Veterinary Gastrointestinal
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| Apomorphine | Emetic, naloxone is reversal, works centrally, hypodermic tablet, wear gloves, SE: protracted vomiting, conjunctivitis, opioid O/D, Cardiovascular depression
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| Syrup of ipecac | Emetic, CARDIOTOXIC, perphiral action (irritates GI mucosa), orally, SE: lacrimation, salivation, cardiotoxic, give gastric lavage if no vomiting in 2 doses
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| Emetics general | avoid when poison is corrosive, patient is unconscious, work in different ways (centrally or peripherally)
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| Chlorpromazine | Thorazine, phenothiazine tranquilizer, depresses Central receptor trigger zone for vomiting SE: drowsiness, hypotension, tachycardia
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| Dimenhydrinate | Gravol, antiemetic, antihistamine, work centrally and at H1 receptors in the middle ear, work best in motion sickness, most common
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| Diphenhydramine | Benadryl, same as Gravol
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| Meclizine | Antivert, same as Gravol
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| Promethiazine | Phenergan, same as Gravol
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| Metaclopramide | Reglan, works centrally and peripherally, may be given as a drip (short half-life), SE:changes in mentation/behavior, constipation, CI: GI obstruction, many drug interactions
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| Maropitant citrate | Cerenia, antiemetic, blocks substance P in the CNS, given in chemotherapy, CI: GI blockage, toxin ingestion, can increase the risk of arrhythmias, use in caution in dogs with liver disease, highly protein bound
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| Antiemetics in general | Give parenterally, most vomiting stopped by withholding food for 1-2 days, work centrally or peripherally, stop vomiting to counteract dehydration, electrolyte imbalances, chemotherapy, motion sickness
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| Anti-ulcer medications in general | 1)H2 receptor antagonists (decrease HCl production) 2) proton pump inhibitors 3)antacids (bind and inactivate HCl) 4)Protect and coat GI from HCl
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| Cimetidine | Tagamet, H2 receptor antagonist, SE: cardiac arrhythmias, headaches, mental confusion, may cause false positive on urine protein stick
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| Ranitidine | Zantec, same as Tagamet
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| Famotidine | Pepcid AC, same as Tagamet
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| Omeprazole | Gastroguard, proton pump inhibitor, can be used in show horses
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| Aluminum/Mg hydroxide | Maalox, Mylanta, Carmilax, Neo-Atropec, Milk of Magnesia, antacids. Non-absorbable SE: constipation or diarrhea, caution in renal patients, do NOT use within 2 hours of any other medication (esp Tetracyclines)
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| Sucralfate | Carafate, gastromucosal protectant SE: constipation, reduces availability of other drugs, give 2 hours after or before
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| Misoprostol | Cytotec, used in NSAID GIT irritation, protects by decreasing HCl production and increasing local mucosal defence, and increasing mucus protection in stomach and bicarb in the duodenum, protect GI in NSAID use!
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| Diphenoxylate | Narcotic, Antidiarrheal, Lomotil, works by increasing segmented contractions, increasing intestinal absorption, and decreasing intestinal secretions SE: constipation, ileus, sedation, CNS excitement
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| loperamide | Narcotic, antidiarrheal, Imodium, see Lomotil
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| Atropine | Neo-Atropec, antidiarrheal, Anticholinergic, decrease GI motility (controversial), ionized in acidic environment = poor absorption orally, SE: dry mouth/eyes, tachycardia, constipation, urinary retention
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| Methcopolamine | Scour Solution, see atropine
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| Hyoscyamine | Calf Scour Bolus, see atropine
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| Bismuth subsalicylate | Pepto-Bismol, beware in cats! Protectant, coats and protects GI mucosa, +/- binds toxins, will bind with other oral meds, give last, not absorbed, acts locally SE: constipation, caution in Cats
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| Kaolin/Pectin | Kaopectate, see Pepto Bismol
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| Activated Charcoal | Charcodote, protectant, absorbent, antidiarrheal, see Pepto
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| Barium | Antidiarrheal, see Pepto
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| Mg. Hydroxide | Milk of Magnesia, Carmilax, Magnalax, Hyperosmotic Laxatives, used before SX for constipation, draw fluids into the colon (be certain of good hydration status before using!)
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| Mg. Sulfate | Epsom Salts, see Mg. Hydroxide
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| Na Phosphate Salts | Fleet Enema, see Mg. Hydroxide - NEVER USE IN CATS!!!
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| Psyllium | Metamucil, bulk-producing agent, increase bulk and water in stool, laxative
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| Glycerine suppositories | lubricant
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| Mineral oil | lubricant
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| Petrolatum | Lubricant, Laxatone, Felaxin
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| DSS (diotcyl Na sulfosuccinate | Dioctol, Bloat-Aid, drentch, gel caps, surfactant/stool softener (laxative) better than lubricants because it penetrates and breaks up the fecal material and decreases surface tension to reduce gas/bubbling in frothy bloat
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| irritants | Ex.Lax, castor oil, not recommended b/c cause hypermotility in response to local irritation = discomfort
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| Laxatives in general | Act locally, not absorped after oral/rectal administration, work by several mechanisms 1) hyperosmotic, 2) bulking agent (fibre), 3) lubricants, 4) surfactants, 5) local irritants
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