treatment of impactions, colic, and constipation? It is not digested and is not usually dangerous

Mineral oil

In what situation can mineral oil be deadly?

Because mineral oil is tasteless, if it is given in a drench, and the animal doesn't realize it needs to swallow, it can be aspirated. Prevent this by using a stomach tube!

Which lubricant is a semi–solid which is administered orally and which is insoluble in water? It is usually used in small animals and often mixed with flavourings and other supplements. Provide 2 examples.

Petrolatum

Examples: Laxatone®, and Tonic–lax®

Why aren't vegetable oils used much as a lubricant?

They can be digested, so they have a limited ability to lubricate unless given in large quantities

Which laxative reduces surface tension on the stool and allow water to penetrate stool which makes it softer? They may also increase intestinal secretions

Surfactants/stool softeners/anti-bloat agents

Which kind of bloat can surfactants help treat in cattle? Provide some examples.

Froathy bloat, because they reduce surface tension of the bubbles and break them down. Also for constipation and impaction

Example: Docusate sodium, dioctyl sodium, and sulfosuccinate

Which category of laxatives irritate the gut wall, increasing peristalsis? They are not used often in veterinary medicine

Irritants

What is an irritant drug that is toxic in large amounts?

Castor oil

True or false: Gastrointestinal stimulants will increase the motility of the GIT which helps material move through more quickly

True. This could affect part of or all of the GI tract

Which anti–emetic also increases gastric motility and emptying?

Metoclopramide

Note: Don't use on a forgein body!

Which gastrointestinal stimulant stimulates various parts of the GIT and may be used to treat constipation, gastroesophageal reflux, and GIT stasis?

Cisapride

Which two gastrointestinal stimulants increase gastric emptying and stimulate peristalsis?

1. Neostigmine
2. Ranitidine

True or false: Like in humans, there are enzymes that can treat insufficiencies (think lactase for lactose intolerance people) in dogs and cats. If true, provide 2 examples.

True. Enzymes include pancreatic enzymes (lipase, amylase, and protease) for pancreatic insufficiency

Examples: Pancrease–V® and Viokase®

Prostora®, Fortiflora®, and Florentero® are examples of which type of GIT drug?

Fun fact: Prostora® can also reduce tear staining

Probiotics

Dirlotapide (Slentrol®) is an oral drug. What does it do? (Hint: very unique!)

Causes weight loss in dogs by interfering with lipid absorption