NSAIDS Flashcards
What are indications for NSAIDS?
Mild chronic pain: osteoarthritis, neoplasia, otitis
Anesthesia/surgery: acute peri-surgical pain in combo with opioids
What patients can you use NSAIDS in?
Well hydrated, normotensive, young-middle ages
Normal renal function
Which has a longer action, NSAIDS or opioids?
NSAIDS
T/F: Opioids have higher efficacy in inflmmatory conditions like dermatitis, polyarthtis, mastitis, or otitis than NSAIDS
False
NSAIDS greater for inflammation
What are the administration routes of NSAIDS?
Common: SQ and IM
Less: IV , oral, topical, suppositories
What is the MOA of NSAIDS
Inhibit COX (1 or 2)
NSAIDS have their anti-inflammatory effects by inhibiton of what mediators ?
Prostacyclin and prostaglandin
How do NSAIDS have an anti-pyretic effect?
Inhibit endotoxin or endogenous pyrogens (eg interleukin 1)
What is a water soluble tablet NASID registered for osteoarthritis in dogs?
Tepoxalin
Inhibits COX and lipooxygenase
Where do steroids exhibit their anti-inflammatory effects?
Inhibit phospholipase to prevent formation of arachadonic acid from cell membrane phospholipids
Where is COX1 found? And what are its functions ?
Constitutively expressed
Liver
Kidney
Platelet
Gastric mucosa
—> mucosal blood flow, mucous production, gastric se creations acidity, gastric epithelium cell turnover
Where is COX2 found and what are its actions?
Indictable in damaged or inflamed tissue —> monocytes, macrophages, or neutrophils
Why do we want high selectivity of COX2 inhibition
COX1 is good—> gastric mucosa
COX2 is bad—> inflammatory
Less adverse effects if you selectively inhibit COX2
What are the adverse effects on NSAIDS ?
GI- vomiting diarrhea and ulceration
Platelet aggregation —> impaired thromboxane
CV: prothrombotic state
Renal: block renal vasodilator COX2 induced PG —> not to be used in renal insufficiency
Liver: impaired hepatic blood flow
What can you give prophylactically to reduce GI ulcers caused by NSAIDS?
Sucralfate : salt binds mucosal defects
Misoprostal: synthetic PG analog
Ranitidine: H2antagonist block gastric secretions
Omeprazole: PPI blocking gastric secretions