NSAID Flashcards
What is the primary use of NSAIDs?
Primarily used for acute, mild to moderate pain associated with inflammatory conditions e.g. degenerative joint disease, dental and oral disease, surgical incision etc.
What is NSAID’s primary mechanism of action in the body?
Blocking of prostaglandin formation via the inhibition of cyclooxygenase enzyme (COX-1 and COX-2) in the arachidonic acid cascade.
What hemostatic functions does COX-1 and COX-2 serve?
COX-1 is involved in hemostatic functions such as renal blood flow, gastrointestinal cytoprotective mechanisms and platelet aggregation.
COX-2 is activated by inflammatory cells and triggers the production of inflammatory prostaglandins that contribute to peripheral sensitization and gastric ulceration.
What are some examples of NSAIDs approved for use in dogs?
Carprofen, deracoxib, etodolac, firocoxib, meloxicam, tepoxalin (inhibitis COX and lipoxygenase LOX),and mavacoxib - all have more selectivity for COX-2 inhibition but some also have weak COX-1 inhibition (Carprofen, etodolac)
Why do cats not metabolise NSAIDs as well as dogs?
They have a deficiency in glucoronyl transferase enzymes.
What NSAID is approved for use in cats in the US?
Robenacoxib - can only be given for a maximum of 3 days.
What are the most widely reported side effects of NSAID administration?
Gastrointestinal toxicity in the form of: gastritis, vomiting, and diarrhea, GI ulceration (severe) and GI perforation.
Usually caused by inappropriate dosing, concurrent administration of another NSAID and/or corticosteroid.
Why should NSAID only be given in patients who are adequately hydrated and avoided in patients with hypoalbuminemia?
Prostaglandins play a role in regulation of normal renal function but maintaining renal blood flow, hence NSAIDs are best avoided in hypotensive, hypovolemic and patients in renal disease.
NSAIDs are also highly protein bound.
What are the long term side effects of NSAID use?
Hepatoxocity and hepatpathy. HOWEVER, increases in liver enzyme does not necessarily mean decreased liver functions hence more test required to determine this (e.g. serum bile acids and ammonia concentration).
