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Pharmacology > Module 5: Anti-inflammatory and pain reducing drugs > Flashcards

Module 5: Anti-inflammatory and pain reducing drugs Flashcards

1
Q

_______________pain occurs from a noxious stimulus and _______________pain is complex but is pain over a prolonged period of time.

A

Acute, chronic

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2
Q

Pain from skin, muscles and bones is known as _______ pain whereas pain from organs is known as ____________ pain.

A

somatic, visceral

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3
Q

Glucocorticoids

A

have a role in metabolism and antiinflamation

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4
Q

have a role in sodium and fluid retention.

A

Mineralcorticoids

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5
Q

Steroid anti-inflammatories block the action of _____________ and non-steroidal anti-inflammatories block the action of _________________ on the inflammatory pathway.

A

phospholipase, cyclooxyrgenase

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6
Q

If high doses of glucocorticoids are given long term, iatrogenic _________ disease may result

A

cushings

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7
Q

If glucocorticoids are stopped suddenly, iatrogenic ____________ disease may result.

A

addisons

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8
Q

prednisone is given to __________

A

dogs

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9
Q

Prednisolone Is given to ___________

A

CATS

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10
Q

COX-2

A

catalyze the production inflammatory prostaglandins

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11
Q

COX 1

A

catalyze the production of prostaglandins for GI mucosa protection, kidney blood flow maintenance and platelet function maintenance

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12
Q

H1 receptors

A

constrict extravascular smooth muscle and mediate immune reactions associated with allergy

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13
Q

H2 receptors

A

increase gastric acid secretions

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14
Q

Affinity

A

the measure of the strength at which the drug binds to its receptor

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15
Q

potency

A

The measure of the amount of drug to produce a desired effect. (dose needed)

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16
Q

Efficacy

A

The drug’s capability to produce an effect

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17
Q

Activity

A

the ability of that drug to cause action in or on a cell which the receptor is found.

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18
Q

Side effects of NSAID

A

GI ulceration
Vomiting
Nephrotoxicity

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19
Q

using an NSAID, opioid and gabapentin is an example of

A

multimodal pain control

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20
Q

What are indications for glucocorticoids?

A

Inflammation

Neoplasia

Pruritis

Allergy

Immune-mediated Diseases

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21
Q

Acetaminophen is not a(n):

A

antinflammatory

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22
Q

Are steroids or NSAIDs a better analgesic?

A

NSAIDS

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23
Q

NSAIDS and steroidal anti-inflammatories do not cure disease, just treat the symptoms. (t/f)

A

true

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24
Q

is butorphanol a potent pain control?

A

NO

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25
Q

Administering NSAIDS with corticosteroids increases the possibility of adverse GI mucosa effects.

A

True

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26
Q

steroids are an immunosuppressant (t/f)

A

true

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27
Q

Preventative pain control is when you use a combination of drugs from different classes that target different sites along the nociceptive pain pathway.

A

false

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28
Q

Full Agonists include

A

Morphine
Hydromorphone
Oxymorphone
Hydrocodone
Fentanyl
Methadone
Codeine

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29
Q

Buprenorphine is a :

A

partial mu agonist

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30
Q

Butorphanol is a :

A

mixed agonist/antagonist

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31
Q

Tramadol is a :

A

atypical opiod

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32
Q

Loperamide

A

non analgesic opiod

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33
Q

Naloxone is a :

A

opioid antagonist

34
Q

compare Corticosteriods vs NSAIDs

A

Corticosteroids:
inhibit phospholipase, are naturally produced in body, dont provide a significant amount of analgesia, many adverse affects

NSAIDS: inhibit cycloxygenase, are not produced in body naturally, not immunosuppressant, does provide analgesia, gi effects primarily,

35
Q

transduction

A

The conversion of a stimulus to a nerve impulse by nociceptors.

36
Q

Transmisson

A

The movement of the nerve impulse to the spinal cord by neurons.

37
Q

Modulation

A

The increase or decrease of the nerve impulse by the spinal cord.

38
Q

perception

A

The interpretation of the nerve impulse as pain.

