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Transcript
• 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)
Cimetidine , Ranitidine, Famotidine, Sucralfate
ANTIULCER MEDICATIONS
H2 Receptor Antagonists
• 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 receptor antagonists block the receptors and reduce the
production of HCl.
Cimetidine *Tagamet, Ranitidine *Zantac,
and Famotidine *Pepcid
• 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 and injectable forms
Gastromucosal protectantSucralfate *Carafate
• Disaccharide that forms a paste in the stomach
and binds to the surface of ulcers to promote
healing (gastric Band-aid)
• 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
Proton Pump InhibitorsOmeprazole *Gastrogard,
Lansoprazole *Prevacid
•Bind to the luminal surface of parietal cells and inhibits the
pump that moves hydrogen ions out of the cell.
•end in the suffix –zole
•Omeprazole (Gastrogard) – used in horses older than 4 weeks.
Primarily for ulcers due to too little hay intake, reoccuring
ulcers, or a sensitive growing GI tract
•Lansoprazole (Prevacid) – treats reflux and blocks gastric acid
production.
Prostaglandin Analogue- Misoprostol
*Cytotec
• Increases mucus production, decreases acid
production.
• Used to treat ulcers due to large doses of
NSAIDS.
• $$$
• Pregnant women should not handle; may cause
abortion
Antacids- *TUMS, *Rolaids, *Maalox,
*Mylanta, *Amphojel
• Fast-acting, relatively nonabsorbable salts of aluminum,
calcium, or magnesium that are used to neutralize acid
molecules by converting HCl to weaker acids.
• Frequent or large doses can cause electrolyte abnormalities.
• 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.
LAXATIVES AND CATHARTICS
Lactulose, Milk of Magnesia
Metamucil, Bran, Docusate sodium
Mineral oil, Petrolatum
• Increase fluid content of feces, making them softer and
easier to pass.
• -Used for constipation, trichobezoars, colon evacuation, 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.
Saline/Hyperosmotic Agents*Lactulose, *Milk of Magnesia
• Contain magnesium or phosphate ions that are
poorly absorbed. They pull water into the bowel
lumen via osmosis.
• Can cause electrolyte imbalances if treatment is
prolonged or large doses are given.
Bulking agents- *Metamucil, Bran
• Psyllium preparations that are indigestible
that swell with water to increase the size
of intestinal contents and stimulate
peristalsis.
Lubricants- Mineral 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, Petrolatum is often used in cats with
hairballs.
Surfactants- Docusate sodium
*Colace
• Often in enema form. Reduce surface tension
and allow water to penetrate stool.
• Used to treat hard, dry feces in small animals,
impaction in horses, digestive upset in cattle.
MISCELLANEOUS GI DRUGS
PROBIOTICS
• Repopulate the GI tract with beneficial bacteria
(Lactobacillus, Enterococcus), as diarrhea can
cause a disruption of the normal intestinal flora
• *Forti-Flora, *Fastrack gel, *Probiocin
ANTIBIOTIC
• Metronidazole *Flagyl
• Diarrhea can cause disruption of the normal flora and
cause an overgrowth of anaerobic bacteria. Flagyl is
effective against anaerobic bacteria & Giardia and
returns stool to its normal consistency.
• Neurological signs may be seen with moderate to
high doses
BLOAT PREVENTION
• Reduce or prevent foam formation in ruminants
• 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 break up the foam
– *Therabloat, *Bloat Guard, *Bloat-Pac
ENZYMATIC SUPPLEMENTATION
• Treatment for Pancreatic
Enzyme Insufficiency
• 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
– *Viokase, *Pancrezyme