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New pharmacology


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veterinary pharmacology

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New pharmacology

  1. 1. PHARMACOLOGY OF DRUGS ACTING ON GIT Submitted to; Dr Ravikumar Head of dept VPT
  2. 2. Gastrointestinal Tract Continuous tube extending from the mouth to the anus. Major function: convert complex compounds into simpler compounds that can be absorbed and used by cells.
  3. 3. GI Transit Time Time it takes for material to pass from one end of the GI tract to the other end. Subdivided into gastric emptying and small intestine and colon transit time. Speeding up transit time = less absorption Slowing transit time = more absorption.
  4. 4. Stomach Composed of layers of smooth muscle lined with glands. Glands secrete Enzymes Hydrochloric acid Mucus Food moves from the stomach to the small intestine where most absorption takes place.
  5. 5. Gastrointestinal System
  6. 6. DRUGS AFFECTING SALIVARY SECRETION  Saliva is watery & froathy substance produced in mouth of human and animals.  Regulation of salivary secretion is via salivary nuclei located in brain stem, which are excited by taste and tactile stimuli from tongue and other areas of mouth.  Saliva contains amylase which helps in breakdown of starch to sugar, salivary lipase helps in fat digestion.
  7. 7. SALIVARY STIMULANTS/SIALICS CLASSIFICATION 1. Indirect acting sialics- e.g. Gentian, Nuxvomica & Quassia. 2. Direct acting sialics- e.g. Carbacol and Arecoline.
  8. 8. INDIRECT ACTING SIALICS  These are mainly vegetable drugs.  They stimulate taste buds by mild irritant action which inturn enhances salivary secretion.  GENTIAN- Obtained from Gentiana Lutea.  Active principle present is Amarogentin &Getiopicrin.  Works as stomachic for increasing appetite.
  10. 10. NUX VOMICA Obtained by strychnus nux vomica Active principle strychnine and Brucine. It posses stomachic action DOSECATTLE;4-8g TOTAL HORSES;1.3-4g TOTAL ROUTE OF ADMINISTRATION PER ORAL.
  11. 11. QUASSIA Obtained from dried stem of Picraena excelsa. It has antihelminthic and fly repellent property. In small dose it act as appetite stimulant but in large dose it induces vomition due to irritation.
  12. 12. DIRECT ACTING SIALICS Directly stimulates salivary gland.e.g Cholinergic sialics like carbachol and arecoline.  MOA Carbachol and arecoline stimulate salivary gland directly via muscuranic receptor and lead to copious flow of saliva . Ptyalism is seen in intoxication of organophosphorous ,carbamates and pyrethroid poisoning.
  13. 13. ANTISIALICS Decrease the flow of saliva . 1. Used in oral surgery and as preanasthetics. 2. Inhibition of saliva is seen as side effect of several drugs. 3. Theraupetically antimuscuranic drugs like ( Atrophine, hyoscine,glycopyronium) used as anti sialics.
  14. 14. ATROPINE & HYOSCINE Occurs naturally & used as preanaesthetic ,primarilly to reduce salivary & bronchial secretions. These are non selective anti muscuranic drugs. Contraindicated in Horse as it causes CNS excitation.  HYOSCINE has greater central effects .
  15. 15. GLYCOPYRRONIUM  Its longer acting synthetic quaternary compound( highly water soluble cannot cross BBB ) to atrophine sulphate.  Safe in horse. DOSE HORSE-0.001-0.003mg/kg IV DOG – 0.01-0.02mg/kg s/c, IM,IV
  16. 16. GERD  It’s long term condition where stomach contents come back upto esophagus.  Symptoms include-Heartburn, vomition, halitosis, chest pain etc..
  17. 17. Factors Contributing to GERD  Pregnancy.  Overeating.  Eating on the run.  Eating late at night.  Drinking alcohol.  Smoking cigarettes.  Consuming various foods (high fat content, caffeine, citrus, spices)
  18. 18. Therapy for GERD Preventative behavior. Preventative dietary changes. Avoiding medications or other substances that promote reflux. Using combination of medications.
  19. 19. Agents used as Antacids aluminum hydroxide (ALternaGel) aluminum hydroxide-magnesium carbonate (Gaviscon ES) aluminum-hydroxide-magnesium hydroxide-simethicone (Maalox Max) magnesium hydroxide (Milk of Magnesia)
  20. 20. Agents for GERD H2 Antagonists Cimetidine (Tagamet, Tagamet HB) Famotidine (Pepcid, Pepcid AC) Nizatidine (Axid, Axid AR) Nanitidine (Zantac, Zantac 75)
  21. 21. Histamine2 Receptor Antagonists Block gastric acid and pepsin secretion. Competitive inhibition on gastric parietal cells. Bedtime dose is most important.
