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Pharmacology II > NSAIDs > Flashcards

NSAIDs Flashcards

1
Q

What can be used to block histamine from binding to the H1 receptor?

A

Antihistamines

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2
Q

What is used after the cell membrane is injured to keep from entering the arachidonic acid cascade?

A

Omega 3 FA

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3
Q

What inhibits phospholipase?

A

Steroids

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4
Q

What effects COX2 gene expression?

A

Steroids

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5
Q

What can prevent cyclooxygenase from tuning arachidonic acid into prostaglandins, prostacyclin, and thromboxane?

A

NSAIDs

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6
Q

What blocks the EP4 receptor?

A

Grapiprant

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7
Q

What blocks interleukins?

A

CADI

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8
Q

What blocks Janus kinase from casuing inflammation

A

Oclaitinib

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9
Q

What blocks free radical release from cause inflammation?

A

DMSO

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10
Q

What helps prevent proteases from causing inflammation?

A

GAGs

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11
Q

Antihistamines are primarily used in what disease situations in dogs?

A

Only effective in managing allergies

Treatment or prevention of vaccine reactions

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12
Q

Why should antihistamines be given cautiously, if at all, by the intravenous route?

A

IV administration can have an effect on the brain. A sudden bolus will cause a stimulatory effect and they get agitated and seizures have been reported
It can cause an excitatory reaction

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13
Q

Offer a proposed mechanism of how omega3 fatty acids supplements decrease inflammation.

A

It is thought to alter the cell membrane phospholipid concentration leading to less arachidonic acid as a substrate for inflammation and/or production of anti-inflammatory cytokines

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14
Q

Regarding glycosaminoglycans (GAGs) and their benefit in osteoarthritis, what is their proposed mechanism of action?

A

Supplies the building blocks for cartilage and inhibits proteases

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15
Q

Regarding glycosaminoglycans (GAGs) and their benefit in osteoarthritis, how does the onset differ from more traditional treatments such as NSAIDs?

A

It has a very slow onset. It can take several weeks for it to show effect

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16
Q

Regarding glycosaminoglycans (GAGs) and their benefit in osteoarthritis, what is their relative therapeutic index?

A

It is very safe

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17
Q

Regarding glycosaminoglycans (GAGs) and their benefit in osteoarthritis, how much evidence supports the benefit or oral nutraceutical GAGS versus prescription injectable GAGs?

A

Adequan (injectable) has a better response rate than the nutraceutical/oral GAG

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18
Q

Regarding glycosaminoglycans (GAGs) and their benefit in osteoarthritis, most oral GAGs include at least glucosamine and chondroitin sulfate. Which is likely the more effective?

A

Chondroitin sulfate

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19
Q

What is the proposed mechanism of action of DMSO?

A

Rapidly penetrate the intact skin

Anti-inflammatory action due to ability to scavenge free radicals

20
Q

What are the most common conditions for approved topical use and extra‐label intravenous use of DMSO?

A

Approved as 90% gel and liquid for topical use in dogs and horses

  • –Label indication is to reduce acute swelling due to trauma
  • –Often used in managing accidental extravasation of cytotoxic IV drugs
  • –Mild inhibition of platelets
  • –Can carry small molecules transdermally

AMDUCA allows only for extra-label use of the approved veterinary product
—Used in a variety of conditions, but mainly CNS disease

21
Q

What is its relative therapeutic index of DMSO?

A

Has a really high therapeutic index

22
Q

What side‐effects can be seen with intravenous DMSO and what actions are taken to minimize the risk of these side‐effects?

A

Hemolysis and histamine release

DMSO is diluted to = 20% and given slowly to minimize

23
Q

What AMDUCA restrictions apply to the use of DMSO relative to allowable products for extra-label use?

A

AMDUCA allows only for extra-label use of the approved veterinary product, not chemical grade DMSO

24
Q

What nonsteroid‐responsive pruritic conditions often respond to oclacitinib? What warnings or contraindications does it have?

A

Food allergies and Sarcoptes
GI side effects occur only in 2.3% according to one study
Because oclacitinib is an immunomodulating drug, patients may be more susceptible ton infection, demodicosis, and neoplasia

25
Q

Contrast the mechanism of action of oclacitinib versus CADI.

A

Oclacitinib is a selective Janus kinase (JAK)-1 and JAK-3 inhibitor
CADI is a canine monoclonal antibody against IL-31 which in turn decreases JAK-mediated itch

26
Q

Why may grapiprant have a larger therapeutic index than traditional NSAIDs?

