135 - Musculo-skel-neuro

Question 1

List the general principles of Neruo-musculo-skel therapy in practice:

Answer 1

Conservative – restrict activity
Corticosteroids
NSAIDs
Chondroprotective agents

Question 2

List the types of NSAIDs and describe how they work in musculo-skeletal conditions:

Answer 2

COX1 – ‘good guy’ normal wear & tear inflammation, normal cellular enzyme in kidney, stomach, and released almost constantly
COX2 – ‘bad guy’ trauma, little > none found in cells normally; COX 2 occurs with inflammation, bacterial products, cytokines
Prostaglandins – vasodilation, pain, swelling, impaired cellular function
Thromboxanes – stimulate vasoconstriction, platelet aggregation

Question 3

Describe the role of methocarbamol / Robaxin-V in the therapy of musculo-skeletal conditions:

Answer 3

Exact MOA unknown, believed to be centrally acting

Decreases muscle hyperactivity w/o interfering with normal muscle tone i.e. disk dz, muscle, joint, tendon inflammation

Question 4

What are glycosaminoglycans (GAGs):

Answer 4

chondroprotectives

Question 5

List the type of musculo-skeletal conditions that glycosaminoglycans (GAGs) are commonly used in :

Answer 5

Noninfective degenerative joint dysfunction

Question 6

How do glycosaminoglycans (GAGs) function in musculo-skeletal therapy:

Answer 6

Stimulate synovial fluid secretion
Increase viscosity
Inhibits proteolytic enzymes that degrade proteoglycans and collagen in joints
Promote synthesis of proteoglycans, hyaluronic acid, collagen
Reduce inflammation by reducing PG E2 concentration
Increase hyaluronate concentrations in joint, restoring synovial joint viscosity

Question 7

What are nutreceuticals:

Answer 7

Food Supplements

Question 8

What two roles do anticonvulsants play in seizure conditions:

Answer 8

Control or prevent seizures

Question 9

List the rules and recommendations that must be given to owners of epileptic animals:

Answer 9

Daily maintenance for life for successful treatment
Do not withdraw medication suddenly
Blood drug levels are checked routinely
Often need to increase drug dose or supplement with additional medications

Question 10

Explain why drugs of the anti-cholinesterase class are used treat myasthenia gravis (MG):

Answer 10

The dz is characterized by a lack of functional acetylcholine receptors, so need to block acetylcholine since dz prevents processing of acetylcholine

Question 11

List the general types of neurotransmitters used in veterinary medicine and what clinical signs they produce: (ie cholinergic agents – bradycardia, bronchial secretions, SLUD, and hypotension)

Answer 11

Anticonvulsants – drowsiness, agitation, anxiety, PU/PD

Cholinergics/ parasympathomimetic agents – bradycardia, hypotension, heart block, lacrimation, diarrhea, vomiting, increased GI motility, intestinal rupture, increased bronchial secretions

Cholinergic blocking – dose related, drowsiness, disorientation, tachycardia, photophobia, constipation, anxiety, burning at injection site

Adrenergics/ sympathetic agents – fight or flight responses, tachycardia, hypertension, nervousness, arrhythmias

Alpha Adrenergic blocking – hypotension, tachycardia, muscle tremors, seizures

Alpha1, alpha2 – excitatory response, except GI

Beta adrenergic blocking – bradycardia, hypotension, worsening heart failure, bronchoconstriction, heart block, syncope

Beta1, beta2 – inhibitory response, except heart

Question 12

List some of the specific neurotransmitter agents and the conditions they are used for:

Answer 12

Cholinergics –
bethanechol/Urecholine – urinary tract atony, GI atony
pilocarpine/Pilocar – decrease IOP
metoclopramide/Reglan – stop vomiting, promote gastric emptying
Anticholinesterase –
edrophonium/Tensilon – dx myasthenia gravis
neostigmine/Protigmine – urine retention, GI atony

Cholinergic blockers –
atropine – pupil dilation, bradycardia, slow GI, preanesthetic, OP antidote
glycopyrrolate/ Robinul V – preanesthetic (longer acting)
aminopentamide/Centrine – control V&D
propantheline/Pro-Banthine – diarrhea, urinary incontinence, bradycardia

Question 13

List the adrenergic receptors, location, and responses trigger by their stimulation:

Answer 13

Alpha1: arterioles – constriction; urethra – increased tone; eye – pupil dilation

Alpha2: skeletal muscle – constriction

Beta1: heart – increased rate, conduction, contractility; kidney – renin release

Beta2: skeletal blood vessel – dilation; bronchioles – dilation

Dopaminergic: kidneys – vessel dilation; heart – coronary vessel dilation; mesenteric blood vessels - dilation