Lect 25

• There are different categories of drugs used to treat gastrointestinal disease.
• Peripherally acting emetics work by blocking the chemoreceptor trigger zone (CTZ) in the brain.
• Prokinetic drugs act by stimulating the enteric nervous system (ENS) to increase motility.
• Drugs used on veterinary medicine for the treatment of gastrointestinal ulcers include cimetidine, famotidine, and ranitidine.
• Drugs used for the treatment of diarrhea in animals include loperamide, ondansetron, and metoclopramide.
• Drugs used for the treatment of inflammatory intestinal disease in animals include mesalamine, sulfasalazine, and budesonide.
• Laxatives and cathartics work by increasing the water content of the stool, thereby increasing its bulk and facilitating its expulsion.
• Drugs used for the treatment of gastrointestinal ulcers include cimetidine, famotidine, and ranitidine.
• Gastric ulceration/erosion (GUE) in people is primarily caused by use of NSAIDs or infection with Helicobacter pylori.
• Misoprostol is helpful for preventing GI ulcers, but is less beneficial for treating ulcers once they occur.
• Combination of metronidazole and/or clarithromycin, plus amoxicillin, and a PPI, or H2-receptor antagonist is used in the treatment of Helicobacter gastritis.
• Synthetic prostaglandins (PGE1) are used to treat Helicobacter gastritis.
• Basal, nocturnal and food-induced gastric acid secretion is inhibited by misoprostol, with 75% to 85% of basal acid secretion may be inhibited (cytoprotective effect).
• Misoprostol can induce uterine contractions and is contraindicated in pregnancy.
• These organisms have been identified in biopsy specimens from dogs and cats.
• The role of these organisms in disease in animals is not well documented.
• Treatment of gastritis and ulcers caused by the bacteria Helicobacter pylori and Helicobacter-like organisms has been used in animals that have not responded to other treatments.
• Drugs used for the treatment of inflammatory intestinal diseases include mesalamine, sulfasalazine, and budesonide.
• Drugs used for the treatment of diarrhea include loperamide, ondansetron, and metoclopramide.
• The onset of action of stool softeners is usually 24 – 48 hours.
• Bulk-forming laxatives are drugs composed of nonabsorbed synthetic or natural polysaccharide and cellulose derivatives that are resistant to digestion and attract water into the intestine.
• Laxatives and cathartics are drugs that increase the motility of bowel and change the character of the stool.
• Castor oil is hydrolyzed in the bowel, releasing ricinoleic acid, causing an increased secretion of water in the small intestine.
• Laxatives and cathartics can be divided into bulk-forming laxatives, stool softeners, lubricants, saline hyperosmotic agents, and stimulants.
• Ursodeoxycholic acid (Ursodiol®) has an important effect in improving liver disease.
• Bile acids, such as dehydrocholic acid and ursodeoxycholic acid, produce both a choleretic (↑ bile flow) and laxative effect.
• Stool softeners, also known as surfactants, act to decrease surface tension and allow more water to accumulate in the stool.
• Clinical efficacy in small animals has not been reported for drugs used to treat inflammatory intestinal diseases.
• Docusate sodium and docusate calcium are used to soften the stool.
• Colitis is not usually associated with hypermotility.
• Inflammatory bowel disease (IBD) is characterized by infiltration of inflammatory cells in the gastric or intestinal mucosa, which can be lymphocytic, plasmacytic, eosinophilic, or neutrophilic.
• Drugs for the treatment of diarrhea include Tylosin, Sulfasalazine, Glucocorticoids, Prednisolone, Azathioprine, Eicosapentanoic acid.
• The diagnosis of colitis is based on biopsy to identify the predominant inflammatory cell.
• Immunosuppressive drugs, such as Azathioprine, are used to treat colitis.
• Enrofloxacin is an antibiotic used to treat coli in dogs.
• Tylosin (powdered form → Tylan ®) is FDA approved for livestock and is used extra-label in dogs and cats.
• Budesonide is a local acting corticosteroid used in people and there is some evidence of a beneficial effect in dogs and cats.
• Tylosin is FDA approved for livestock and is used extra-label in dogs and cats.
• Coli is a bacterial pathogen that causes diarrhea in dogs.
• Some dogs respond to Tylosin within 24 hours, others within 3 days.