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Musculoskeletal > 3 - Treatment Of Arthritis > Flashcards

3 - Treatment Of Arthritis Flashcards

1
Q

Most common treatment for OA

A

NSAIDs

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2
Q

Does NSAIDs halt progression of OA

A

No

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3
Q

MOA of grapiprant

A

Inhibitor of PGE2 EP4 receptor

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4
Q

Grapiprant binds with what type of affinity

A

High

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5
Q

Does grapiprant inhibit production of prostanoids

A

No

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6
Q

Grapiprant well tolerated in beagles for 9 months at doses up to

A

15x therapeutic dose

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7
Q

MOA of Firocoxib

A

COX-2 inhibitor, highly selective

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8
Q

What is the bioavailability of previcox

A

38%

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9
Q

What can delay bioavailability of firocoxib

A

Food delays absorption 1-5 hours

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10
Q

Firocoxib is metabolized how

A

By the liver

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11
Q

Firocoxib is not for use in

A

Puppie < 7 months of age at greater than 5 mg/ kg

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12
Q

Half life of firocoxib

A

7.8 hour s

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13
Q

What medicine can control post op pain and inflammation associated with orthopedic urgent

A

Deracoxib

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14
Q

MOA of deracoxib

A

COX - 2 inhibitor

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15
Q

Acute pain dose of deracoxib

A

3 - 4 mg/kg SID

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16
Q

Chronic pain dose of Deracoxib

A

1 - 2 mg/kg Sid

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17
Q

What drug can help control post op pain and inflammation in dogs with soft tissue surgery

A

RObenaxocib

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18
Q

What drug can be used to control post op pain and inflammation in cats with ortho, OVE, castration

A

Robenacoxib

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19
Q

Carprofen

A

Arylpropionic acid class of NSAIDs , reverse inhibitor of COX

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20
Q

What percent of carprofen is absorbed in 1 - 3 hours

A

90%

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21
Q

Half life of carprofen

A

8 hours

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22
Q

What percent of carprofen is bound to plasma proteins

A

99%

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23
Q

How is carprofen processed in the body

A

Bio transformation by the liver, eliminated in the feces and urine

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24
Q

Which receptor does grapiprant block

A

PGE2

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25
Q

Why would you use grapiprant in renal disease dog

A

Does not block the receptors aociated with renal

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26
Q

What does Previcox inhibit

A

Cox - 2

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27
Q

Another name for Robenacoxib

A

Onsior

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28
Q

Half life of onsior in circulating blood

A

0.5 - 1 hours

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29
Q

Onsior accumulates at

A

Site of inflammation

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30
Q

How is onsior eliminated

A

Biliary route

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31
Q

Which drug can improve use of limbs in naturally occurring OA

A

Carprofen

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32
Q

Side effect of carprofen

A

GI and idiosyncratic hepatopathy

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33
Q

Meloxicam useful in

A

Hyp dysplasia

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34
Q

Peak conc of meloxicam

A

8 hours

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35
Q

Meloxicam formulated as

A

Syrup

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36
Q

Meloxicam has some of what action

A

COX - 2 selectivity

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37
Q

Etodolac

A

Effective inhibitor of PGE2 synthesis by chondrocytes and synoviocytes

38
Q

Etodolac is effective in

A

Improving lameness of hipdysplasia

39
Q

Etodolac adverse reaction

A

GI and ulcers

40
Q

Slow acting disease modifying agents are called

A

Chondroprotective agent

41
Q

Chondroprotective agents have positive effects

A

Cartilage matrix synthesis , HA synthesis, and inhibit catabolic enzymes in OA joints

