NSAIDs Flashcards
What does NSAID stand for?
Non-steroidal anti inflammatory analgesic
What are the effects of NSAIDs? (3)
- Analgesia
- Anti-inflammatory
- Antipyretic
T/F: NSAIDs have a shorter duration of effect than opioids.
False- NSAIDs have a longer duration compared with opioids
Do NSAIDs have a sedative effect?
No- opioids do
What are NSAIDs suitable for?
Mild to moderate post op pain or management of long term inflammatory pain (arthritis, otitis, cystitis, dermatitis, etc)
Can NSAIDs be combined with other drugs to control pain?
Yes- commonly combined with opioids post op for synergistic effect
What is the MOA of NSAIDs?
Inhibition of COX enzymes (inflammatory mediators)
Down regulation of inflammatory mediators reduces inflammation and prevents pain
What are the two main types of COX enzymes?
COX-1: constitutive
COX-2: inducible
Which COX enzyme is important for normal function of the GIT, platelets, and kidneys?
COX-1
Which COX enzyme is produced in response to inflammation and leads to development of pain?
COX-2
Which COX enzyme should be selectively managed for relief of pain?
COX-2
T/F: The less COX-2 selective the NSAID is, the more side effects are expected to develop.
True- down regulation of COX-1 interferes with normal organ function
What is COX-3 and do we care yet?
COX-3: identified in CNS of dogs but not humans
Selectively inhibited by acetaminophen
We don’t really care
Do selective COX-2 inhibitors have zero side effects?
No, COX-2 does serve some constitutive function and can produce some side effectss
T/F: Inhibition of COX may increase LOX activity.
True
T/F: Monitoring effects/side effects of NSAIDs is limited and makes accurate dosing difficult.
True- wide range of side effects that can not be accurately monitored
What are some main side effects of NSAIDs?
- GI ulceration, perforation, vomiting, or diarrhea
- Inhibition of platelet function
- Renal impairment
- Hepatotoxicity (carprofen)
- Impair cartilage synthesis
What is the mechanism for renal damage in NSAID use?
With decreased perfusion, PGs mediate vasodilation and keep blood flow and GFR up. NSAIDs inhibit this mechanism
Particularly concerning under anesthesia
Should NSAIDs be given peri or post operatively for best analgesic effect?
Peri operatively
What is a concern with giving NSAID perioperatively?
If excessive bleeding occurs, chances of renal damage are high.
Is it safer to give NSAIDs peri or post operatively?
Post operatively
What is given instead of NSAIDs to provide analgesia during surgeries?
Opioids
What are contraindications to NSAID use?
- Hypovolemia or hypotension
- Organ disease (esp kidney)
- Hemostatic abnormality
- Pregnancy, lactation, conception
- Age extremes
- Concomitant steroid therapy
What are suitable NSAIDs for chronic therapy in dogs and cats?
Dogs: carprogen, meloxicam, coxibs
Cats: meloxicam
