Exam 5: NSAID Toxicosis Flashcards

1
Q

What is toxicology?

A

The study of adverse effects of chemical or physical agents on living organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a toxin?

A

Toxic substance produced by biological systems (plants, animals, fungi, bacteria)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a toxicant?

A

Toxic substance made by man

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is toxicity?

A

The degree to which a substance can damage an organism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is toxicosis?

A

The disease state that results from exposure to a toxin or toxicant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is toxicokinetics?

A

The rate a toxin or toxicant will enter the body and what happens to it when it is in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is venom?

A

A toxin that is injected from a living organism into another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does NSAID stand for?

A

Non-steroidal anti-inflammatory drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe NSAIDs

A

Anti-inflammatory
Analgesic
Antipyretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are examples of NSAIDs?

A
Carprofen
Meloxicam
Deracoxib
Firocoxib
Robenacoxib
Aspirin
Ibuprofen
Naproxen sodium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What would indicate that NSAIDs should be used?

A

Acute pain (surgery, injury)
Chronic pain (arthirits, neoplasia)
Inflammation
Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What can cause toxicosis in animals?

A

Human NSAIDs
Flavored medication
Accidental over dosage
Potentiating factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are potentiating factors that can cause toxicosis?

A

Concurrent corticosteroids (number 1 problem)
Multiple NSAIDs
Dehydration
Hypovolemia
Concurrent medications that may affect renal physiology
Pre-existing renal/GI disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do NSAIDs help with inflammation?

A

They inhibit prostaglandins via COX enzyme inhibition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does COX1 do?

A

Renal perfusion
Gastric mucus secretion
Platelet function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does COX2 do?

A

Mediation of pain, fever, and inflammation

Neoplasia

17
Q

What are the highly selective drugs?

A

Firocoxib
Robenacoxib
Deracoxib

18
Q

What are the moderately selective drugs?

A

Meloxicam
Carprofen
Etodolac

19
Q

What are the drugs with little to no selectivity?

A

Aspirin
Piroxicam
Ketoprofen

20
Q

Which drugs are more selective, newer or older drugs?

21
Q

What can NSAID toxicosis cause?

A
Gastric ulceration (dose dpendent)
Acute renal failure (dose dpendent)
Neurotoxicosis (dose dpendent)
Hepatic injury
22
Q

What occurs with gastric ulceration?

A

Topical irritation
Disruption of gastric mucosa barrier
Delayed healing
Increased bleeding

23
Q

What happens with acute renal faiulre?

A

NSAID induced decreased GFR

Prostaglandins cause dilation of renal afferent arteriole

24
Q

How do you treat NSAID toxicosis that is acute?

A

Emesis
Activate charcoal
Supportive therapy to protect the kidneys, GI tract
Treat secondary problems

25
What is the supportive management used for GI?
Misoprostol Sucralfate H2 antagonists Proton pump inhibitors
26
What is the supportive management used for renal?
Fluid diuresis with isotonic fluids at 1.5-2.5x maintenance Monitor electrolytes, renal values, "in and outs", and weight Manage acid/base imbalances Maintain fluid therapy until values decline
27
What is the long term management for NSAID toxicosis?
Dietary management (reduced protein and phosphorus) SQ fluids Famotidine/omeprazole, monitor bloodwork