  22. 22. Therapeutic Uses of ranitidine (Zantac, Zantac 75)  Active duodenal ulcers.  Benign gastric ulcers.  Long-term prevention of duodenal ulcers.  Gastric hypersecretory states.  GERD.  Postoperative ulcers.  Upper GI bleeding.  Preventing stress ulcers.
  23. 23. Proton Pump Inhibitors Blocks acid secretion by inhibiting the hydrogen-potassium ion pump in parietal cells.
  24. 24. omeprazole (Prilosec) Indicated for short-term treatment. Take before meals. Also indicated for helicobacter pylori . Diarrhea is primary side effect.
  25. 25. lansoprazole (Prevacid) Indicated for short-term therapy of ulcers and esophagitis. Indicated for long-term treatment of hypersecretory disorders and Zollinger-Ellison syndrome.
  26. 26. esomeprazole (Nexium) Very similar to Prilosec, but is metabolized slower which increases the duration of action. Taken empty stomach.
  27. 27. pantoprazole (Protonix) Less expensive than others in this class. Drug of choice in many hospitals due to IV dosage form availability.
  28. 28. Agents for GERD Combinations calcium carbonate-famotidine- magnesium hydroxide (Pepcid Complete) lansoprazole-naproxen (Prevacid NapraPAC)
  29. 29. Agents for GERD Coating Agent: Sucralfate (Carafate)-It’s sucrose sulfate- aluminium complex that binds to ulcer creating physical barrier protecting GIT from stomach acid. Prostaglandin E Analog: Misoprostol (Cytotec) Cholinergic Agent: Bethanechol (Urecholine)
  30. 30. Prostaglandin E Analog: Misoprostol (Cytotec) Cholinergic Agent: Bethanechol (Urecholine)
  31. 31. Peptic Disease Includes: Mucosal injury. Erythema. Erosions. Ulceration.
  32. 32. Ulcer Local defect or excavation of the surface of an organ or tissue. 3 common types: Gastric. Duodenal. Stress.
  33. 33. Gastric Ulcers Local excavation in the gastric mucosa. Have malignant potential. Occur more in men than women. Prevalent in smokers and populations in the Western Hemisphere. H. pylori is a common contributing factor.
  34. 34. Duodenal Ulcers Peptic lesion in the duodenum. Occur more in hypersecretors. More difficult to treat than gastric ulcers due to the difficulty in getting the medication to the duodenum.
  35. 35. Rx for H. pylori H. pylori is the cause of most peptic ulcers. H. pylori secretes enzymes that neutralize stomach acid. Antibiotics are the mainstay of therapy, mixed with an antacid or proton pump inhibitor.
  36. 36. Gastrointestinal Disease Crohn’s disease: inflammatory bowel disease Can affect any portion of tubular GI tract Cannot be cured with surgery
  37. 37. EMESIS Emesis is complex process occurs due to stimulation of vomition centre located in medula oblangata , & due to visual & olfactory stimuli.  Apparent emetic impulse originating from semicircular canal of vestibular apparatus are transmitted by 8th cr nerve to vestibular nuclei via cerebellum and induces vomition.
  38. 38. Contd.. --Peripheral efferent pathway include stimulation arising from various visceral organs and tissues. Blood borne emetic substance include drugs, hormones ,endotoxic substance induce vomition via CTZ.
  39. 39. EMETICS Drugs which are used to evoke vomiting. Clinically emesis is induced to empty anterior portion of GIT, Prior to induction of general anaesthesia. Mainly employed in dogs and cats.
  40. 40. Classification LOCALLY ACTING EMETICS e.g Ipecacuanha,luke warm water,sodium chloride,copper sulphate,zinc sulphate, hydrogen peroxide. CENTRALLY ACTING EMETICS e.g Apomorphine and xylazine.
  41. 41. LOCALLY ACTING  Vomition is induced by irritating the epithelium of oropharynx, oesophagus, stomach and duodenum.  IPECACUANHA contains active ingredient emetine and cephaline thus irritating gastric mucosa stimulating CTZ .  Pharmacological effect it takes 15-30 mis to induce emesis in dogs and cats .
