Equine Anti-inflammatory Drugs

Question 1

What type of anti-inflammatory reduces biosynthesis of prostaglandins by inhibiting cyclooxygenase (COX)?

Answer 1

NSAIDS

Question 2

Cyclooxygenase (COX) converts _________ into prostaglandins, which participate in generating inflammation and fever.

Answer 2

Arachidonic acid

Question 3

Cyclooxygenase enzyme type that is found in all tissues and forms constitutive prostaglandins that mediate various physiologic effects such as hemostasis, GI mucosal protection, and protection of the kidney from hypotensive insult.

Answer 3

COX-1

Question 4

Cyclooxygenase enzyme type that is activated in inflamed and damaged tissues and catalyzes formation of inducible prostaglandin (PGE2) to intensify the inflammatory response.

Answer 4

COX-2

Question 5

Cyclooxygenase enzyme involved in thermoregulation and the pain response to injury.

Answer 5

COX-2

Question 6

Because NSAIDS compromise the body’s natural protective mechanisms, some potential side effects are:

Answer 6

Toxicity
Colic
Protein loss
Diarrhea
Gastric ulcers
R dorsal colitis
Renal papillary necrosis

Question 7

What are the 3 NSAIDS used in equine medicine?

Answer 7

Flunixin Meglumine
Phenylbutazone
Ketoprofen

Question 8

While most NSAIDS used are both COX-1 and COX-2 inhibitors, this drug is strictly a COX-2 inhibitor, which leads to less negative side effects.

Answer 8

Previcox/Equioxx (firocoxib)

Question 9

Most frequently used drugs for abdominal pain in horses

Answer 9

Flunixin meglumine

Phenylbutazone

Question 10

This drug is a derivative of nicotinic acid, has analgesic and antipyretic effects, and is the ONLY NSAID approved for use in cattle.

Answer 10

Flunixin meglumine

Question 11

A client’s horse just got out of its stall and overloaded on grain. Which NSAID will you administer to prevent systemic effects of endotoxemia?

Answer 11

Flunixin meglumine

*Studies show that pretreatment with FM prevents occurrence of clinical signs related to endotoxemia.

Question 12

Although the analgesic dose of FM is 1.1 mg/kg IV, a low dose of 0.25 mg/kg TID can be indicated for endotoxemia as it reduces these potential side effects:

Answer 12

GI ulceration
Ileus
Renal papillary necrosis

Question 13

NSAID with analgesic and antipyretic effects that can be given only once per day and is common for use in foals:

Answer 13

Ketoprofen

Question 14

Equioxx (firocoxib) was specifically formulated for horses for which ailment?

Answer 14

Navicular disease

Question 15

A foal with a severe Rhodococcus respiratory infection that won’t respond well enough to NSAIDS and antibiotics can be given _______ for a stronger anti-inflammatory effect.

Answer 15

Corticosteroids

Question 16

Mechanism of action of corticosteroids:

Answer 16

altering mRNA synthesis

Question 17

T/F: Dexamethasone can be given with a nebulizer for faster onset without being absorbed systemically?

Answer 17

TRUE

Question 18

Corticosteroids are anti-inflammatory by suppressing:

Answer 18

the immune response: leukocyte migration and function

Question 19

What mechanism of action makes corticosteroids, applied topically, good for wounds that are healing too quickly and form too much granulation tissue (proud flesh)?

Answer 19

Reduction of fibroblastic activity, collagen synthesis, and tissue repair

Question 20

Corticosteroids directly suppress the immune system in what ways?

Answer 20

Decreased cytokine production

Decreased phagocytic activity of macrophages

Suppressed neutrophil function

Question 21

Glucocorticoids stimulate gluconeogenesis, increasing lipolysis and redistribution of lipids, leading to:

Answer 21

hyperglycemia

Question 22

Why should caution be used when giving glucocorticoids to insulin resistant animals?

Answer 22

Causes hyperglycemia, which should trigger insulin secretion. In animals that are already insulin resistant, hyperglycemia is not counteracted.

*Long term administration can also damage B-cells of the pancreas!

Question 23

How does corticosteroid use lead to PU/PD?

Answer 23

Decreased osmoreceptor sensitivity leads to reduced ADH secretion.

Question 24

How do corticosteroids result in osteoporosis and bone fracture?

Answer 24

Inhibit Ca++ absorption from the gut

Inhibit Ca++ reabsorption in the renal tubules

Hypocalcemia = PTH secretion = bone resorption

Apoptosis of osteoblasts

Question 25

T/F: Because corticosteroids increase expression of B2 receptors, they can replace traditional bronchodilators such as Albuterol

Answer 25

FALSE

The bronchodilatory effects are not significant enough to warrant using corticosteroids instead of a bronchodilator.

Question 26

What is the consequence long term corticosteroid use has on skeletal muscle?

Answer 26

Muscle wasting due to muscle protein breakdown