CPD ARTICLE
Gastrointestinal Therapy
Anti-emetics and Antacids
Dr. Wilco Botha, BSc BVSc (Hons) MMedVet (Med)
Section of Small Animal Medicine, Department of Companion Animal Clinical Studies,
Faculty of Veterinary Science, University of Pretoria.
The drug arsenal available to the veterinarian to treat gastrointestinal
related diseases has seen some advances in recent years.
The release of maropitant on the South African
market has replaced some of the older drugs as the
empirical choice to manage nausea and vomiting.
Various recent studies in the pharmacokinetics of
antacids in dogs and cats have suggested that proton
pump inhibitors may very well be the only truly
clinically useful drugs to prevent and treat conditions
manifesting in intestinal ulceration in these species.
ANTIEMETICS
Vomiting is a clinical sign for which owners
commonly seek veterinary attention for. Anti-emetics
are commonly used to address this complaint and to
avoid possible consequences such as dehydration
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and electrolyte abnormalities due to protracted
vomiting. One should however be cautious of using
anti-emetics in suspected self-limiting cases as they
may mask disease progression.
Maropitant
Maropitant is one of the most effective anti-emetics.
It acts by inhibiting the binding of substance P to
neurokinin-1 (NK-1) receptors as an antagonist. These
NK-1 receptors are found within the vomiting centre,
chemoreceptor trigger zone and in vagal afferent
nerves in the gastrointestinal tract 1 (Figure 1). This
inhibition gives a relatively broad spectrum of coverage
against emetogens, compared to, for example,
metoclopramide and chlorpromazine, which are