42
Q

Adeuqan is made from

A

Bovine tracheal cartilage

43
Q

Adequan

A

Injectionable prep of highly updated GAGs

44
Q

Max blood conc of adequan

A

20 - 40 mins after IM

45
Q

Adequan distributes to

A

Tissues, body fluids, incl articular cartilage, synovial fluid, skeletal muscle

46
Q

Why is synovial membrane not a significant barrier from blood to synovial fluid

A

Low molecular weight

47
Q

Adequan highest uptake

A

Superficial layers of cartilage and lowest uptake near subchondral layer

48
Q

Adequan has predilection for

A

Inflamed or diseased tissues

49
Q

HA stimulates synthesis of HA by

A

Fibroblast and synovial cells

50
Q

Is tramadol an opioid

51
Q

Does tramadol work well for OA pain

52
Q

NMDA receptor anatgonist is used as an

A

Adjuctive drug to improve the control of pain

53
Q

what is mediated by activation of NMDA receptor

A

Central sensitization of pain receptors

54
Q

Most common oral NMDA receptor anatagonist

A

Amantadine

55
Q

Amantadine must be given how

A

Continual basic

56
Q

How is Amantadine eliminated

57
Q

Side effects of Amantadine

A

Rare - agitation or diarrhea

58
Q

Gabapentin

A

Anti convulsant with purported adjuctive analgeic action

59
Q

1 goal in life long management of OA

A

Weight control

60
Q

Nutraceuticals purported to have beneficial effects on

A

Cartilage matrix synthesis, HA synthesis by synovial membrane and catabolic enzymes

61
Q

What should you be cautious of with adequan

A

Disturbances of blood coagulation

62
Q

What is injectable HA

A

Nonsulfated GAG made from rooster combs or bacterial culture

63
Q

HA can interact with what in the articular cartilage

A

Aggrecan monomers

64
Q

Injectable HA may help to restore

A

Viscosity of synovial fluid

65
Q

HA can have direct inhibition of

A

White blood cell and enzyme chemotaxis

66
Q

HA can also reduce

A

Nitric oxide production in the meniscus and synovium

67
Q

Gabapentin is mainly for

A

Neuropathic pain

68
Q

Gabapentin

A

Anti convulsant with purported adjuctive analgesic action

69
Q

MOA gaba

A

Unknown, may involve inhibition of posy synaptic neuron firing

70
Q

Gabapentin is metabolized by

A

The liver and excreted by the kidneys

71
Q

What are the side effects of Gabapentin

A

Sedation and weight gain

72
Q

Most common nutritional supplements

A

Omega 3 fatty acids

73
Q

PUFA competitively inhibit

A

Conversion of arachnids is acid to eicosanoids by inhibiting cyclooxygenase and lipoxygenase

74
Q

PUFA supplements decrease

A

Membrane AA levels, decreasing substrates to synthesize eicosanoids

75
Q

PUFA form

A

Eicosapentaenoic acid - EPa

76
Q

EPA gives rise to

A

3 series PGs and 5 series leukotrienes which are weakly inflammatory

77
Q

Glucosamine

A

An amino monosaccharide used in synthesis of disaccharide units of glycosaminoglycans and proteoglycans

78
Q

What forms the side chains of the core protein of Aggrecan of articular cartilage

A

Glycosaminoglycans

79
Q

What may inhibit cartilage degradation

A

Glucosamine

80
Q

What is used by synovioctyes to produce HA

A

Glucosamine

81
Q

Chondroitin sulfates are

A

Glycosaminoglycans

82
Q

Typical sources

A

Bovine trachea, nasal septum, and shark cartilages

83
Q

Chondroitin sulfate stimulate synthesis

84
Q

Chondroitin sulfate inhibits

A

Degradative enzymes

85
Q

Chondroitin sulfate has an affinity for

A

Synovial fluid and cartilage

86
Q

Undenatured type 2 collagen *

A

Interaction between gut associated lymphoid tissue in the duodenum and orally administered undenatrued type 2 collagen

87
Q

Cold is used to help with

A

Edema and pain

88
Q

What is heat used for

A

Decrease pain and increase tissue extensibility

89
Q

Initial excersie of arthritic patient

A

Several short periods with rest periods throughout the day

90
Q

What is third level arthritic treatment

A

Platelet rich plasma, stem cells, IA joint injection, surgery , cartilage transplant

91
Q

Biological modalities for all stages of arthritis include

A

PRP, IRAP, stem cell therapy, prolotherapy, botulinum toxin

Musculoskeletal (15 decks)

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