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GIT Drugs - Coggle Diagram
GIT Drugs
Anti-emetics
Anti-histamines
Diphenhydramine (benadryl)
- good for motion sickness
- can cause paradoxical excitement in cats
- can cause sedation
Meclizine
- good for motion sickness
- can cause paradoxical excitement in cats
- can cause sedation
Dopamine antagonists
Phenothiazines (Prochlorperazine or Acepromazine)
- block many neurotransmitters involve in vomiting, but main job is to block dopamine receptors in the CTZ
- adverse effects = hypotension, sedation and can lower seizure threshold in epileptics
Metoclopramide
- anti emetic effects AND promotes GI motility -> contraindicated in GI obstruction or perforation
- useful for emesis induced by GI disease and chemotherapy
- can cause CNS stimulation
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Neurokinin-1 antagonists
Maropitant (Cerenia)
- blocks effects of substance P
- can use in dogs and cats
- has some analgesia effects
Glucocorticoids
Dexamethasone
- not indicated for treatment of vomiting but can help to reduce vomiting by inhibiting prostaglandin production (can be added to other antiemetics for refractory vomiting)
Laxatives and Cathartics
- laxatives produce soft stool and cathartics produce watery stool
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Hyperosmotics = salts and sugars
- mannitol, sorbitol and lactulose = the sugars
- magnesium sulfate and sodium sulfate = the salts
Anti-diarrheals
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Anticholinergics
- opposite of SLUDGE!
- help to facilitate rectal exams (calms the rectal muscles)
Atropine, hyoscine butylbromide
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Anti-ulcer
H2 (Histamine) Blockers
- histamine has the greatest effect on ulcers in the stomach
- histamine binds to H2 receptors on parietal cells to increase cAMP and proton pump activity
Cimetidine
- least potent and rarely used now
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Famotidine
- most potent
- less rebound hypersecretion compared to others
- does not inhibit p450 enzymes
Proton Pump Inhibitors
- most potent gastric antisecretory drugs available
Omeprazole
- irreversibly binds the parietal cell (sodium potassium proton pump, which is the final step in gastric acid secretion)
- it is a PROdrug
Mucosal protectants
Sucralfate
- binds to ulcerated area
- requires acidic environment for activation
- good for ulcer healing but not for ulcer prevention
Antacids
- work by neutralizing pH
- formulated as hydroxide bases of aluminum, magnesium and calcium
Misoprostol
- PGE analogue
- increases mucous production, bicarbonate, re-epithelization of mucosa and increases local blood flow
- reduces HCL secretion from parietal cells
- used for the prevention of gastric ulcers
- contraindicated during pregnancy bc it can cause uterine contractions
Prokinetics
- dopamine is inhibitory NT
- Serotonin is excitatory NT
Dopamine Antagonists
Metoclopramide
- blocks inhibitor (dopamine) receptors and stimulates excitatory (serotonin) receptors) on enteric cholinergic nerves = double whammy to promote motility
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Emetics
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Centrally acting
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Alpha 2 Agonists (Xylazine, dexmedetomidine)