Drugs acting on the gastrointestinal tract

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Drugs acting on the gastrointestinal tract

  1. 1. Drugs Acting on the Gastrointestinaltract
  2. 2. GIT related disorders In appetence Other disordersAppetite stimulants Different drugs Diarrhoea Acids Antiacids Antidiarhoeal Indigestion Constipation Digestants Laxatives and cathartics Vomiting/Emesis Emetics/antiemetics
  3. 3. Introduction Most of the GIT disorders are related with motility Non specific treatment of GIT disorders may be useful by - Correction of fluid and electrolyte balance - Rest of the GIT - Diet modification - Provision of nutritional support - Alleviation of visceral pain
  4. 4. Appetite stimulants Benzodiazepines Cyproheptadine Glucorcorticoids Bitters Zinc
  5. 5. Appetite stimulants Benzodiazepines - Diazepam - OxazepamMode of action- Stimulation of GABAClinical use – Most in cats, less in Horses, dogs and goatsAdmn – Oral
  6. 6. CyproheptadineIt suppreses the satiety center in the brain by acting as serotonin and Histamine (H1) antagonistClinica use – in cats and human, not in dogsAdverse effects – Excitement and aggressive behavior in some cats
  7. 7. GlucocorticoidsExamples - Prednisolone - DexamethazoneMode of action – may be induce euphoriaAdverse effects – Immunosuppression and gastric ulcers may result
  8. 8. BittersThese are plant derived compounds containing alkaloids such as Nux vomicaMode of action – They stimulate salivation
  9. 9. ZincIt is essential for the sensation of taste; therefore zinc supplements may increase appetite in zinc-deficient animals
  10. 10. ANTACIDSThey include- Acid secretion inhibitors- Proton pump inhibitors- Locally acting antacids- Gastric protectants
  11. 11. Acid secretion inhibitorsHistamine (H2) blockers - Cimetidine - RanitidineMode of action – H2 stimulates the proton (acid) pump in parietal cells. H2 blockers block the H2 receptors hence decrease HCL secretion
  12. 12. Proton pump inhibitorsExample OmeprazoleMode of action – they inhibit H+-K+- ATPase hence reduce hydrogen secretion
  13. 13. Locally acting antacidsThey include- Aluminum salts (Aluminum hydroxide, Aluminum carbonate, Aluminum silicate)- Magnesium salts (Magnesium oxide (milk of magnesia), Magnesium tricilicate- They act by neutralizing gastric HCL
  14. 14. Gastric protectiveExample is SucralfateThis is a sucrose sulfate-aluminum hydroxide complexMode of action – it polymerizes to a viscous gel. The sulfate groups bind to proteins in ulcerated tissue and protect ulcers from acids and pepsin
  15. 15. DIGESTANTSIntroductionDefinition - Digestants are a group of drugs used to promote the process of digestion in the gastrointestinal tractThey include - Pancrelipase - Bile acids and salts
  16. 16. PancrelipaseIt consists of pancreatic enzymes (e.g. lipase, amylase, trypsin)Clinical use – Used to treat exocrine pancreatic insufficiency in dogs, cats and birds
  17. 17. Bile acids and saltsThey include; - Bile acids (e.g. cholic acid, chenodeoxycholic acid) - Semisynthetic bile acid derivatives (e.g. dehydrocholic acid) - Sodium salts of bile acidsMode of action – they stimulate choleresis (bile flow)
  18. 18. EMETICSThey include - Centrally acting emetics Apomorphine Xylazine - Peripherally acting emetics Sodium Chloride Syrup of ipecac (from Ipecacuanha) Copper sulfate, zinc sulfate, hydrogen peroxide
  19. 19. ANTI EMETICSThey include - Antidopaminergic agents - Antihistamines - Anticholinergic agents - Miscellaneous antiemetics
  20. 20. Antidopaminergic agentsPhenothiazine drugs Acepromazine Chlorpromazine Promazine ProchlorperazineMetoclopramideButyrophenones Droperidol Haloperidol
  21. 21. Antihistamines Dimenhydrinate Diphenhydramine Promethazine
  22. 22. Anticholinergic agents Aminopentamide Propantheline Isopropamide Darbazine (isopropamide plus prochlorperazine)
  23. 23. Miscellaneous antiemeticsIntestinal protectants and adsorbents (kaolin, pectin, bismuth salts)Locally acting gastric antacids (Mg hydroxide, Mg silicate, Al hydrox., Al silicate) may reduce vomiting caused by gastric hyperacidity
  24. 24. LAXATIVES AND CATHARTICSThey are used for - Relief of acute non-dietary constipation - Removal of poisons from the gastrointestinal tract - Prevention of Tenesmus in advanced pregnancy or prolapse - Evacuation of bowel prior to surgery or radiography
  25. 25. LAXATIVES AND CATHARTICSThey include - Osmotic cathartics - Irritant cathartics - Bulk laxatives - Lubricants - Surfactants
  26. 26. Osmotic catharticsExamples - Mg sulfate (Epsom salt), Mg oxide - Sodium sulfate (Glauber’s salt) - Polyethylene glycol electrolyte solutions - Sodium phosphate and sodium tartrate mixtures (fleet enemas)
  27. 27. Irritant catharticsExamples - Castor oil - Aloe - Senna - Cascara sagrada
  28. 28. Bulk laxativesExamples - Methylcellulose - Agar - Psyllium - Wheat bran
  29. 29. Lubricants and surfactantsLubricants - Mineral oil (liquid petrolatum) and white petrolatumSurfactants – Docusate
  30. 30. ANTI DIARHOEAL DRUGSThey include - Opiates - Anticholinergic agents - Protectants and adsorbent agents
  31. 31. OpiatesThey include - Paregoric – a camphorated tincture of opium - Diphenoxilate - Loperamide - Codeine
  32. 32. Anticholinergic agentsThey include - Methoscopolamine - Aminopentamide - Propantheline - Isopropamide
  33. 33. Protectants and adsorbent agentsPreparations - Kaolin-pectin suspensions - Bismuth sub-salicylate
  34. 34. DRUGS USED TO TREAT INFLAMMATORY BOWEL DISEASEExamples - Sulfasalazine - Olsalazine - Tylosin - Metronidazole
  35. 35. DRUGS FOR TREATMENT OF RUMINANTGASTROINTESTINAL DISORDERSSeveral groups - Agents for inducing closure of the esophageal groove - Ruminotorics - Rumen antacids - Rumen acidifiers - Viscosity-altering (antibloat) agents
  36. 36. Agents for inducing closure of theesophageal grooveExample - Milk - Sodium bicarbonate (10% to calves) - Copper sulfate (5% to calves, 2% to lambs) -
  37. 37. RuminotoricsThey include - Bitters - Cholinergics - Opiate antagonists (eg naloxone) - Rumen fluid transfer
  38. 38. Rumen antacidsExamples include - Magnesium oxide - Magnesium carbonate - Aluminum hydroxide - Calcium carbonate - Ammonium carbonate
  39. 39. Rumen AcidifiersExample - Vinegar - 4%-5% Acetic acid
  40. 40. Viscosity-altering (anti-bloat) agentsPreparations include - Poloxalene - Polymerized methyl silicone - Mineral oil and - Vegetable oil (e.g. soybean, peanut, sunflower oil).

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