Gastric system Drugs

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Author:
Anonymous
ID:
45502
Filename:
Gastric system Drugs
Updated:
2010-10-27 17:09:25
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Gastrointestinal drugs
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Description:
Drugs affecting the GI system
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  1. Anticholinergics
    Atropine and glycopyrrolate

    •↓ salivary secretions

    •↓ peristalsis

    •Paralytic ileus
  2. Antidiarrheals-anticholinergics
    • Atropine --should not be used
    • Aminopentamide
    • Isopropamide
    • Propantheline
    • Methscopolamine

    SE=dry mouth, constipation, increased HR
  3. Protectants and Absorbants
    • Bismuth subsalicylate
    • •Coats intestine, mild anti-inflammatory properties
    • •Aspirin like – do not use in cats
    • •Dark stools
    • Kaolin- pectin
    • •Coats intestine and is an adsorbent
    • Activated Charcoal
    • Great adsorbent – adsorbs toxins
    • Physiologically inert
  4. Opiate Antidiarrheals
    • Diphenoxolate
    • Ioperamide
    • +Increased segmental contractions
    • +Lomotil is controlled, atropine added
    • +Very effective, relatively safe
    • +Dosage is less in cats
    • -Do not use in horses or cattle
  5. Osmotic Cathartics
    • Lactulose
    • +(also decreases NH4, liver dz)
    • Sodium Phosphate enemas
    • - (not in cats)
    • MgSO4
    • Magnesium Hydroxide (Milk of Magnesia)
  6. Irritant cathartics
    • Phenophthalein
    • *aka Ex Lax
    • Castor oil
  7. Bulk forming laxatives
    • +Dry water into the intestinal tract in a more natural manner
    • Psyllium seed extract
    • +forms a gel when mixed with water, used to pass
    • out sand that horses eat on accident
    • Polycarbophil
    • Bran
  8. Emollients
    • Surfactants - reduce surface tension, water soaks into the fecal material
    • ie, Ducosate derivatives (DSS)
    • gel caps in small animal
    • solution for horses and cattle
    • Mineral oil
    • 1 gallon for horses with colic
  9. Vomiting control
    CRTZ=Chemoreceptor trigger zone. Outside the blood brain barrier.

    Irritants cause dopamine release and stimulation of the vomiting center
  10. Dopamine inhibitors
    • Acepromazine
    • Chloropromazine
    • Prochloropromazine

    -SE: hypotention, sedation
  11. Antihistamines
    +Act to decrease input to the CRTZ from the vestibular apparatus

    • Dimenhydrinate - Dramamine
    • Diphenhydramine - Benadryl
    • Meclizine - Bonine
  12. Anticholinergics
    • Aminopentamide
    • +Blocks Ack peripherally, decreasing input into the CRTZ.
    • + May also act to directly block CRTZ
    • Atropine - not a good choise
  13. Procainmide derivatives
    • Metoclopramide
    • +Reglan
    • +Widely used
    • +Blocks the CRTZ
    • +Speeds gastric emptying
    • +Increases cardiac sphincter tone
  14. Serotonin inhibitors
    • Serotonin antagonists in the vagal system and at the level of the CRTZ
    • $$$
    • Not widely used
  15. Emetics
    • Apomorphine
    • +Causes stimulation of dopamine receptors in the CRTZ. Preferred IV or conjunctivally
    • Ipecac syrup
    • +Irritates the stomach lining causing vomiting
  16. Antacids
    • CaCO3
    • MgOH
    • AlOH
    • +Act to neutralize the H+ ions in the stomach
    • -Do nothing to prevent acid production
    • GERD=Gastro-enteric reflux disease
    • Sialorrhea= excessive salivation
  17. Anti-ulcer drugs
    • +Block H2 receptors to prevent acid production
    • +They do not neutralize and acid already
    • produced

    • Cimetidine
    • Famotidine
    • Ranitidine – also stimulates gastric emptying
    • slightly
  18. Mucosal protectants
    • Pepsin inhibitors
    • Sucralfate (Carafate)
    • Only works in an acidic stomach
    • Do not give with H2 antagonists
  19. Prostaglandin analogs
    • PG is necessary for intestinal epithelial regeneration
    • NSAIDS block normal epithelial healing
    • Misoprostol (Cytotec) used to counter ulcer causing potential of NSAIDS
    • *Can also stop itching
  20. Proton pump inhibitors
    • lBlock the pumping action of the H+ pump
    • lining the gastric mucosa

    •Omeprazole (Prilosec)

    •Lansoprazole


    •Take 1 – 4 days for full effect
  21. Pro motility drugs
    • Neostigmine
    • •Parasympathetic agonist
    • •Stimulates Ach receptors
    • •Rumen atony
    • •Myasthenia gravis in dogs
  22. Pancreatic exocrine insufficiency
    • Digestive enzymes
    • •Viokase
    • •Pancrezyme
  23. Feline megacolon

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