Anti-inflammatories Flashcards
What is the inflammatory response?
Body’s response to injury
True or False - “injury” can include trauma, chemical agents, antigens
True
____________ cells release inflammatory mediators
damaged
What are some inflammatory mediators?
Prostaglandins
Leukotrienes (mast cells + basophils)
Histamine
Cytokines
What do Inflammatory mediators do?
Signal body to:
- Destroy & remove deleterious agents
- Sequester injury to localized area
- Repair any damaged areas
What are the cardinal signs of inflammation?
Heat
Swelling
Pain
Redness
________ temperature = sign of inflammation
Elevated
Increased blood flow leads to which 2 signs?
Heat
Redness
____________ stimulate the ____________ to increase body temperature
Prostaglandins, hypothalamus
What are pyogens?
They can cause fever
________ increases biochemical reaction rate
Fever
True or false - Increased blood flow leads to dilution of offending agents with plasma
True
What is occurring redness
Increased blood flow brings:
- Fibrin to immobilize offending agent
- Brings phagocytic cells to clean up antigens and damaged cells
Inflammatory mediators ___________ permeability of __________ ___________ @ site of damage
Increase, blood vessels
What does swelling response allow for?
Leukocytes and antibodies to reach damaged cells
What is a protective mechanism?
Pain
Inflammatory mediators stimulate ___________ of nerve endings
sensitization
What are the 3 types of anti-inflammatories?
NSAIDs
Glucocorticosteriods
DMSO
What steroids are produced in the adrenal medulla?
Epinephrine
Norepinephrine
What steroids are produced in the adrenal cortex?
Glucocorticoids
Mineralcorticoids
Adrenal sex hormones
What do natural glucocorticoids contribute to?
CHO, protein and lipid metabolism, anti-inflammatory effects
What do mineralcorticoids contribute to?
Water & electrolyte balance
What are the two adrenal sex hormones produced?
Androgens
Estrogens
True or False - Adrenal Sex Hormones are produced in small amounts & have minimal effects
True
True or False - Adrenocorticoids have absolute glucocorticoid or mineral corticoid activity
False - can have some of both but one is dominant
Which anti-inflammatory blocks inflammatory response early?
Glucocorticoids
What do glucocorticoids block formation of?
Prostaglandins
Thromboxanes
Leukotrines
True or False - NSAIDs are as effective as glucocorticoids
False
What do NSAIDs block formation of?
Prostaglandins and Thromboxanes
Glucocorticoids affect glucose metabolism in what way?
Stimulates gluconeogenesis (contraindicted in diabetics)
Increases glucose utilization by the cells
What catabolism processes do glucocorticoids affect?
Protein (amino acids from muscle to liver)
Lipid
Glucocorticoids promotes which anti-inflammatory effects?
Promotes vasoconstriction
Decreases capillary permeability=results in decrease loss of plasma
Stabilize cell membranes, so no release of inflammatory mediators
Decreases histamine and interleukin synthesis
Blocks arachidonic acid production
What immunosupressive effects do glucocorticoids cause?
Decreases:
- Synthesis of macrophages and monocytes
- Phagocytosis
- Lymphocytes and eosinophils
- Antibody formation
- Neutrophil migration
What effect do glucocorticoids have on the CNS?
Increases BG, results in improved mood, behaviour and appetite
What effect do glucocorticoids have on mineralcorticoid activity?
Mild activity
Results in sodium and water retention
What are 7 uses for glucocorticoids?
Shock
Anti-inflammatory
Immunosuppressive
Addison’s Disease
Chemotherapy
Ketosis in cows
Induce abortion in last trimester
True of False - Glucocorticoids are used as a low dose IV for vasoconstriction in shock situations
False - High dose
Glucocorticoids are used in ___________ or __________ shock
septic, endotoxic
What are 2 common anti-inflammatory situations for glucocorticoids to be used?
Arthritis
Allergic reactions
Skin conditions
What are 2 common immunosuppressive situations for glucocorticoids to be used?
Autoimmune diseases (AIHA)
Allergic Reactions
True or False - Addison’s disease is hypoadrenocorticism
True
When treating addison’s disease, glucocorticoids replace __________
corticosterioids
Glucocorticoids are used for chemotherapy of which type of cancer?
Malignancies ie. Lymphosarcoma’s
What process do glucocorticoids cause when used for ketosis in cows?
Gluconeogenesis
How do glucocorticoids work for inducing labor?
Stimulates release of fetal cortisol
Premature birthing process
What are short term toxicities of glucocorticoids? (less than 2 weeks)
PU/PD
Increased susceptibility to infection
What are long term toxicities of glucocorticoids?
Iatrogenic Cushing’s (Hyperadrenocorticism)
Iatrogenic Addison’s (Hypoadrenocorticsm)
Gastric Ulceration
Osteoporosis
Impaired wound healing
Pancreatitis
Nephrotoxicity
True or False - Too much glucocorticoids cause cushing’s?
True
True or False - Chronic therapy with abrupt cessation causes addisons?
True
____________ help with maintenance of the mucous barrier in stomach
Prostaglandins
True or False - Prostaglandins reduce hydrochloric acid production
True
What is Osteoporosis?
Catabolism of protein in bone marrow
What can pancreatitis lead to?
Diabetes Mellitus through B-cell exhaustion
What are 5 ways to decrease toxicity?
Use only when necessary
Use small of dose as possible
Use as large dose interval as possible
Treat only as long as necessary
Always wean animals off dose rather than abruptly
What does NSAIDs stand for?
Non-steroidal anti-inflammatory drugs
What are 4 characteristics for NSAIDs
Block prostaglandins formation
Not as effective as steroids
Fewer side effects
Have analgesic & antipyretic properties
What is an antipyretic?
Blocks hypothalamic response to prostaglandin to “reset the thermometer”
NSAIDs __________ platelet aggregation
decreases
True or False - NSAIDs inhibit the COX enzyme
True
What are the two types of COX enzyme?
COX-1 = participates in daily cell function
COX-2 = Induced inflammation
What are the 5 common uses for NSAIDs?
Analgesia
Antipyretic
Anti-Inflammatory
Septic Shock
Anti-Thrombotic
What are the toxicities of NSAIDs
Gastric irritation and ulceration
Nephrotoxicity
Decreased platelet aggregation
Decreased metabolism and excretion in cats
Hepatotoxicity reports with carprofen in dogs
Ibuprofen is contraindicated in small animals
Phenylbutazone, very irritating if injected SQ or IM
What is DMSO?
Dimethyl Sulfoxide, is a potent solvent
Penetrates skin easily
What are toxicities for DMSO?
Garlic taste when absorbed in the skin (WHERE GLOVES)
Teratogenic
Lenticular changes have been noted in dogs and rabbits when it is used chronically and at high doses
Rare cases of hepatotoxicity and renal toxicity
