T/F Sedatives depress GI motility
True (that is why short acting are often used before surgery)
Name 2 alpha-2s used in horses
Xylazine and Detomidine
Which drug causes ataxia when used for a caudal epidural?
Xylazine
What is Neuroleptanalgesia?
Butorphanol with non-opioid agonist
What type of drug is banamine?
NSAID
Name 3 NSAIDs used for GI conditions?
Flunixin/Banamine & Ketoprofren & Phenylbutazone
What is the dose of NSAIDs in horses?
1.1mg/kg IV 2x a day
Which NSAID is best at treating endotoxemia?
Phenylbutazone
Excessive use of NSAIDs in a stressed horse can lead to _____ colitis
Right Dorsal Ulcerative Colitis
Name some anti-endotoxic drugs
NSAIDs
Hyperimmune plasma (J5 plasma-harvested from horses)
Polymixin B
Pentoxifylline
DMSO (Dimethylsulfoxide)
Polymyxin B
Binds the lipid A portion of endotoxin
At higher doses it has anti-gram neg bacterial activity
Pentoxifyline
Supresses TNFalpha, IL-1 & IL-6 production
DMSO
Radical scavenger & anti-inflammatory effects
Causes hemolysis if given to fast!
Bismuth Subsalicylate (pepto-bismol)
Absorbs toxins
Provides a protective coat
Mild antibacterial action
Anti-diarrhea agent
Usually only used in foals
Activated Charcoal
Absorbs certain toxins and drugs (prevents absorbtion)
Sometimes a laxative is given after 30 mins to hasten removal of toxins
Why shouldn't you give activated charcoal with other drugs?
It may keep them from being absorbed
Di-Tri-Octahedral Smectite (Bio-Sponge)
Intestinal absorbent
Absorbs C. diff & C perfringens toxins
Absorbs toxins, viruses, bacteria and free radicals
Tastes REALLY bad!
Cathartic
An agent for cleansing/purging the bowels
Magnesium Sulfate (Epsom salt)
Laxative
Osmotic agent: draws water into GI lumen
Used in horses with simple impactions
Do NOT exceed 3 days of tx
DSS Diocylt sodium succinate
Laxative
Last resort
Used in severe/refractory cases of impaction
Which laxative is the last resort laxative for impaction? Why?
DSS Diocylt sodium succinate
Last resort because it can cause adbominal cramping and irritation
Dehydration
Why should you not exceed 3 consecutive days of treatment with Magnesium Sulfate?
Mg toxicity or Enteritis
Mineral Oil
Used as a laxative
Lubricates the GI tract
Psyllium (Equine Enteric Colloid)
Laxative
Used for sand impactions
Becomes a gooey mass very quickly
Which laxative is used for sand impaction?
Psyllium (Equine Enteric Colloid)
Can water alone be used as a laxative?
Yes
Cimetidine & Ranitidine
H2 receptors antagonists
Used for healing gastric ulcers
Omeprazole (Gastrogard)
Irreversible proton pump inhibitor
What is the most potent Anti-ulcer med?
Omeprazole (Gastrogard)
Sucralfate (Carafate)
Coats ulcerated mucosa
Increased Prostaglandin E & increased mucous secretion
Lidocaine
Used as a prokinetic, anti-inflam and Analgesic
Used for tx of proximal ileus
Toxic: Muscle fasciculations, ataxia, collapse & seizures
Erythromycin lactobionate
Macrolide antibiotic with motilin receptor agonism
Cisapride
Bendamide
Progressive motility
Does NOT cross the BBB
Bethanechol chloride
Synthetic muscarinic cholinergic agonist
Promotes gastric emptying, & mild cecal and colonic contractions
Neostigmine methylsulfate
Achetylcholinesterase inhibitor
Promotes cecal and large colon motility
Given slowly
Butylscopolammonium bromide (Buscopan)
Anticholinergic, spasmolytic drug
Indicated for control of pain associated with spasmodic colic, flatulent colic or simple impaction colic
Metronidazole
Treatment of clostridial diarhhea
Clostridium ___ is seen in neonatal foals
perfringens is in neonates and difficile is in both
Macrolide AB (clarithromycin, erythromycin, azithromycin)
Used for Lawsonia & Enterocolitis caused by Rhodococcus equi
Which macrolide is best for treatment of lawsonia and rhodococcus?
Clarithromysin +/- rifampin
Chloramphenicol
Treatment of Lawsonia
Humans need to be careful bc of aplastic anemia
Oxytetracycline
Indicated for use against Potomac Horse Fever (neorickettsia resticii)
This can also be the first step in treatment of lawsonia