39
Q

Mu vs kappa receptors:

A

Mu: Cause analgesia, euphoria, respiratory depression, physical dependence, and hypothermia when stimulated

Kappa: Cause spinal analgesia, sedation, and depression when stimulated

40
Q

Antagonists:

A

reverse the effects of other opiods

41
Q

partial mu agonist

A

Opioid type, Affinity for some receptors but not others

42
Q

Mu

A

Receptor, most profound analgesia, primarily in spinal cord and respiratory centers,

43
Q

Neuroleptanalgesia

A

Using a sedative with an analgesic for more profound sedation and potentially better analgesia.

44
Q

morphine

A

Full mu agonist

Naturally occurring opiate.

Used in severe pain treatments, preanesthetic and anesthesia (epidural).

IV, IM, SQ, epidural (24 hours), Intra-articular, oral

Lasts 4-6 hours

May cause histamine release if IV rapidly (vasodilation and hypotension)

Avoid in animlas at risk of aspiration risks and in elevated intracranial pressure.

Causes dysphoria in cats

Vomiting lessis less common in painful patients.

Respiratory depression

Vagal tone bradycardia

45
Q

Full mu agonist

5-7x morphine potency

Synthetic (opioid)

Does not cause histamine release

IV, IM, SQ

Lasts 2-4 hours

More sedation and less vomiting than morphine

Causes respiratory depression and, bradycardia and vomiting

May cause hyperthermia in cats

A

Hydropmorphone

46
Q

Full Agonist

10X morphine potency

Dogs primarily

IV, IM, SQ

Sedation, restraint, analgesia

Lasts 3-6 hours

Respiratory depression, bradycardia, vomiting

A

Oxymorphone

47
Q

Full Agonist

Antitussive

Lasts 6-12 hours

Comes in syrup form, caution with additives!

A

Hydrocodone

48
Q

Full mu agonist

100x morphine potency

Available as injection or transdermal patch:

It is an art to get them to stick!

IV: lasts 20-30 minutes.

Side effect: GI effects, respiratory depression, skin irritation from patch

A

Fentanyl

49
Q

Opioid and is a NMDA receptor antagonist

Lasts 3-6 hours

Less sedation, less vomiting

A

methadone

50
Q

Full mu agonist

Antitussive

Mild pain control in dogs

Lasts 4-8 hours

May be combined with acetaminophen (not for cats!)

A

codeine

51
Q

Partial mu agonist

30X morphine potency

Lasts 4-6 hours

IV, IM, Epidural, TM

Ceiling effect

Remarkably high affinity for Mu receptors

May prevent other mu agonists from binding.

Difficult to reverse

Significant first pass liver metabolism

A

buprenorphine

52
Q

Kappa agonist, mu antagonist

Antitussive and MILD pain in dogs

Lasts 20-90 minutes in dogs and cats

Moderate pain in birds and horses- they have more kappa receptors.

Can be used as a reversal agent for pure mu agonists!!

Should not be the only analgesic in painful patients.

Ceiling effect

Less respiratory depression

A

butorphanol

53
Q

Atypical Opioid

Not an effective analgesic in dogs due to inadequate production of M1 metabolite

Dysphoria in cats

Increased chance of serotonin syndrome with serotonin drugs

A

tramadol

54
Q

Opioid Antagonist

Higher affinity for mu and kappa opioid receptor sites!

Displaces and prevents binding of opioids

Treats respiratory and CNS depression

Reverses all analgesia!

Lasts 30-60 minutes – continue observation beyond this time as opioids may last longer!!

Buprenorphine has an even higher affinity!

A

Naloxone

55
Q

A short -acting glucocorticoid

A

HYdrocortisone

56
Q

A long-acting glucocorticoid

A

dexamethasone

57
Q

A class of drugs used for:
Inflammation
Neoplasia
Allergy
Immune-mediated diseases
Pruritus

A

glucocorticoids

58
Q

Help the body retain sodium and water
Not primarily anti-inflammatory
Aldosterone

A

mineralocorticoids

59
Q

Anti-inflammatory

Wear gloves

Can cause birth defects

Causes vasodilation and is anti-inflammatory

Not fully understood

Penetrates the skin

Is an efficient carrier of other drugs

Dimethyl Sulfoxide

A

DMSO

60
Q

NSAID

Selective COX-2 Inhibitors: Coxibs

Post-op pain in dogs and cats.

On label for cats!

