Anti-Inflammatory Agents Flashcards
3 phases of inflammation
acute inflammation
immune response
chronic inflammation
Mediators released in acute inflammation
histamine serotonin bradykinin prostaglandins leukotrienes
Chronic inflammation causes
pain
destruction of tissue
disability
Acute inflammation precedes
immune response
2 pathways of mediator synthesis
cyclooxygenase
lipoxygenase
Prostaglandins are
proinflammatory mediators
Cyclooxygenase mediators
COX 1 & COX 2:
prostaglandins
prostacyclins
Thromboxane A2
Lipoxygenase pathway mediators
Leukotrienes
E cosanoids (4) that cause vasoconstriction, bronchospasm and increased permeability
Leukotriene A4
Leukotriene C4
Leukotriene D4
Leukotriene E4
steroids inhibit
phospholipases
12-Lypoxygenase —>
Lypoxin A4
Lypoxin B4
Lypoxin effects
Vasodilation
inhibit neutrophil chemotaxis
stimulate monocyte adhesion
Prostaglandin PGI2 effect
vasodilation
inhibits platelet aggregation
Thromboxane A2 effect
vasoconstriction
promotes platelet aggregation
COX 1 & COX 2 inhibitors inhibit
cyclooxygenase
Prostaglandin G2 —>
Prostaglandin PGI2
Thromboxane A2
PGE2
PGE2 effects
vasodilation
potential edema
NSAIDs block what pathway?
Prostaglandin G2
Steroids block
the entire inflammation cascade
Steroids are superior/in-superior?
superior
Steroids’ side effects are
more systemic
Effect of E cosanoids on vascular muscle
vasodilation or vasoconstriction
Effect of E cosanoids on GI muscle
contraction, colic
Effect of E cosanoids on uterus
contraction
Effect of E cosanoids on pulmonary muscle
constriction
activity of NSAIDs is mediated by inhibition of
prostaglandins
(NSAIDs) inflammation is reduced by
decreasing the release of mediators from granulocytes, basophils and mast cells
NSAID effects
analgesic
anti-inflammatory
antipyretic
inhibit platelet aggregation
NSAIDS irritate
the GI tract
NSAIDs can cause kidney problems by
hypoprofusion
NSAIDs used in horses (7)
- Flunixin meglumine (banamine)
- phenylbutazone
- Ketoprofen
- Naproxen
- Firocoxib
- Aspirin
- Dypirone
prostaglandins cause…
pain, fever
risks of high fever
denature protein
irreversible brain damage
endotoxemia
when bacteria toxins reach the bloodstream - can be life-threatening
preferred NSAID for endotoxemia
banamine
by blocking thromboxane production, NSAIDs help
maintain blood flow in situations where excessive blood clotting causes problems
Bute - pain relief and fever reduction usually starts in
1-2 hours
Bute administration
IV or orally
Bute uses
pain relief, antipyretic, anti-inflammatory
Banamine uses
colic pain
endotoxic or septic shock
anti-inflammatory in eye conditions
fever control due to viral or bacterial infection
Banamine administration
IV
PO
Can banamine cause ulcers?
Yes
Cortisol is produced by the
adrenal cortex
cortisol is synthesized from
cholesterol
Actions of cortisol
proper glucose metabolism regulation of blood pressure insulin release for blood sugar maintenance immune function inflammatory response
Cortisol levels are higher
in the morning
Cortisol is the ______ hormone
stress
Physical response to cortisol
burst of energy heightened memory function increased immunity lower sensitivity to pain maintenance of homeostasis
Chronic stress (prolonged cortisol levels) have negative effects such as
impaired cognitive performance suppressed thyroid function blood sugar imbalances decreased bone density decreased muscle tissue higher blood pressure lowered immune & inflammatory response
metabolic effects of glucocorticoids
carbohydrate, protein and fat metabolism
increase serum glucose
stimulate insulin release and lipogenesis
catabolic effects of glucocorticoids
supraphyiologic amounts of steroids lead to decreased muscle mass and weakness
osteoporosis (Cushing’s)
Anti-inflammatory effect of glucocorticoids
effects concentration, distribution and function of peripheral leukocytes. reduces prostaglandin, leukotriene, etc.
Immunosuppressive effects of glucocorticoids
inhibit macrophages and antigen-presenting cells
antibody production is reduced by ____ doses of steroids
large
Chronic administration of glucocorticoids suppresses
pituitary release of ACTH, HG, TSH and LH
Glucocorticoid side effects
increased body fat: visceral, facial, nuchal and superclavicular
antagonizes effects of vitamin D on calcium absorption
Synthetic corticosteroids are used in the treatment of
inflammatory, allergic and other disorders
Short and medium acting synthetic corticosteroids
cortisone, hydrocortisone, prednisone, prednisolone, medpredisone
Long acting synthetic corticosteroids
dexamethasone
betamethasone
Cushing’s can be due to
excessive secretion of ACTH by pituitary
what causes excessive secretion of ACTH by the pituitary?
Negative feedback (when cortisol levels in blood are adequate) with the adrenal gland (producing cortisol) is impaired by a tumor on the pituitary
Cushing’s symptoms
frail, dry skin fat deposition obesity excessive hair poor wound healing osteoporosis laminitis insulin resistance
How to diagnose Cushing’s
dexamethasone suppression test
horse given high levels - should decrease in normal horse, stays same in Cushing’s horse
How to withdraw a horse from corticosteroids
tapering dosage and increasing time between doses
Corticosteroids suppress
immune response
corticosteroids can/cannot be used on a Cushing’s horse
cannot
Horses use prednisone/prednisolone
prednisolone
Side effects of prolonged corticosteroid use
polyuria
polydipsia
muscle wasting
Side effect usually occur with
long-term administration of the drug, especially at high doses
Corticosteroid preferred administration
alternate day therapy with short acting preparations
Dexamethasone is used in high doses for
anaphylactic shock
spinal chord trauma
Dexamethasone is used in low doses for
allergic reations
inflammation
Fluticasone is used for controlling
heaves
Fluticasone is given as
an aerosol
