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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
COX1 sparing/cox2 inhibitor drugs have less likely to cause
Increased risk of cardio events with COX2 selective drugs Thromboemboli (People problem)
26
Injection site reaction
Common in horses Swelling, abscess, clostridial myositits, tissue necrosis Phenylbutazone Fluxinin meglumine
27
Minimizing adverse effects
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
Underlying diseases to show extreme caution when dosing
Sub clin renal disease, GI disease, liver disease Anorexia, dehydration
29
Acetylsalicylic acid
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
What drug should you not give IM to horses?
Flunixin Can cause major myonecrosis from IM injection
31
Flunixin meglumine Formulation, species, side effects
Oral - horses Parenteral - horses, rum, pigs Transdermal - rum Treats orthopedic or soft tissue pain, visceral pain, endotox, pyrexia
32
Phenylbutazone Formulation, species, side effects
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
Ketoprofen
Parenteral - horses, rum Muscle pain, pyrexia w BRD Least ulcerogenic in foals
34
Carprofen Formulation, species, side effects
Cox 2 preferential Oral & inject - dogs Ortho/soft tissue pain, OA, pain/inflammation Anti-thromboxane activity Idiosyncratic hepatic toxicosis
35
Meloxicam Formulation, species, side effects
Cox 2 preferential Oral, transmucosal - dogs Parenteral - cats & dogs OA, muscle pain/inflame, ortho/soft tissue surgery
36
Deracoxib Formulation, species, side effects
Cox 2 selective Oral - dogs Post op pain, OA pain, synovitis GIT perforation, ^ coagulability Never co admin w GC or NSAIDS
37
Firocoxib Formulation, species, side effects
Cox 2 selective Tablets - dogs & horses Paste, parenteral - horses OA, synovitis, soft tissue pain/inflame Takes long time to act (day 15)
38
Robenacoxib Formulation, species, side effects
Cox 2 selective Oral, parenteral - cats & dogs OA, muscle pain, othro/soft tissue surgery Superior to Meloxicam Non toxic in cats
39
Drugs that are COX 2 selective
Robenacoxib Firocoxib Deracoxib
40
Drugs that are cox 2 preferential
Meloxicam Carprofen
41
Nonselective drugs
Phenylbutazone Flunixin meglumine Acetylsalicylic acid (aspirin)

Moving Exam 2 (26 decks)

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