NSAIDs Flashcards
What is the importance of mananging chronic pain?
- it is maladaptive and of no benefit to the animal
- pain comprises the sensory discrimination aspect being processed by the brain and then interpreted with both physical and emotional components
- pain is a welfare issue
What is the definition of pain?
nociceptive or neuropathic
What is nociceptive pain?
originating in the tissues that are not in the nervous system
What is neuropathic pain?
pain that originates in the tissues in the nervous system
Which conditions can have a combination of neuropathic and nociceptive pain?
chronic pain conditions such as osetoarthritis and cancer
What patients will you see with neuropathic pain?
those that have direct damage to the nervous system
What happens when nerves are damaged?
cholecystokinin is released
What happens when cholecystokinin is released?
it antagnoises opioid mediated analgesia meaning opioids are less effective
How do NSAIDs work?
by inhibiting prostaglandin production from arachidonic acid by inhibiting to clycooxygenase (COX) enzyme
How do NSAIDs affect leukotriene production?
inhibits lipoxygenase enzyme
What is the newest NSAID grapiprant?
non-cyclooxygenase inhibiting anti-inflammatory drug
What does grapiprant act as?
selective antagonist of the EP4 receptor
What is the EP4 receptor?
a key prostaglandin E2 receptor that predominant mediates prostaglandin E2-elicited nociception
Where do most NSAIDs work?
the periphery
Where can some NSAIDs act?
centrally in the dorsal hron by inhibiting COX
What are the adverse effects associated with NSAID administration in relation to?
- protective function that prostaglandins have in the body
- how easily the NSAID can leave the circulation and cross into the tissues
How can prostaglandins be divided?
constitutive or ‘housekeeping’
What functions to the contitutive prostaglandins have?
protective ones which can be blocked by NSAIDs
What enzymes are produced by constitutive prostaglandin production?
COX-1 isoenzyme
What enzyme is produced by inducible prostaglandin production?
COX-2 isoenzyme
Which drugs are non-specific and block COX-1 and COX-2?
older NSAIDs such as aspirin and flunixin
What do meloxicam nad carprofen block?
COX-2
What are prostaglandins essential for in the GI system?
- maintenance of mucosal blood flow
- bicarbondate and mucous secretion
- epithelialisation
What GI signs can NSAIDs lead to?
ulceration and bleeding
