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Moving Exam 2 > Nonsteroidal Anti-inflammatory Drugs > Flashcards

Nonsteroidal Anti-inflammatory Drugs Flashcards

1
Q

NSAIDS

A

Commonly prescribed
Diverse class
Cox inhibitory
- analgesics
- anti inflame
- antipyretic

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2
Q

Approved NSAIDS for dogs

A

Carprofen
Etodolac
Meloxicam
Deracoxib
Firocoxib

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3
Q

NSAIDs approved for cats

A

Meloxicam
Robenacoxib

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4
Q

Approved nsaids in horses

A

Phenylbutazone
Flunixin
Firocoxib
Ketoprofen

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5
Q

Approved nsaids in bovine

A

Flunixin
Ketoprofen

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6
Q

Effects of prostanoids

A

Inflammation
-vasodilation
- ^ vascular permeability
- pain

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7
Q

Effects of prostanoids

A

Homeostasis
GIT protection
Renal perfusion
Platelet aggreagation
Bone formation & healing
Temp regulation

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8
Q

COX1

A

Constitutive enzyme
Normal physiological function

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9
Q

COX2

A

Inducible enzyme
Synthesized by macrophages
Induced by cytokines and inflammatory mediators
=inflame and pain

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10
Q

Cox 1 vs cox 2 inhibition

A

Drugs are categorized based on cox 2 selectivity

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11
Q

nonselective cox inhibitors

A

Phenylbutazone
Flunixin
Aspirin

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12
Q

Cox 2 preferential drugs

A

Meloxicam
Carprofen

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13
Q

COX2 selective drugs

A

Deracoxib
Robenacoxib
Firocoxib

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14
Q

COX1 selective

A

Aspirin

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15
Q

Cox 2 in homeostatic functions

A

Gastric and duodenal Musca
Cox 2 up-regulated in response to inflame
Protective and healing role
Kidney
- cox 2 upregulate in response to renal stress
- important in normal renal function

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16
Q

Potential MOAs

A

Some nsaids may inhibit nuclear factor Kappa-B
Some may inhibit kinase ERK
Physical distribution of cell signaling and protein to protein interactions
Interactions w endo opioid systems

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17
Q

PK for cox inhibitors

A

Oral absorption is high - feeding may effect
High protein bound
Biotransmored by hepatic mechanisms
Clearance varies - plasma vs inflamed tissue
Nonlinear kinetics

18
Q

Examples of drugs impacted by admin w eating

A

Phenylbutazones absoption is delayed
Robenacoxib absorption is inhibited
Grapiprant absorption is increased

19
Q

GI side effects

A

Common in dogs and horses
Nausea, vomiting, diarrhea, inappetence, pain
Diffuse directly into GI mucosa cells = damage
(Indirect mucosal injury) Decreased mucus secretion, diminished blood flow, inhibition of mucosal cell turnover & repair

20
Q

Prognosis for GI side effects

A

Gastritis, enteritits, erosion, ulcers, perforation
Guarded
Typically attributed to super therapeutic doses
Concurrent corticosteroid admin
Concurrent GI disease or Injury
Dehydration
Tolerance - develops

21
Q

Renal side effects

A

Primarily in horses (people)
Decreased renal perfusion, sodiu, and fluid retention
Supra therapeutic dose
Concurrent w corticosteroids admin
Concurrent dehydration, anesthesia, shock
Pre-existing renal disease

22
Q

Hepatic side effects

A

Intrinsic
Acetaminophen and aspirin
Dose dependent and reproducible
Idiosyncratic
Any NSAID, carprofen, not dose dependent

23
Q

Coagulation

A

Inhibition of COX1 decreases TXA2 & platelet function
Perioperative bleeding
COX1 sparing/cox2 inhibitor drugs have less likely to cause

24
Q

Inhibition of COX1 decreases TXA2 & platelet function

A

Acetylated NSAID irreversibly inhibited platelets (7-10d)
Non-acetylated NSAIDS reversibly inhibit platelets

25
Q

COX1 sparing/cox2 inhibitor drugs have less likely to cause

A

Increased risk of cardio events with COX2 selective drugs
Thromboemboli
(People problem)

26
Q

Injection site reaction

A

Common in horses
Swelling, abscess, clostridial myositits, tissue necrosis
Phenylbutazone
Fluxinin meglumine

27
Q

Minimizing adverse effects

A

Dosing appropriately
Ideal drug & formulation
PGE analog (GI protection)
Proton pump inhibitors
Avoid co administration w nephrotoxic drugs
Avoid co administration w NSAIDS or GC

28
Q

Underlying diseases to show extreme caution when dosing

A

Sub clin renal disease, GI disease, liver disease
Anorexia, dehydration

29
Q

Acetylsalicylic acid

A

Nonselective cox 1 selective
Oral
Antithrombotic (lung, laminitis, glaucoma)
OA or musculoskeletal pain
Irreversibly inhibits platelet aggregation (bleeding)
Narrow therapeutic index
Chondrocyte destruction
GIT bleeding/ulceration

30
Q

What drug should you not give IM to horses?

A

Flunixin
Can cause major myonecrosis from IM injection

31
Q

Flunixin meglumine Formulation, species, side effects

A

Oral - horses
Parenteral - horses, rum, pigs
Transdermal - rum
Treats orthopedic or soft tissue pain, visceral pain, endotox, pyrexia

32
Q

Phenylbutazone Formulation, species, side effects

A

Nonselective
Oral - horses
Parenteral - horses
Orthopedic or soft tissue pain
Tissue necrosis w peri vascular injection
Narrow therapeutic index
Highest risk of GI tox

33
Q

Ketoprofen

A

Parenteral - horses, rum
Muscle pain, pyrexia w BRD
Least ulcerogenic in foals

34
Q

Carprofen
Formulation, species, side effects

A

Cox 2 preferential
Oral & inject - dogs
Ortho/soft tissue pain, OA, pain/inflammation
Anti-thromboxane activity
Idiosyncratic hepatic toxicosis

35
Q

Meloxicam
Formulation, species, side effects

A

Cox 2 preferential
Oral, transmucosal - dogs
Parenteral - cats & dogs
OA, muscle pain/inflame, ortho/soft tissue surgery

36
Q

Deracoxib Formulation, species, side effects

A

Cox 2 selective
Oral - dogs
Post op pain, OA pain, synovitis
GIT perforation, ^ coagulability
Never co admin w GC or NSAIDS

37
Q

Firocoxib Formulation, species, side effects

A

Cox 2 selective
Tablets - dogs & horses
Paste, parenteral - horses
OA, synovitis, soft tissue pain/inflame
Takes long time to act (day 15)

38
Q

Robenacoxib Formulation, species, side effects

A

Cox 2 selective
Oral, parenteral - cats & dogs
OA, muscle pain, othro/soft tissue surgery
Superior to Meloxicam
Non toxic in cats

39
Q

Drugs that are COX 2 selective

A

Robenacoxib
Firocoxib
Deracoxib

40
Q

Drugs that are cox 2 preferential

A

Meloxicam
Carprofen

41
Q

Nonselective drugs

A

Phenylbutazone
Flunixin meglumine
Acetylsalicylic acid (aspirin)

Moving Exam 2 (26 decks)

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