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Pathology > Anti-inflammatory drugs > Flashcards

Anti-inflammatory drugs Flashcards

1
Q

NSAIDs are like which drug?

A

Aspirin like

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2
Q

What do NSAIDs inhibit?

A

COX enzyme
Prostaglandin synthesis
Thromboxane synthesis

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3
Q

NSAIDs inhibit COX, prostaglandins and thromboxanes. What affects do NSAIDs have on blood vessels?

A

Vasodilation

Increased vascular permeability

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4
Q

What do COX enzymes do?

A

Synthesise prostaglandins, which cause inflammation

NSAIDs - inhibit COX

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5
Q

What are NSAIDs used to treat?

A

Pain, inflammation and fever

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6
Q

What do anti-inflammatories do?

A

Prevent prostaglandin and prostacyclin synthesis

Cause vasodilation - oedema

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7
Q

What do analgesics do to cause pain relief?

A

Inhibit prostaglandin

Decreases sensitivity of nociceptive nerve endings to inflammatory mediators

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8
Q

Give an example of an inflammatory mediator

A

Bradykinin

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9
Q

When are prostaglandins produced? What do they cause?

A

In response to injury or infection - causes inflammation and fever

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10
Q

Antipyretics reduce fever by reducing prostaglandin. What releases prostaglandins in the CNS? How does prostaglandin cause fever?

A

IL-1 releases prostaglandins in CNS

Prostaglandins raise hypothalamic set point of temperature

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11
Q

What type of enzyme is COX1? What is it involved with?

A

Constitutive enzyme

Homeostasis

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12
Q

What type of enzyme is COX2? Where is it produced? What is it responsible for?

A

Induced enzyme
In inflammatory cells
Responsible for prostanoid-mediators of inflammation

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13
Q

NSAIDs work by inhibiting COX and prostanoid (prostaglandin, thromboxane) synthesis. Do NSAIDs inhibit COX1 or COX 2? What is the significance of this?

A

Either or both
Inhibiting COX 2 causes anti-inflammatory. antipyretic and analgesic effects
COX 1 causes side effects
Drugs that are specific COX 2 inhibitors aren’t very common yet

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14
Q

How are NSAIDs administered? Why are they given like this, and not as injections?

A

Oral -weak acids easily absorbed from GI tract

Injectable solutions tend to be alkaline - painful

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15
Q

NSAIDs are distributed by binding to which protein?

A

Albumin

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16
Q

How are NSAIDs eliminated?

A

Urine and faeces

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17
Q

When are adverse effects of NSAIDs experienced?

A

When using large doses for a long period of time

18
Q

Can be paracetamol be used in cats and dogs?

A

Dogs only- with care

19
Q

Is ibuprofen used in small animals?

A

No - not licensed as too many adverse effects

20
Q

Which NSAID drugs cause poisoning in small animals?

A

Aspirin
Paracetamol
Ibuprofen

21
Q

What are the adverse affects of using NSAIDs such as ibuprofen, paracetamol and aspirin in small animals?

A

Toxicity - renal and hepatic
GI ulceration
CNS depression
Circulatory disturbances

22
Q

How does NSAID use cause gastric ulceration?

A

Inhibit prostaglandins
Prostanglandins protect mucosa and inhibit gastric acid secretion
NSAIDs = decreased gastric mucosal production and increase gastric acid production

23
Q

When are NSAIDs contraindicated?

A

Renal, liver, cardiac impairment
Pregnancy
If taking glucocorticoids- don’t use NSAIDs and glucocorticoids together!

24
Q

Why should NSAID use be very careful in cats?

A

Cats lack the enzymes required that safely metabolise the drug

25
Q

How does aspirin work? (What enzyme does it affect)

A

COX 1 inhibitor

less side effects

26
Q

What does aspirin cause?

A

Anti-inflammation and anti-thrombotic effects

27
Q

Aspirin itself is inactive but is metabolised to an active form. What is its active form?

A

Salicylic acid

28
Q

What are the adverse effects of aspirin? (Fewer than other NSAIDs as COX 1 inhibitor)

A

GI upset
Vomitting
Ulceration
Anorexia

29
Q

Why should aspirin not be given before surgery?

A

Antithrombotic effects - could cause haemorrhage

30
Q

What is the only licensed NSAID drug in cats? How does it work?

A

Meloxicam

COX 2 inhibitor

31
Q

What is meloxicam used for? Where is it metabolised?

A

Acute/chronic pain and inflammation

Liver

32
Q

How does firocoxib work? What is it used to treat?

A

Selective COX-2 inhibitor

Acute or chronic pain and inflammation

33
Q

Where is firocoxib metabolised and excreted?

A

Metabolised in liver

Excreted in faeces

34
Q

What is the drug commonly known as bute? What does it inhibit?

A

Phenylbutazone

COX 1 AND COX 2

35
Q

Why is phenylbutazone popular in dogs and horses?

A

Cheap
Very effective pain killer and local anti-inflammatory
Long duration (long half life)

36
Q

Which animals is phenylbutazone not licensed in? Why?

A

Food production animals

Long half life

37
Q

What are paracetamols actions?

A

Antipyretic
Analgesics
(Poor anti-inflammatory!)

38
Q

Does paracetamol have many adverse effects?

A

No - hence popularity in humans

39
Q

How does paracetamol work?

A

Inhibit prostaglandin synthesis in BRAIN only

40
Q

Where is paracetamol metabolised? Why should paracetamol not be used in cats?

A

Liver

If not metabolised in liver, converted to toxic compound that kills hepatocytes

Pathology (22 decks)

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