Clinical NSAIDs Flashcards
Name the 3 NSAIDs that are safest in cats:
Aspirin: low dose every 72 hours (COX 1 selective)
Robenicoxib: Daily oral (COX 2 selective)
Meloxicam: Once via injection (COX 2 selective)
Name the COX 2 selective NSAIDs and why do these drugs spare the GI tract?
Coxibs; Have no COX 1 activity so they do not inhibit gastric production in the stomach
Name the NSAID that can be used to treat visceral pain:
Flunixin (COX 2 selective)
Preferred drug against colic and is mainly a large animal drug
Name two NSAIDs that can be used vs endotoxemia:
Flunixin: preferred NSAID against endotoxicosis
Tepoxaline: Inhibits COX1, COX2, and LOX
Why is Flunixine preferred against endotoxicosis?
Doesn’t bind to the LPS/endotoxin
Why would you prescribe Carprofen in dogs and what are the major risks?
It’s cheap
Causes reversible hepatotoxicity in labs
Name 2 NSAIDs banned for use in food animals:
Phenylbutazone: excreted for a long time
Dipyrone:
DMSO: banned in dairy cattle
What are some general considerations for the profens?
Most neprhotoxic group and they are generally non-selective
Ibuprofen not safe for veterinary patients
Why did some of the coxibs get removed from the marketplace?
Rofecoxib was withdrawn because of CV issues in humans
It was COX2 selective, which helps maintain vascular integrity
Why is the Rofecoxib issue not an issue with dogs?
They are at no real risk to develop CV disease
Name two coxibs that are used in veterinary medicine
Deracoxib and Firocoxib: best for long term treatment of inflammation with osteoarthritis.
Robenacoxib: Appears to be tissue-specific and targets joints
Why can Deracoxib and Firocoxib be used in patients with renal disease?
It is largely excreted in bile/feces
Name the NSAID that is approved for use in swin:
Flunixin
Name the two NSAIDs preferred in horses:
Flunixin (COX2 selective)
Phenylbutazone (COX2 selective)
Naproxen
Firocoxib and naproxen can also be used
What is the preferred NSAID in horses?
Phenylbutazone
Why is acetaminophen a weak NSAID?
Non-selective inhibitor
Binds to COX2 centrally, but not peripherally
Binds to COX3
Does not bind to COX1
Why is the route of administation an advantage for MEloxicam?
It is an oral suspension tat can be dropped into food or used as a transmucosal spray
Why is the route of administration an advantage for robenacoxib/
This is available as an injectable
What is unique about Tepoxaline? Why is it gastroprotective?
Inhibits COX1, COX2, and LOX
Inhibition of LOX makes it gastroprotective
What is a unique clinical application of piroxicam?
COX 2 selective used in dogs against bladder cancer, specifically transitional cell carcinoma
What can piroxicam be combined with?
Misoprostol: GI protectant
What is the only safe NSAID for long term use in cats?
Aspirin: low dose every 72 hours
What is the obstacle with long term phenylbutazone tx in horse?
They can develop a tolerance to it
Describe how ketamine could be an adjunct to treat endotoxicosis
Prevents PMN-LPS interaction; can be used with Flunixin
Why does aspirin cause such profound bleeding disorders/
Selective COX1 inhibition; platelets cannot create more COX1 which is important for aggregation
What are some NSAIDs that should not be used in pregnant animals?
Carprofen
Ketoprofen
Why should Carprofen or Ketoprofen not be used in prehnant animals?
Inhibit PGF2alpha, which is needed for partruition, thus prolonging the pregnancy
What is the clinical application of DMSO?
Inhibits prostaglandins and scavenges free radicals
What can DMSO be combined with to treat otic conditions?
Corticosteroids
What is a precaution with DMSO?
Makes everything smell/taste like garlic; prohibited in dariy cows
What NSAID is best for long-term use in dogs?
Deracoxib and Firocoxib: inflammation and pain of osteoarthritis
What are the “profens”?
Ibuprofen
Ketoprofen
Carprofen
Naproxen
What are the oxicams?
Meloxicam (cats and dogs)
Piroxicam (dogs)
What are the coxibs?
Rofecoxib (BAD in humans)
Deracoxib
Firocoxib
Robenacoxib
What are the miscellaneous agents from this lecture?
Tepoxaline
Etodolac (CHEAPEST COX2)
DMSO
Dipyrone (banned in FA)
