Anti-Inflammatory Drugs Flashcards
When are mediators recruited
Within the first 24 hours
Pruritis
Itchy skin
Cytokines
Peptides that often work in the medium-long term. Cause production of acute-phase proteins when released into the circulation (inflammatory proterties) and elevate temp through liver
Chemokines
Chemoattractant cytokines that cause inflammatory cell recruitment
Cytokine and chemokine action
Increase blood flow and vascular permeability but MAINLY cause cell recruitment and activation
Stored in Mast Cells
Histamine
Histamine inflammation receptor type and anti-inflammatory drug type
H1 histamine receptor. Anti-histamine antagonist
Emetic
Vomiting
Lipid Mediators causing inflammation
Prostaglandin, leukotrienes, and Platelet-activating factors (PAF)
Prostaglandin Synthesis
Cell membrane phospholipid + phospholipase A2 -> arachidonic acid, this is acted on by COX to create prostaglandin
NSAIDs
Non-Steroidal Anti-Inflammatory Drugs
How do NSAIDs block inflammation
They block COX from acting on arachidonic acid, the last step in prostaglandin synthesis
Synthesis of Leukotrienes (LTs)
Arachidonic acid acted on by 5-LO
How to block leukotrienes (LTs) Inflammation
Leukotriene D4 (LD4) receptor antagonist
What are the main Leukotriene receptor antagonists
Monolukast and Zafirlukast. Reduce bronchoconstriction/asthma
Analgesia
Relieves pain
What does COX inhibition lead to
Decreased vasodilation/swelling/fever, analgesia, and has little effect on the cellular changes in inflammation
Cox-1
Constitutive type that drives the physiological response. Does not specifically target the inflammatory response
Selective Cox-2 inhibitors
Inducible type. Block inflammation at specific sites
Examples of NSAIDs used in Large and Small Vet Med
Carprofen, ketoprofen, meloxicam
Pharmacokinetic considerations of NSAIDs
Highly protein plasma bound. Do not use an NSAID within 24 hrs of another NSAID. Avoid use in dehydrated patients
Side Effects of NSAID
Damage to GIT, Nephrotoxicity, Hepatotoxicity
What do glucocorticoids mimic
The actions of cortisol
What is cortisol
The natural inhibitor of the inflammatory response
Glucocorticoids mechanism of action
Decrease the production of pro-inflammatory mediators, release of inflammatory mediators/cells, and circulating complement components
Clinical uses of corticosteroids
Allergic disease or anaphylaxis, topical, or chronic inflammation. Immunosuppression
Contra-indicators using corticosteroids
Renal disease or diabetes mellitus
Avoid corticosteroid use in…
Pregnant animals, immediately after surgery, or without being paired with an antibacterial in animals with bacterial infections
1 Side effect of Corticosteroids
Suppression of wound healing, induction of iatrogenic Cushings syndrome in long term use
2 Side Effects of Corticosteroids
Suppression of endogenous steroid production.
Attention Points of Lecture
Most anti-inflammatory drugs only provide symptomatic relief. They have long-term side effects. Focus and treat the underlying causes of the clinical problem
