Transcript CH4 GI pt3

LAXATIVES AND CATHARTICS
Lactulose, Milk of Magnesia
Metamucil, Bran, Docusate sodium
Mineral oil, Petrolatum, Glycerin
• Increase fluid content of feces, making them softer and
easier to pass.
• -Used for animals with constipation, trichobezoars, colon
evacuation, pelvic fractures, and surgeries of the rear-end
• -Laxatives are used when the goal is to soften the stool,
Cathartics are used when evacuation of the bowel is the
goal.
Emollient laxatives- mineral oil, cod
liver oil, petrolatum (Laxatone)
• Oils that soften the fecal mass,
making it easier to move through the
body.
• Mineral oil is often used in horses with
impaction and/or colic. Must ensure that
nasogastric tube is not in the lungs!
• Petrolatum is often used in cats with
hairballs.
Emollient laxativesglycerin, docusate sodium succinate
(________)
• Glycerin is in suppository form; stools are softened
to pass through narrow pelvic canal
• DSS is often in enema form; allows water to
penetrate dry, hard stool.
Bulking laxatives- Metamucil, bran
• Psyllium preparations that are indigestible;
cause stool to swell with water to increase
the size of intestinal contents and stimulate
peristalsis.
• Flatulence increases
Cathartics- Milk of
Magnesia, lactulose
• Milk of magnesia is an osmotic cathartic that contain
magnesium or phosphate salts that are poorly absorbed.
Pulls water into the bowel lumen via osmosis.
– CCK is released which increases peristalsis.
– Can cause electrolyte imbalances if treatment is
prolonged or large doses are given.
• Lactulose is an osmotic sugar cathartic that treats
constipation and reduces ammonia absorption, which is
helpful in patients with hepatic encephalopathy.
ANTIULCER MEDICATIONS
Cimetidine , Ranitidine, Famotidine, Sucralfate
• Signs of ulcers: anorexia,
hematemesis, pain, melena
• NOTE: Many of these products
effect the pH of the stomach. Be
sure to read the package insert as
they will instruct not to give other
oral meds for 2 hours after
administration.
Omeprazole, Lansoprazole
Misoprostol
TUMS, Rolaids, Maalox, Mylanta, Amphojel
• Causes of ulcers: gastric
hyperacidity, bile reflux from
duodenum to stomach,
accumulation of toxins in the blood
(renal failure), stress, inhibition of
Prostaglandin Type E, drugs
(steroids, NSAIDS)
Nonsystemic antacids- TUMS, Rolaids,
Maalox, Mylanta, Amphojel
• Fast-acting, relatively nonabsorbable salts of aluminum,
calcium, or magnesium taken PO to neutralize acid
molecules by converting HCl to weaker acids.
• Can affect other drugs by adsorbing to them, increasing
stomach pH, and increasing urinary pH
• Calcium and aluminum products can cause constipation,
magnesium products can cause diarrhea. Many products
contain both to counteract these effects.
Systemic Antacids
H2 Blockers- cimetidine (_________),
ranitidine (__________), and famotidine
(__________)
• H2 receptors are one of three
types of receptors on parietal cells.
When receptor is stimulated by
histamine, more hydrochloric acid is
released from parietal cells.
• H2 blockers block the receptors
and reduce the production of HCl.
H2 Blockers cont’d
• Cimetidine is the least potent- must be given up to 4
times a day to see results. Ranitidine is given less
frequently- twice daily. Famotidine is only given once
daily.
• Cimetidine inhibits some of the liver enzymes needed to
metabolize other drugs. If given with other meds
(especially cardiac drugs), cimetidine may cause their
concentrations in the blood to rise to toxic levels.
• All come in oral (OTC and Rx) and
injectable forms
Proton Pump Inhibitorsomeprazole (__________,
__________, ___________),
lansoprazole (__________)
•Bind to the luminal surface of parietal cells and inhibits the
pump that moves hydrogen ions out of the cell.
•end in the suffix –azole
•Omeprazole – used in horses older than 4 weeks. Primarily
for ulcers due to too little hay intake, reoccurring ulcers, or
a sensitive growing GI tract. Compounding must be done
carefully.
Gastromucosal protectantsucralfate (_________)
• Disaccharide that forms a paste in the stomach and
binds to the surface of ulcers to promote healing
(gastric Band-aid).
• Increases mucus production and blood flow to ulcer site.
• Avoid giving with drugs that alkalinize the stomach because
it works better in the normal pH of the stomach (2-3)
– Nonabsorbable
– Only side effect is constipation
Prostaglandin Analoguemisoprostol (_________)
• Increases mucus production, decreases acid
production.
• Used to treat ulcers due to large doses of NSAIDS.
• $$$
• Can cause colic in horses
• May cause abortion in both patient and administrator
MISCELLANEOUS GI DRUGS
RUMINATORIC- neostigmine
• Prokinetics that stimulate a flaccid rumen.
• Stimulate the parasympathetic nervous
system to increase GI motility.
• Will cause other signs of PNS stimulation
ANTIBLOAT- DSS, poloxalene
• Reduce gas buildup or facilitate the removal of
gas from the rumen
• Rumen is at risk for frothy bloat
– Gas distention in rumen from grazing certain
plants (legumes usually) that mixes with
fluid to cause a froth
– This froth can kill them by blocking the
ability to burp
• These agents cause small gas bubbles to coalesce
into a belchable gas pocket.
ANTIBIOTIC- metronidazole
(_________)
• Effective against anaerobic bacteria & Giardia
• Often used to treat diarrhea as it reduces
inflammation in the GI tract and returns stool to its
normal consistency.
• Neurological signs may be seen with moderate to
• high doses
• Carcinogenic in food animals
ENZYMATIC SUPPLEMENTATIONViokase, Pancrezyme
• Treatment for Pancreatic
Enzyme Insufficiency which
causes maldigestion and
malabsorption
• Pancreas is not making its
digestive enzymes
– Amylase, lipase, protease (enzymes used
to digest fat, starch, and protein)
• The enzymes can be provided to
the patient in the diet