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Anticholinergics
Atropine and glycopyrrolate
•↓ salivary secretions
•↓ peristalsis
•Paralytic ileus
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Antidiarrheals-anticholinergics
- Atropine --should not be used
- Aminopentamide
- Isopropamide
- Propantheline
- Methscopolamine
SE=dry mouth, constipation, increased HR
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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
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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
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Osmotic Cathartics
- Lactulose
- +(also decreases NH4, liver dz)
- Sodium Phosphate enemas
- - (not in cats)
- MgSO4
- Magnesium Hydroxide (Milk of Magnesia)
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Irritant cathartics
- Phenophthalein
- *aka Ex Lax
- Castor oil
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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
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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
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Vomiting control
CRTZ=Chemoreceptor trigger zone. Outside the blood brain barrier.
Irritants cause dopamine release and stimulation of the vomiting center
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Dopamine inhibitors
- Acepromazine
- Chloropromazine
- Prochloropromazine
-SE: hypotention, sedation
-
Antihistamines
+Act to decrease input to the CRTZ from the vestibular apparatus
- Dimenhydrinate - Dramamine
- Diphenhydramine - Benadryl
- Meclizine - Bonine
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Anticholinergics
- Aminopentamide
- +Blocks Ack peripherally, decreasing input into the CRTZ.
- + May also act to directly block CRTZ
- Atropine - not a good choise
-
Procainmide derivatives
- Metoclopramide
- +Reglan
- +Widely used
- +Blocks the CRTZ
- +Speeds gastric emptying
- +Increases cardiac sphincter tone
-
Serotonin inhibitors
- Serotonin antagonists in the vagal system and at the level of the CRTZ
- $$$
- Not widely used
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Emetics
- Apomorphine
- +Causes stimulation of dopamine receptors in the CRTZ. Preferred IV or conjunctivally
- Ipecac syrup
- +Irritates the stomach lining causing vomiting
-
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
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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
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Mucosal protectants
- Pepsin inhibitors
- Sucralfate (Carafate)
- Only works in an acidic stomach
- Do not give with H2 antagonists
-
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
-
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
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Pro motility drugs
- Neostigmine
- •Parasympathetic agonist
- •Stimulates Ach receptors
- •Rumen atony
- •Myasthenia gravis in dogs
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Pancreatic exocrine insufficiency
- Digestive enzymes
- •Viokase
- •Pancrezyme
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