NSAID Dosing/Overdosing

Question 1

What are the labeled uses of deracoxib, firocoxib, and carprofen in dogs?

Answer 1

(Post-op pain/inflammation and osteoarthritis)

Question 2

What is the labeled use for meloxicam in dogs?

Answer 2

(Osteoarthritis)

Question 3

Dogs weighing less than what value in pounds cannot be accurately dosed with firocoxib?

Answer 3

(12.5 pounds)

Question 4

Both meloxicam and onsior/robenacoxib are labeled for use in cats for what purpose?

Answer 4

(Postoperative pain and inflammation associated with surgery)

Question 5

You placed a cat on a low dose of meloxicam for chronic pain and the owner comes to you bitching about the black box warning they found on the paper inserts and how you’re trying to kill their cat, what do you say?

Answer 5

(Karen that black box label is pertinent to the label dosing (0.3 mg/kg) which we are not following for your cat with chronic pain (0.05 mg/kg or lower) which is written clearly on your discharge paperwork that probably burned to ashes in your witchy presence, gtfo)

Question 6

If a cat you put on low dose meloxicam for chronic pain has not responded by 2 weeks, what should you do next?

Answer 6

(Discontinue the meloxicam, try something else; same for onsior but 6 weeks instead of 2 weeks)

Question 7

If you want to put a cat on onsior for long term management of chronic pain, how can you get around the minimum dose being 1 mg/kg because the tablets cannot be split?

Answer 7

(Can lengthen the dosage intervals)

Question 8

A horse should not receive more than how many grams of phenylbutazone per day?

Answer 8

(4 grams, everything else from the label is shit)

Question 9

(T/F) Transdermal flunixin meglumine has been shown to not be effective when used for horses/donkeys.

Answer 9

(F, both horses and donkeys absorb the transdermal form and it is a good option for needle shy and picky eaters; can you imagine the 460 accidents if they used transdermal banamine on an ACE horse and didn’t take them off those pastures?)

Question 10

Why is firocoxib not recommended for acute pain in horses?

Answer 10

(Bc the half life is long, it takes forever to reach steady state = takes at least 3 days to see a clinical response; can get around that by using a loading dose)

Question 11

How should firocoxib injectable solutions be administered?

Answer 11

(Either directly IV or through a catheter, why? bc it precipitates out in aqueous solutions i.e. any fluids you’re administering to the horse)

Question 12

What are Equioxx tablets (57 mg) commonly used for?

Answer 12

(Chronic OA in older horses, make sure giving the Equioxx tablets and not large previcox tab (227 mg) bc can cause renal dz, RDC, and GI ulcers at doses of 0.2 mg/kg or higher)

Question 13

(T/F) Firocoxib and meloxicam are cleared slower in foals so a lower dose range is recommended for use in foals.

Answer 13

(F, cleared faster so their minimum dose is actually higher than adults (0.2 mg/kg q12h)

Question 14

(T/F) Ketoprofen (NSAID used for inflammation and pain associated with musculoskeletal disorders in horses) can be given IM.

Answer 14

(T, is water soluble so doesn’t have a weird vehicle like banamine)

Question 15

(T/F) Co-adminstration of NSAIDs does not increase efficacy.

Answer 15

(T, does increase frequency of ADEs)

Question 16

In general, washout periods are anywhere from 5-7 days and the minimum for severe pain is suggested to be at least 3 days long; with which NSAID does the washout period need to be longer (7-10 days)?

Answer 16

(Aspirin bc remember it sticks with platelets for their entire life span which is about 7 days)

Question 17

You are switching a patient from a glucocorticoid to an NSAID, how long do you want their washout period to be?

Answer 17

(Depends on if it was a short or long acting GC, if short 7 days and if long, who knows maybe weeks)