NSAIDs

Question 1

What are the effects of NSAIDs?

Answer 1

Analgesia, anti-inflammatory, antipyretic

Question 2

True/False: NSAIDs have a narrower therapeutic window than opioids.

Answer 2

True

Question 3

True/False: NSAIDs have a longer duration of effect than opioids.

Answer 3

True

Question 4

What is the MOA of NSAIDs?

Answer 4

Inhibition of COX

Question 5

When are COX-1 and COX-2 produced?

Answer 5

COX-1: constantly

COX-2: in response to inflammation

Question 6

True/False: NSAIDs are the largest group of veterinary drugs having adverse effects.

Answer 6

True

Question 7

What are the main side effects of NSAIDs?

Answer 7

GI effects (ulceration, perforation; V/D); hemostatic abnormality (inhibition of platelet function); renal impairment (if hypovolemic); hepatotoxicity; impairment of cartilage synthesis

Question 8

Why are NSAIDs dangerous to use when the patient is under anesthesia?

Answer 8

Anesthetics cause vasodilation and hypotension –> renal damage from NSAIDs

Question 9

What are contraindications of NSAIDs?

Answer 9

Hypovolemia, hypotension; organ diseases (liver, kidney, heart, etc.); hemostatic abnormality (some NSAIDs); pregnancy, lactation, conception (PGs keep the ductus arterioles open in the fetus); very young or very old patient; concomitant glucocorticoid therapy

Question 10

What are some indications of NSAIDs?

Answer 10

Arthritis, cystitis, dermatitis, gingivitis, cancer, etc.

Question 11

What are suitable NSAIDs for chronic therapy?

Answer 11

Dogs: carprofen, meloxicam, coxibs
Cats: meloxicam

Question 12

How are doses calculated for chronic NSAID therapy?

Answer 12

Calculated for lean bodyweight; lowest dose should be given for shortest necessary duration

Question 13

What type of COX inhibitor is carprofen?

Answer 13

Preferential COX-2 inhibitor

Question 14

What are the side effects of carprofen?

Answer 14

Little side effects (mainly GI related); does not inhibit platelet function; renal damage is rare but possible; fatal hepatotoxicity has been reported in dogs

Question 15

What are the clinical uses for carprofen?

Answer 15

Peri-operative analgesia; chronic therapy is allowed for dogs; not approved for cats

Question 16

What type of COX inhibitor is meloxicam?

Answer 16

Preferential COX-2 inhibitor

Question 17

What type of COX inhibitor is robenacoxib and other coxibs?

Answer 17

Selective COX-2 inhibitor

Question 18

What are the side effects of robenacoxib?

Answer 18

Minimal side effects

Question 19

What type of treatment is robenacoxib approved for?

Answer 19

Cats: post OP analgesia up to 3 days
Dogs: post OP analgesia, chronic treatment

Question 20

What type of COX inhibitor is phenylbutazone?

Answer 20

Non-selective COX inhibitor

Question 21

True/False: phenylbutazone is used in small animals.

Answer 21

False. Suitable for horses and cattle, but not for small animals

Question 22

What are some side effect of phenylbutazone?

Answer 22

GI ulceration, nephrotoxicity, residues are toxic to humans

Question 23

What type of COX inhibitor is flunixin meglumine?

Answer 23

Non-selective COX inhibitor

Question 24

True/False: flunixin meglumine is suitable for horses and cattle.

Answer 24

True

Question 25

What type of COX inhibitor is ketoprofen?

Answer 25

Non-selective COX inhibitor

Question 26

What are the side effects of ketoprofen?

Answer 26

Hemostatic abnormality, adverse GI effects

Question 27

What type of COX inhibitor is acetylsalicylic acid (Aspirin)?

Answer 27

Non-selective COX inhibitor

Question 28

What are the side effects of acetylsalicylic acid?

Answer 28

GI effects and hemostatic abnormality; common and can be serious

Question 29

What are the off label uses for acetylsalicylic acid in vet med?

Answer 29

Dogs: sometimes used as a cheap analgesic
Cats: small doses are used as an antithrombotic agent in cats with cardiomyopathy