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NSAIDs 2 Flashcards

1
Q

Which drug is preferred for the treatment of colic in horses?

A

Flunixin

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2
Q

Flunixin is COX__-selective in horses.

A

COX2

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3
Q

Flunixin is COX__-selective in dogs.

A

COX1

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4
Q

Flunixin is the only NSAID effective verses _____ pain.

A

Visceral pain

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5
Q

Flunixin is the NSAID with the longest t1/2 in which species?

A

The horse

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6
Q

In which species is the use of Flunixin FDA-approved?

A

Bovine & swine

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7
Q

Besides its use verses visceral pain, what are the 3 main effects of Flunixin?

A
  1. Analgesia
  2. Anti-inflammatory
  3. Anti-pyretic
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8
Q

What is the preferred NSAID versus endotoxicosis?

A

Flunixin

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9
Q

True or False: Flunixin binds strongly to LPS and endotoxi.

A

FALSE: Flunixin does NOT bind LPS or endotoxi

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10
Q

True or False: Polymyxin binds to LPS.

A

TRUE

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11
Q

What two drugs would you combine versus endotoxicosis in the horse?

A

Ketamine + Flunixin

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12
Q

How does Flunixin work versus endotoxicosis?

A

Flunixin blocks the PG-related events activated by LPS.

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13
Q

Acetaminophen is selective or non-selective?

A

Non-selective

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14
Q

To which COX does Acetaminophen bind?

A

COX2 & COX3

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15
Q

Acetaminophen does NOT inhibit ____ COX2.

A

Peripheral

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16
Q

Acetaminophen does inhibit ____ COX2 and COX3.

A

Central

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17
Q

What makes Acetaminophen a weak anti-inflammatory?

A

Lack of peripheral COX2 inhibition.

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18
Q

What is the primary COX involved in the inflammatory process?

A

COX2

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19
Q

Anti-COX2 activity of Acetaminophen provides the ____ effect.

A

Analgesic

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20
Q

Anti-COX3 activity of Acetaminophen provides the ____ effect.

A

Anti-pyretic

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21
Q

Acetaminophen’s lack of anti-COX1 activity spares the ____ and the ____.

A

Stomach and platelets

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22
Q

____ at the site of inflammation are able to inactivate Acetaminophen.

A

Peroxides

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23
Q

What are the two clinical uses for which Acetaminophen would be used?

A
  1. Anti-pyresis

2. Analgesia (reduces the pain associated with inflammation without eliminating the cause)

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24
Q

True or False: Acetaminophen has minimal GI effects.

A

TRUE - lack of COX1 activity

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25
Q

Why is Acetaminophen rarely used in veterinary medicine?

A

Hepatotoxicity

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26
Q

What is the most nephrotoxic NSAID group?

A

The “profens”

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27
Q

What are profens?

A

Propionic acid derivatives

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28
Q

What are the 4 profens?

A
  1. Ibuprofen
  2. Ketoprofen
  3. Carprofen
  4. Naproxen
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29
Q

Which of the “profens” are non-selective?

A
  1. Ibuprofen
  2. Ketoprofen
  3. Naproxen
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30
Q

Which of the “profens” are selective?

A
  1. Carprofen
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31
Q

Ketoprofen is a ____ inhibitor and a partial ____ inhibitor.

A

Ketoprofen is a COX inhibitor and a partial LOX inhibitor.

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32
Q

Which of the “profens” is only approved in the U.S. for use in horses?

A

Ketoprofen

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33
Q

Ketoprofen is for short or long-term use?

A

Short-term use

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34
Q

Carprofen is a COX__ inhibitor used in dogs.

A

COX2

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35
Q

Which two “profens” are contraindicated in pregnant animals?

A
  1. Carprofen

2. Ketoprofen

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36
Q

Why are Carprofen and Ketoprofen contraindicated in pregnant animals?

A

Due to the inhibition of PGF2-alpha, pregnancy can be prolonged.

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37
Q

Carprofen is (more expensive or cheaper) than coxibs?

38
Q

Which of the “profens” is approved for use in horses against myositis?

39
Q

What is the disadvantage to Naproxen?

40
Q

When is really the only time Naproxen should be used versus myositis in a horse?

A

When the myositis is first unresponsive to Phenylbutazone.

41
Q

Aspirin is a selective COX__ inhibitor.

42
Q

What are the 4 therapeutic effects of Aspirin?

A
  1. Analgesia
  2. Anti-inflammatory
  3. Anti-pyretic
  4. Anti-coagulant
43
Q

Aspirin irreversibly acetylates the COX1 enzyme. This irreversibility causes 2 dramatic side effects. What are they?

A
  1. Prolonged bleeding time

2. GI ulcers

44
Q

What is the moiety that “falls off” the NSAID after leaving the acetyl group on COX1?

