Analgesics Flashcards
Dull, poorly localized pain
Type C - unmyelinated
Sharp, localized pain
Type A - Delta
Signs of inflammation
Redness, heat, swelling, and pain
Basic response to tissue injury
Inflammation
Increases permeability of blood vessels
Vasodilation
______ inflammation must be reduced to avoid additional damage to the body.
Severe
Pain sensation starts with____?
transduction and then carried to CNS
Two main groups of Anti-inflammatory drugs
Steroidal and Non-steroidal
Block the action of phospholipase
Steroidal anti-inflammatory drugs
Block the action of cyclooxygenase
Non-steroidal anti-inflammatory drugs
NSAID’s two forms
Cox-1 and Cox-2
Cox-1
Involved with modulation of renal blood flow and synthesis of gastric mucosa.
Cox-2
Involved with inflammation by promoting prostaglandin formation from cell membrane arachadonic acid.
NSAID’s are also referred to as?
prostaglandin inhibitors
What has fewer side effects than glucocorticoids?
NSAIDs
Side effects of NSAIDs?
GI ulceration and bleeding and bone marrow suppression.
Other adverse side effects of NSAIDs?
Hepatoxicity, nephrotoxicity, inhibition of cartilage metabolism, reduced platelet aggregation.
Potent inhibitors of prostaglandin synthesis by inhibiting cyclooxygenase?
Salicylates aka acetylsalicylates (aspirin)
Uses of Salicylates
Mild to Moderate pain Postadulticide HW treatment Analgesia/antipyrexia Feline cardiomyopathy Endotoxic shock
What drug are cats very susceptible to overdosing?
What side effect can this drug cause in dogs?
Salicylates (NSAID)
GI problems
Pyrazolone derivatives
Inhibit prostaglandin synthesis
Phenylbutazone is…?
Analgesic for mild to moderate pain, antipyretic and anti-inflammatory. Used for musculoskeletal pain in equine and canine medicine. Inject by IV only but can also be given orally. (NSAID)
Flunixin meglumin is…?
Inhibits cyclooxygenase, used in cattle and horses for musculoskeletal and colic pain, potent analgesic, antipyretic and anti-inflammatory. (NSAID)
What drug inactivates superoxide radicals produced by inflammation?
Dimethyl sulfoxide (DMSO)(NSAID)
Dimethyl sulfoxide is also able to…?
Penetrate skin, and serve as a carrier of other drugs. May cause burning and must use caution when applying.
Buscopan compositum (NSAID)
Contains dipyrone, is used for abdominal pain in colic, and penetrates the skin like DMSO.
What drug has a limited use in VM and should never be given to cats?
Acetominophen (NSAID)
Adverse side effects of Acetominophen?
Formation of methemoglobin and cyanosis, anemia and liver damage.
What drug blocks both cyclooxygenase and lipoxygenase?
Proprionic acid derivatives (NSAID)
Examples of proprionic acid derivatives?
Ibuprofen, ketoprofen, carprofen, and naproxen.
Side effects of proprionic acid derivatives?
GI problems, possible liver toxicities, not recommended for use in cats.
What drug inhibits cyclooxygenase (more selective for Cox-2)?
Indol acetic acid derivatives (NSAID)
Indol acetic acid derivatives is…?
An analgesic and anti-inflammatory. Example: Etodolac- benefit of once-a-day dosing. (NSAID)
Labelled for use with orthopedic pain in canines >4#?
Deracoxib Ex: Deramaxx (NSAID)
Previcoxx contains…?
Firacoxib (NSAID)
Rapidly disintegrating and labeled to block both arms of pain cascade.
Tepoxalin Ex: Zubrin (NSAID)
Types of NSAIDs
Polysulfonated glycosaminglycans Hyaluronate sodium Legend Selenium Vitamin E Cosequin
Opiod Agonists
Relieve pain by binding with specific receptor sites in the brain, spinal cord and peripheral tissue.
Block or inhibit pain impulses to CNS.
Most effective drug to relieve moderate to severe pain.
Produce respiratory depression, sedation and addiction.
What drug relieves pain by binding with specific receptor sites in the brain, spinal cord and peripheral tissue?
