cearticle #2 ce test - VetLearn.com

More documents

Recommendations

Info

Compendium June 2002 Drug Therapy/GI Disease 459 mucosal blood flow. Its major effect is the ability to promote gastroduodenal ulcer healing. Preventive therapy or treatment of NSAID-induced gastroduodenal ulceration is the primary indication, but misoprostol may also be helpful in treating GI ulcers of other causes. Sucralfate Sucralfate is an orally administered disaccharide aluminum hydroxide product that binds to the submucosa of an ulcerated lesion in the stomach and duodenum and protects the submucosa from acid, bile salts, and pepsin activity. Binding also prevents exudation of protein and electrolytes and stimulates production of prostaglandins, sulfhydryl ions, and oxygen radical scavengers, which are natural gastric mucosal protectants. Potential binding and inhibition of other drugs may occur when given with sucralfate; therefore, sucralfate should be given on an empty stomach at least 2 hours before or after other medications. PROTECTANTS AND ADSORBENTS Protectants are nonabsorbable compounds that line the GI mucosa and prevent irritation and erosion by potentially harmful substances (Table 5). Although commonly used for vomiting, protectants such as kaolin, pectin, bismuth salts, demulcents, and antacids generally do not work and often increase vomiting by causing stomach distention and irritation. Adsorbents physically bind chemicals to prevent their absorption and promote elimination in the feces. Commonly used products contain both absorbent and protective properties. Indications for these products in small animal medicine are limited, and studies showing efficacy are lacking. Kaolin–Pectin Kaolin–pectin is a demulcent and adsorbent that is used for the nonspecific treatment of diarrhea. Although improvement may be seen in the consistency of stools, kaolin–pectin has not been shown to reduce stool volume or shorten the course of the disease, and fluid and electrolyte loss remains unchanged. 13 Bismuth Salts Bismuth salts are demulcents and lesser adsorbents. When given to rabbits experimentally, bismuth subcarbonate and subsalicylate have been shown to inhibit Escherichia coli and Vibrio cholerae enterotoxins when administered before or immediately after enterotoxins. 14 They have benefit in preventing enterotoxin-induced
460 Small Animal/Exotics Compendium June 2002 Table 7. Antimicrobials Drug Dose Indication Comment Ampicillin/ Dogs and cats: 10–20 mg/kg Gram-positive bacteria, Disrupts normal GI flora amoxicillin PO, IM, or IV q6–8h anaerobes Cephalexin Dogs and cats: 22 mg/kg PO Gram-positive bacteria, Disrupts normal GI flora; give q8–12h some gram-negative bacteria; mucosal injury, sepsis with food if vomiting occurs Metronidazole Dogs and cats: 10–20 mg/kg Bacterial overgrowth, Neurotoxicity at higher PO q8–12h anaerobes, IBD, Clostridium, doses; use one third of dose Giardia if liver disease is present Erythromycin Dogs and cats: 10 mg/kg PO q8h Campylobacteriosis Can cause GI upset Enrofloxacin Dogs: 2.5–5.0 mg/kg PO or IM Gram-positive bacteria, gram- Can cause cartilage q12h; cats: 2.5 mg/kg PO or IM negative bacteria, sepsis defects in puppies (if given q12h >5 mg/kg) and possible blindness in cats Sulfasalazine Dogs: 10–30 mg/kg PO q8h; IBD, colitis Can cause keratoconjunccats: 20 mg/kg or 250 mg PO q8h tivitis sicca; use with caution (three times), then q24h in cats because of possible salicylate toxicity Tetracycline Dogs and cats: 20 mg/kg PO q8h Bacterial overgrowth, Can cause liver toxicity, hydrochloride rickettsial diarrhea, sepsis GI upset, discolored teeth (in puppies), drug fever (in cats) Gentamicin sulfate Dogs and cats: 2.2 mg/kg IM, Sepsis Can cause nephrotoxicity; IV, or SC q12h do not use in dehydrated patients or those with renal disease Tylosin Dogs and cats: 11–200 or Bacterial overgrowth, IBD Sprinkle on food; broad dose 20–40 mg/kg PO q12h; range with wide safety 5–10 mg/kg PO q8–12h; margin; each gram contains 1 /4–1 tsp with food q8–12h 100 mg tylosin Trimethoprim Dogs and cats: 15 mg/kg PO Mucosal injury, gram-negative Immune disease (in liver, sulfonamide or SC q12h bacteria, Salmonella, coccidia bone marrow) is a possible reaction diarrhea but are not effective once clinical illness is apparent. Bismuth subsalicylate has been shown to have antiprostaglandin synthetase effects that enhance the ability to control diarrhea caused by the subsalicylate component. This compound should be used cautiously in cats because the subsalicylate is absorbed systemically and toxicity is associated with use of this drug in cats. 1 Activated Charcoal Activated charcoal, which is a commonly used adsorbent to treat intoxications from ingestion of harmful drugs or substances, absorbs the toxin in the gut and decreases the amount of toxin entering the systemic circulation. If the drug or toxin is eliminated by the liver and reabsorbed in the intestine, activated charcoal can absorb the toxin and increase the rate of elimination from plasma and tis- sues. Timing of treatment is important for maximal efficacy, and delays of even 30 minutes can decrease absorption substantially. Activated charcoal is available in readymade liquid, powder, or tablet form; the liquid and powder forms are more absorptive than the tablets. Cholestyramine Cholestyramine is the chloride salt of a basic anion exchange resin and acts by forming ionic bonds with acidic side chains. 13 This drug is known for its bile acid–binding capacity and is used for bile acid–induced diarrhea following resection of the ileum. Cholestyramine can interfere with intestinal absorption of drugs (e.g., chlorothiazide, phenylbutazone, phenobarbital, anticoagulants, thyroxine, digitalis) and can be used to treat intoxication. Side effects include hypochloremic
Page 1 and 2: CE 452 V Vol. 24, No. 6 June 2002 A
Page 3 and 4: 454 Small Animal/Exotics Compendium
Page 7: 458 Small Animal/Exotics Compendium
Page 15 and 16: Compendium June 2002 Drug Therapy/G
Page 17: Compendium June 2002 Drug Therapy/G

cearticle #2 ce test - VetLearn.com

Create successful ePaper yourself

Delete template?

Save as template?