A

It is working further down the arachidonic acid cascade and does not affect as much as NSAIDs
It is only better than a NSAID in the side effect profile

27
Q

How can NSAID use adversely affect heart failure or hypertension and its treatment?

A

NSAIDs worsen congestive heart failure by increasing salt and water retention
They blunt the anti-hypertensive effects of ACE inhibitors ad beta blockers due to the loss of vasodilatory prostaglandins

28
Q

Which NSAID commonly given as repeated doses in cats actually carries a label warning against this practice?

A

Meloxicam

29
Q

Which NSAIDs are approved in cats?

Which NSAIDs can be used chronically in cats?

A

Robenacoxid (for 3 days)
Meloxicam injection
Aspirin, piroxicam, robenacoxib, and meloxicam are all extra-label
No NSAIDs are approved for chronic use. Though, oral meloxicam is used chronically against the label. Aspirin and Piroxicam can be used chronically

30
Q

Which NSAID is approved as a transmucosal oral spray?

A

Meloxicam

31
Q

Name a topical NSAID approved in horses

A

Surpass: 1% diclofenac sodium

32
Q

Which NSAIDs have shown activity in management of TCCs?

A

Piroxicam

33
Q

What role do endogenous prostaglandins play in maintaining renal blood flow as part of normal homeostasis versus when GFR decreases? Explain why this difference is important relative to NSAID use.

A

Normally vasodilatory prostaglandins in the kidney enhance GFR and inhibit chloride and sodium reabsorption that promote water loss
NSAIDs can:
—Worsen congestive heart failure by increasing salt and water retention
—Blunt the anti-hypertensive effects of ACE inhibitors and beta blockers due to the loss of vasodilatory prostaglandins

34
Q

In most species aspirin is useful as an antipyretic, analgesic, and anticoagulant. How does the horse differ in the utility of aspirin and why? How does the cow differ?

A

Aspirin is not used as an anticoagulant in cows, though it is antipyretic and analgesic. Something else drive platelet function other than thromboxane
Aspirin is only an anticoagulant in horses

35
Q

Under what conditions would acetaminophen be a good choice in a dog?

A

It is an effective antipyretic and analgesic for mild somatic pain
It has little anti-inflammatory activity

36
Q

Which of the adverse reactions seen with NSAIDs are type B reactions?

A

Bone marrow suppression

Hepatotoxicity

37
Q

Why has phenylbutazone been banned by the FDA from use in adult dairy cattle?

A

Farmers were giving it for control of the lameness in cattle, but they weren’t following the withdrawal periods

38
Q

Which form of aspirin should not be used in the dog and why?

A

Don’t use enteric coated aspirin (Ecotrin)

Ecotrin sticks to the mucosa and erratically breaks off and goes through

39
Q

Name the five adverse events associated with use of NSAIDs. Indicate which two are type B adverse reactions.

A

GI ulceration
Renal papillary necrosis
Altered platelet function (except in cattle)
Bone marrow suppression (type B adverse reaction)
Hepatotoxicity (type B adverse reaction)

40
Q

When switching between NSAIDs what is a “washout” and why is it recommended? Which NSAID(s) would a washout be most warranted for?

A

In general, a day wash-out between NSAIDs is recommended and 10 days specifically for aspirin and adverse effects.
The potential for adverse use, regular metabolic moniotoring, and regular metabolic monitoring should be performed

41
Q

What is the non‐antibiotic benefit believed due to an ability to modulating inflammatory or immune responses of tetracyclines?

A

Inhibits collagenase and protein kinase C, inhibits granuloma formation
Used in vet dentistry and ophthalmology

42
Q

What is the non‐antibiotic benefit believed due to an ability to modulating inflammatory or immune responses of enrofloxacin?

A

Responsive histiocytic ulcerative colitis

Eradication of invasive intramucosal E. coli

43
Q

What is the non‐antibiotic benefit believed due to an ability to modulating inflammatory or immune responses of macrolides?

A

Inhibits NF-κB activation in T cells, monocytes/macrophages
Tylosin for refractory large bowel diarrhea
Azithromycin for oral papillomatosis

44
Q

What is the non‐antibiotic benefit believed due to an ability to modulating inflammatory or immune responses of metronidazole?

A

Used for IBD
2 hypotheses for mechanism:
—Changing the intestinal microbiota prevents colonization by pathogenic bacteria
—Suppression of the microbiota might lead to down-regulation of aberrant host responses directed against microbial antigens that trigger and perpetuate chronic mucosal injury

45
Q

Which NSAID is approved as a transdermal formulation in cattle?

A

Flunixin (Finadyne Transdermal and Banamine Transdermal)

Approved as an antipyretic, not an analgesic

Pharmacology II (18 decks)

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