Opiod Agonists
What drug blocks or inhibits pain impulses to the CNS?
Opiod Agonists
What drug is the most effective for moderate to severe pain?
Opiod Agonists
What drug produces respiratory depression, sedation and addiction?
Opiod Agonists
Class C-II drugs?
Opiod Agonists
Opiod Agonists-Antagonists
Bind with Kappa receptors
Antagonize Mu receptors
Effective for mild to moderate pain
Most are C-IV
What drug binds with kappa receptors and antagonize mu receptors?
Opiod Agonists-Antagonists
Class C-IV drugs?
Opiod Agonists-Antagonists
Opiod Partial Agonists
Bind to mu receptors but only partially activate them
Useful for mild to moderate pain
Buprenorphrine is the primary drug in category
May be administered sublingually in cats
Buprenorphine is the primary drug in what category?
Opiod Partial Agonists
Other pain control agents?
Ketamine, alpha-2-agonists, lidocaine, benzodiazepines, tricyclic antidepressants.
What drug prevents histamine from combining with tissue receptors?
Antihistamines
Released by mast cells when stimulated by IgE?
Histamine
What drug causes vasodilation of small vessels, smooth muscle spasms, and increased secretion from glands?
Antihistamines
_______ inhibits the effects of inflammatory response spread but does not inhibit formation of prostaglandins.
Antihistamines
Antihistamines
Prevents histamine from combining with tissue receptors.
Released by mast cells when stimulated by IgE
Causes vasodilation of small vessels, smooth muscle spasms, and increased secretion from glands
Inhibits the effects of inflammatory response spread but does not inhibit formation of prostaglandins.
Muscle Relaxers
Skeletal muscle relaxers used to aid the treatment of acute inflammatory and traumatic conditions.
Believed to decrease muscle hyperactivity without interfering with normal muscle tone.
What drugs are believed to decrease muscle hyperactivity without interfering with normal muscle tone?
Muscle relaxers
What drug is used to aid the treatment of acute inflammatory and traumatic conditions?
Muscle relaxers
Example of a muscle relaxer?
Methocarbamol (Robaxin)
Hormones that are produced by the adrenal cortex.
Corticosteroids
Two groups of corticosteroids.
Gulcocorticoids and Mineralocorticoids
Glucocorticoids
Have anti-inflammatory effects due to their inhibition of phospholipase.
Raise the concentration of liver glycogen and increase blood glucose.
Affect carbohydrate, protein and fat metabolism.
Regulated by negative feedback.
What drug has anti-inflammatory effects due to their inhibition of phospholipase?
Glucocorticoids
What drug raises the concentration of liver glycogen and increase blood glucose?
Glucocorticoids
What drug affects carbohydrate, protein and fat metabolism?
Glucocorticoids
What drug is regulated by negative feedback?
Glucocorticoids
Glucocorticoids are categorized by…?
Short acting (duration of action < 12 hours) Ex: Cortisone and hydrocortisone
Intermediate-acting (duration of action 12-36 hours)
Ex: Prednisone, prednisolone, methylpredisolone
Long-acting (duration of > 36 hours)
Ex: Dexamethasone, Betamethasone, Fluocinolone
Glucocorticoids can be given…?
Orally, parenterally, and topically
Benefits of Glucocorticoid use?
Reduce pain and inflammation, relieve pruritis, reduce scarring by delayed wound healing, reduce tissue damage.
Drawbacks of Glucocorticoid use?
Delay wound healing, increase risk of infection, may cause GI ulceration and bleeding, increase the risk of corneal ulceration if corneal damage exists, and may induce abortion in some species.
Taper animals off glucocorticoids to prevent…?
iatrogenic Addison’s disease.
Use alternate-day dosing at the lowest possible doses to prevent…?
iatrogenic Cushing’s disease.
Glucocorticoids do not cure ________ and may help disseminate__________.
Diseases, infectious microorganisms.
Special anesthetic agents
Nerve blocks
Local anesthetics
Epidurals
Paravertebral blocks
______ or ______ anesthesia can be used to relieve pain.
Local, topical
