ANTIULCER MEDICATIONS

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ANTIULCER MEDICATIONS

• 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)
• 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
Cimetidine , Ranitidine, Famotidine, Sucralfate
TUMS, Rolaids, Maalox, Mylanta, Amphojel
Misoprostol
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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.

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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 

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Gastromucosal protectant- Sucralfate 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

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Proton Pump Inhibitors- Omeprazole 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.

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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

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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.

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LAXATIVES AND CATHARTICS
Lactulose, Milk of Magnesia

• 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.

Metamucil, Bran, Docusate sodium
Mineral oil, Petrolatum
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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.

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Bulking agents- Metamucil, Bran

• Psyllium preparations that are indigestible that
  swell with water to increase the size of
  intestinal contents and stimulate peristalsis.

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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.

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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.

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MISCELLANEOUS GI DRUGS
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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

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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

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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

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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