Alternatives To NSAIDs And Opioids For Analgesia Flashcards
Name some alternatives to NSAIDs and Opioids for analgesia?
Anti-NGF mabs, Gabapentin, Amantadine, amitryptilline, alpha-2 agonists, bisphosphonates, CBD oil
mAbs are first absorbed into the what?
Lymphatics
mAbs are eliminated by what?
Metabolism
What are some advantages of mAbs?
Large therapeutic index, highly specific therapy, long half-life (monthly dosing)
What are some disadvantages of mAbs?
Cost, large size, parenteral administration, slow onset
Name some mAbs that are anti-nerve growth factors in cats and dogs?
- Librela = ranevetmab/bedinvetmab (dogs)
- Solensia = frunevetmab (cats)
Nerve growth factor is expressed at sites of _______ and _______ and is a major factor promoting pain and hyperalgesia
Injury and inflammation
Nerve growth factor (NGF) binds to what receptor?
Tropomyosin receptor kinase A
This is a calcium channel blocker with anticonvulsant activity; effective for neuropathic pain
Gabapentin
What side effect is most common with Gabapentin?
Sedation/ataxia
With gabapentin formulations, what should you avoid?
Formulations with xylitol
Which drugs are NMDA antagonists that interrupt “wind up” or central sensitization?
Ketamine, Amantadine, Dextromethorphan
What should be careful of when administering ketamine to horses?
Give low doses because they can fall over
What drug is an oral NMDA-antagonist AND antiviral?
Amantadine
What is the MOA of Tricyclic antidepressants?
Inhibit reuptake of monoamines (serotonin and norepinephrine)
What drug in the tricyclic antidepressants class is the most studied as an analgesic?
Amitryptylline
What drug in the local anesthetics class is used for infiltration during CCL surgeries and perineural blocks on cats?
Nocita (bupivacaine liposomal)
How do you treat local anesthetic toxicity?
Lipid emulsion
This is a NK1-receptor antagonist that prevents substance P binding
Maropitant (Cerenia)
What is the MOA of bisphosphonates?
It is taken up by osteoclasts and decreases bone turnover/remodeling
What to bisphosphonates bind to?
Calcium
What are the two labeled bisphonphonates for horses and what are they used for?
Tildren (Tiludronate) and OsPho (clodronate)
- they are used to control signs associated with navicular syndrome in horses
Clodronate (Osphos) is administered (IM/IV) and Tiludronate is administered (IM/IV)
IM;IV
Name some alpha-2 agonists
Dexmedetomidine, Detomidine, Romifidine, Xylazine
CB1 receptor agonists have ______ effects and CB2 receptor agonists have _____-________ ____
Psychotropic effects; anti-nociceptive effects
This is a Cannabinoids that the FDA now defines as a drug
Epidolex (cannabidiol)
This is a nondrug substance produced in a purified form intended to improve health and well-being
Nutraceuticals