Give without food to enhance drug absorption

Onsior

A

robenacoxib

61
Q

NSAID- other

Topical use in horses for joint pain and inflammation

A

Diclofenac Sodium

62
Q

Propionic Acid Derivative NSAID

Used in horses and cattle

Anafen

A

ketoprofen

63
Q

Selective COX-2 Inhibitors: Oxicams

QUITE common in veterinary medicine

Used in dogs for osteoarthritis and post surgically (off label)

Used in cats, but off-label and for short durations

Caution in cats, often lower doses.

Gaining popularity in calves after dehorning!

Caution with liver, kidney, cardiac and GI problems.

Metacam

A

Meloxicam

64
Q

carprofen

A

NSAID

Preferential COX-2 inhibitor in dogs

Caution in Labrador Retrievers may result in liver toxicities

Assess liver enzymes

Rimadyl

65
Q

NSAID

Selective COX-2 Inhibitors: Coxibs

Used in dogs after orthopedic surgery, dental procedures and for arthritis.

Give after a meal

Deramaxx

A

Deracoxib

66
Q

NSAID

Selective COX-2 Inhibitors: Coxibs

Used in dogs and horses for osteoarthritis

Horses need a fraction of the dose that dogs do!

Caution in pre-existing renal, hepatic, and cardiac disease

A

Firocoxib

67
Q

NSAID

Advil

Not approved in veterinary species, not commonly used

A

ibuprofen

68
Q

NSAID- other

Used in horses, cattle, and swine

Common in Horses, Used for musculoskeletal pain and colic.

IV or oral only, IM can result in tissue inflammation in horses.

Used in Cattle for fever, inflammation, and pain.

IV only in cattle due to withdrawal time

Often combined with antibiotics for various treatments

Potent COX inhibitor

Banamine

A

flunixin

69
Q

Pyrazolone derivative NSAID

Common in horses

Analgesic, anti-inflammatory, antipyretic.

AVOID EXTRAVASIATION- NECROSIS!

IV, oral

GI ulceration is a common side effect, often given with omeprazole to prevent this

Not for food animals, can cause blood disorders in humans

“bute”

A

Phenylbutazone

70
Q

Relatively new

NSAID

Does not block COX enzymes, is an EP4 prostaglandin antagonist.

Used for osteoarthritis in dogs.

Not for cats

Still have adverse GI effects

Galliprant

A

Grapiprant

71
Q

They are used for analgesia, inflammation and as an antipyretic.

Inhibit the activity of cyclooxygenase enzymes which then inhibits prostaglandins.

Not produced endogenously

Not immunosuppressing

Usually give with food, robenacoxib is an exception

A

NSAIDS

72
Q

Anti-pyretic

Not anti-inflammatory

Thought to reduce the perception of pain

Use is rare in vet med

Hepatoxic

Very toxic to cats! Methemoglobin! Brown gums! Death!

A

acetaminophen

73
Q

NMDA Antagonist

Decreases sensitivity to pain

Pain preventative

Used in CRIs

On label for cats, not dogs!

Adjunctive pain control

A

ketamine

74
Q

Type of analgesic

Used to provide pain control to localized areas

Can be injectable, topical, transdermal

A

local anestheitc

75
Q

Group of Disease Modifying Osteoarthritis Drugs (DMOAD)

Inhibits catabolic enzymes that destroy cartilage and improve lubrication

Cartrophen

Adequan

Pentosan polysulfate

Newer uses in bladder discomfort (cystitis)

A

polysulfated glycosaminoglycans

76
Q

Nutraceuticals, two of them

Used to maintain cartilage structure and function

Supplements or added to food.

A

Glucosamine and chondroitin

77
Q

Muscle Relaxant

Robaxin

Used in conjunction with other pain drugs

Common for back pain.

A

methocarbamol

78
Q

Immunosuppressant

Used in dogs and cats

Used for atopic dermatitis and other immune-mediated disease

Anti-inflammatory and antipruritic

Taper to lowest effective dose,

Vomiting common, give with food (or freeze) to reduce

Atopica®

A

cyclosporine

79
Q

Inhibits activity of Janus kinase enzyme which is involved in the production of pruritic cytokines.

Stops the itch!

Twice a day for two weeks then once a day longer term

May increases risk of infection or neoplasms

Apoquel

A

oclacitinib

80
Q

May inhibit growth of some tumor cells.

Used in urinary bladder carcinoma and squamous cell carcinoma.

NSAID.

A

piroxicam

Pharmacology (12 decks)

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