Alternative Analgesics (Atypical NSAIDs And Opiods) Flashcards
Name some examples of atypical NSAIDs
Grapiprant, Acetaminophen, Dipyrone
Why are these NSAIDs called “atypical”?
They have the same clinical effects of NSAIDs without affecting COX-1 or COX-2 or causing the same adverse effects
What is the MOA of Grapiprant?
Non-COX-inhibiting prostaglandin receptor antagonist that specifically blocks the EP4 receptor
Why is the EP4 receptor important?
It is important in mediating pain and inflammation (it is unregulated in chronic joint inflammation/OA in dogs)
What is Grapiprant used for?
The control of pain and inflammation associated with OA in dogs
In what two species is Grapiprant not well absorbed in?
Horses and Alpacas
What is the MOA of acetaminophen?
(COX-3) Analegesic effects are largely centrally mediated
Acetaminophen is largely used for pain/lameness and fever in what species?
Horses
When prescribing acetaminophen to dogs, what is often combined with?
Codeine
What is considered a toxic dose of acetaminophen in dogs?
100 mg/kg
Acetaminophen is toxic to what species?
Cats because they make toxic metabolites
What is another name for Dipyrone?
Metamizole
In what group of animals can you not use Dipyrone in the US ?
Food animals
What is Dipyrone used for in horses?
Fever and colic
Dipyrone is AKA as a spasmolytic, what does this mean?
It blocks muscle contraction by inhibiting the release of intracellular Ca2+
What are some uses for opioids?
Antitussive, analgesia, anti-diarrheal, +/- sedative, immobilization, induction of anesthesia, decrease MAC of inhalants
For the Opioids that are agonist drugs, so higher doses result in increases in what?
Analgesia
What are some opioid agonists?
Morphine, Fentanyl, and Hydroxymorphone
What effect do partial Opioid agonists have?
A “ceiling” effect: higher doses do not result in increased analgesia or adverse effects
What is a partial Opioid agonist?
Buprenorphine
Name an Opioid antagonist
Naloxone
Opioids have a large 1st pass ______ effect
Hepatic
Opioids have a (large/small) volume of distribution
Large
Where is the main site of action for Opioids?
CNS
Where does metabolism and elimination of opioids take place?
Metabolism = hepatic
Elimination = renal
Opioids are best for what kind of pain?
Severe, acute pain
What is a major GI effect of Opioids in dogs?
Emesis
Opioids causes mioisis in ______ and _______ in cats/horses
Dogs; mydriasis
What is a big side effect of Opioids?
Cardiovascular depression
When should you be most concerned when using Opioids?
Neonates, head trauma/CNS disease, respiratory disease
What opioid is a preferred drug for epidural administration?
Morphine
What drug is commonly used as a transdermal patch in vet med?
Fentanyl
What pain level indicates injectable opioid use for acute and surgical pain?
Moderate to severe pain
What is species is tramadol not considered an opioid?
Dogs and horses
In what species IS tramadol considered an opioid?
Cats (and humans)
Dogs and horses don’t achieve therapeutic concentrations of this metabolite unlike cats and human
M1