A

Salicylate

45
Q

Salicylate is a reversible ____ inhibitor.

46
Q

Canine chondrocytes are very sensitive to the complete absence of COX__ activity.

47
Q

In sheep, aspirin causes what unwanted side effect?

A

Pulmonary edema

48
Q

Is Phenylbutazone a selective or non-selective NSAID?

49
Q

Phenylbutazone is a COX__ inhibitor.

50
Q

What is the NSAID with the longest t1/2 in the horse?

51
Q

What is the most commonly used NSAID in horses?

A

Phenylbutazone

52
Q

Phenylbutazone is a ____ analgesic versus ____, such as laminitis.

A

Phenylbutazone is a MUSCULOSKELETAL analgesic versus LAMENESS, such as laminitis.

53
Q

Which NSAID is banned in food-producing animals, especially lactating dairy cattle?

A

Phenylbutazone

54
Q

How does Phenylbutazone cause tolerance to build up in the horse?

A

Phenylbutazone induces microsomal enzymes that accentuate its metabolism.

55
Q

Phenylbutazone is banned in food-producing animals because it causes what in humans?

A

Blood dyscrasias

56
Q

In which species can Meloxicam be used?

A

Cats & dogs

57
Q

In which species can Piroxicam be used?

58
Q

Meloxicam and Piroxicam are selective ____ inhibitors.

59
Q

Put the following in order of least to most expensive: Carprofen, Meloxicam, Coxibs, Etodolac

60
Q

Meloxicam interferes with ____ inhibitors.

61
Q

For what is Meloxicam approved in the cat?

A

As a single injection

62
Q

What is the adverse effect of long-term Meloxicam use in the cat?

A

Renal failure

63
Q

What is Piroxicam most commonly used to treat in the dog?

A

Bladder cancer (specifically Transitional cell carcinoma)

64
Q

What is specific about bladder cancer that allows Piroxicam able to treat it?

A

The neoplastic cells overexpress COX2 and are dependent on that. By blocking the COX2, you decrease their lifespan.

65
Q

With what 3 things should Piroxicam be combined when treating bladder cancer?

A
  1. Misoprostol
  2. Chemotherapy
  3. Surgery
66
Q

Which drug can be used as an alternative to Piroxicam?

67
Q

What is the advantage of Deracoxib over Piroxicam?

A

Deracoxib would not have the nasty effects on the stomach.

68
Q

Which NSAIDs have the highest affinity/selectivity for COX2?

69
Q

Which drug was withdrawn from use in humans because of its CV issues?

70
Q

What are the BEST drugs for long-term use against the pain and inflammation of osteoarthritis?

A

Deracoxib & Firocoxib

71
Q

True or False: Deracoxib & Firocoxib can be used in dogs with renal insufficiency.

72
Q

Why are you able to use Deracoxib & Firocoxib in dogs with renal insufficiency?

A

These drugs are eliminated via the bile/feces. (Downside: if you have a dog that likes to eat its own feces, they are taking in double the dose.)

73
Q

Firocoxib: low or high Vd?

74
Q

NSAIDs: low or high Vd?

75
Q

Robenacoxib appears to be tissue specific. Which tissue does it target?

76
Q

True or False: Robenacoxib is approved for use in cats.

77
Q

Robenacoxib is approved for daily oral use in cats for how long?

78
Q

What is the cheapest selective COX2 inhibitor?

79
Q

What is the adverse side effect associated with Etodolac?

A

Keratoconjunctivitis sicca

80
Q

What does Tepoxaline inhibit? (Ex: COX1? COX2? COX3?)

A

COX1, COX2, LOX

81
Q

DMSO works by inhibiting what?

A

Inhibits PGs and scavenges free radicals

82
Q

How is DMSO administered?

A

Topically, orally, IV

83
Q

What is DMSO used against in dogs?

A

Lick granulomas

84
Q

In which animal(s) is DMSO banned?

A

Dairy cattle

85
Q

True or False: DMSO is not to be used in conjunction with corticosteroids.

A

FALSE - DMSO can be combined with corticosteroids.

86
Q

True or False: Dipyrone is approved for use in food animals.

A

FALSE - Dipyrone is BANNED in food animals.

87
Q

What are the only 3 NSAIDs that can be used in cats?

A
  1. Aspirin
  2. Meloxicam
  3. Robenicoxib
88
Q

Which NSAID can be used in swine?

89
Q

Which 2 NSAIDs can be used in cattle?

A

Flunixin & aspirin

90
Q

Which 5 NSAIDs can be used in horses?

A
  1. Flunixin
  2. Phenylbutazone
  3. DMSO
  4. Naproxen
  5. Fibrocoxib

Pharmacology (21 decks)

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