  42. 42. SIDE EFFECTS cardiotoxicity. NO SPECIFIC ANTIDOTE IS THERE activated charcoal may be given. DOSE  Dogs & Cats ; 1-2ml/kg PO. Total dose more than 15 ml for dog.
  43. 43.  LUKE WARM WATER  Administered by stomach tube for inducing vomition.  Used in non corrosive poisoning .  SODIUM CHLORIDE  Induce vomition by irritating GI mucosa  In DOG 30-60ml PO
  44. 44. Centrally acting anti emetics  APOMORPHINE –It acts on vomiting centre and CTZ , its semi synthetic derivative of morphine ,dopamine agonist acts on D2 receptors present on CTZ inturn induce vomition.  CONTRAINDICATED in cats because of CNS excitation.  DOSE in DOG ; 0.04mg/kg IV  XYLAZINE alpha 2 adrenoreceptor agonist its reliable emetic in CATS.  DOSE IN CATS ;0.4-1mg/kg IM
  45. 45. ANTI EMETICS  Drugs which prevent vomition.  LOCALLY ACTING ANTI EMETICS 1. Demulcants and protectants e.g. kaolin, pectin, bismuth salts 2. Gastric antacids and local anaesthetics e.g. magnesium hydroxide, aluminium hydroxide and benzocaine. 3. Anticholinergics e.g. glycopyronneum, methscopalamine, propantheline. 4. Prokinetics e.g. domperidone and cisapride
  46. 46. CENTRALLY ACTING ANTI EMETICS – directly act on emetic centre 1. H1 receptor antagonist used in case of motion sickness e.g meclozine 2-6g/kg PO in dogs ,cyclizine,cinnerazine. these are administered 30-60 min before journey . 2. D2 receptor antagonist- phenothiazine derivative, e.g. Chlorpromazine in dogs 0.25-0.5 mg/kg .Benzamides e.g. Metachlopromide D2 blocker acts on CTZ dose in dogs 0.1-0.3 mg/kg po. 3. 5HT3 receptor antagonist acts centrally e.g. Ondansetron dogs and cats 0.1-0.2mg/kg. 4. Muscuranic receptor antagonist e.g.hyoscine dogs 0.03mg/kg.
  47. 47. MISCELLANEOUS DRUGS 1. GLUCOCORTICOIDS e.g. Dexamethasone, Methyl prednisolone. 2. BENZODIAZEPINES e.g. Diazepam, lorazepam and midazolam. 3. CANNABINOIDS e.g. Dronabinone and Nabilone.
  48. 48. DRUGS AFFECTING APPETITE  Appetite is regulated by hunger & satiety centre in hypothalamic nuclei & other component of limbic system.  Neurotransmitter are alpha 2 adrenoreceptor,D1 dopamine receptor,seretonine are involved in controll of appetite.  Appetite stimulants are also called as orexigenics/ Appetisers.  Inhibition of satiety centre increase in appetite.  Stimulation of satiety centre –decrease in appetite.
  49. 49. CLASSIFICATION OF APPETISERS 1. BENZODIAZEPINES – inhibit satiety centre via nor adrenaline/D1 receptor. eg, Diazepam – 0.05-0.15g in Dog PO, Oxazepam 0.3-0.4 mg PO in dogs. 2. CYPROHEPTADINE- is H1 blocker it inhibits seratogenic receptors thus inhibition of satiety centre. 5-20mg PO in dogs. 3. GLUCOCORTICOIDS-steroids induced euphoria results in increase feed intake. E.g.0.25-0.5mg prednisolone in dogs PO once a day.
  50. 50. 3)GLUCOCORTICOIDS-steroids induced euphoria results in increase feed intake. E.g.0.25-0.5mg prednisolone in dogs PO once a day. 4) ANABOLIC STEROIDS-Synthetic analogue of testosterone , they promote appetite ,increase weight gain.e.g.Stanozolol-0.25-3mg/kg PO once daily.
  51. 51. contd 5) PROGESTERONE –e,g Megesterol acetate – 5mg/kg PO in dogs. 6) MISCELLANEOUS DRUGS –e,g, Vitamin B preperations.
  52. 52. APPETITE SUPPRESENTS These are the agents which suppress the appetite by stimulation of satiety centre.  These are used in management of obesity due to excessive food intake.  These are not used in veterinary medicine.  E,g, AMPHATAMINE used in case of obesity.
  53. 53. Sumitted by, C.P Sahithya Dept of VPT