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VETM 443 Clin Pharm Tox > NSAIDS and Cannabis > Flashcards

NSAIDS and Cannabis Flashcards

1
Q

response of vascularized tissues to infections and damaged tissues that brings cells and molecules of host defense from the circulation to the sites where they are needed, in order to eliminate the offending agent = what

A

inflammation

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2
Q

the inflammatory mediators prostaglandins and leukotrienes are metabolites of what

A

arachidonic acid

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3
Q

NSAID drugs act on ____ enzymes

A

cyclooxyrgenase enzymes COX1 and COX2

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4
Q

what are constitutive vs inducible CLOX

A

constitutive = expressed at relatively constant level sin most tissues
inducible = induced by inflammatory stimuli

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5
Q

of COX1 and COX2, which is constitutive and has homeostatic functions, important in gastric mucosa, kidney, platelets, vascular endothelium? which is primarily induced by inflammatory cytokines and is produces prostanoids associated with inflammation, fever, and pain?

A

COX1 (constitutive), COX2 (inducible)

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6
Q

a non-selective COX inhibitor will inhibit ___, while a selective COX inhibitor to target pain, fever, inflammation would inhibit ____

A

both COX1 and COX2; COX2 (and a little bit of COX-1 effects also, not perfect)

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7
Q

give 6 clinical uses of NSAIDs

A

anti-inflammatory, analgesic, antipyretic, treatment septic shock, antithrombotic, anti-cancer in certain cases

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8
Q

COX inhibition reduces the ____ and _____ effects of prostaglandins

A

central and peripheral

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9
Q

Chronic nociceptor stimulation (as occurs with inflammation) results in changes at the level of the synapse within the spinal cord. Upregulation of ________ and __________ leads to sensitization of post-synaptic neurons = increased perception of pain

A

post-synaptic receptors and spinal cord COX-2 lead

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10
Q

septic shock occurs when

A

bacterial products, which can be LPS endotoxin or others, enter systemic circulation

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11
Q

septic shock leukocyte, complement, and endothelial cell activation lead to what 4 effects? what overall effect

A

immunosuppression; vasodilation (increased vascular permeability and decreased perfusion); systemic effects of fever, decreased ionotropy and metabolic abnormality; and microvascular thrombosis. multi-organ failure!

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12
Q

what should you consider about giving patients with poor perfusion (eg. in septic shock) NSAIDs.

A

benefits may not outweigh the risk

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13
Q

is a horse that is hemorrhaging a good candidate for NSAIDs? why?

A

no! both non-selective and selective COX-2 NSAIDs have some COX-1 inhibition. COX-1 is involved in platelet activation and aggregation, so going to increase bleeding.thin the blood

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14
Q

COX-2 is ________ in some tumours, therefore NSAIDs will have what effect in certain tumors

A

upregulated; suppress certain tumors

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15
Q

PK of NSAIDs: how is it bound? absorbed? metabolized? half-life?

A

highly protein bound, well-absorbed orally, metabolized liver, half-lief varies dramatically between species

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16
Q

give at least 5 adverse effects of NSAIDs

A

GI irritation (COV-1 has gastroprotective effects)and ulceration, renotoxicity if dehydrated/hypovolemic (renal papillary necrosis), hepatotoxicity, hemorrhage (inhibition of COX1 clotting), blood dyscrasia, delayed parturition, delayed tissue healing, delayed fracture healing (think, COX is involved in soft tissue and bones)

17
Q

give 5 NSAIDs used in dogs

A

dogs only: carprofen CAR, deracoxib DER
dogs and cats: robenacoxib ROB
dogs and horses: firocoxib FIR
all species: meloxicam MXM

18
Q

give 2 NSAIDs used in cats

A

meloxicam (used in all species) and robenacoxib (also used in dogs)

19
Q

4 NSAIDs used in cattle

A

meloxicam MXM (used in all species)
aspirin, flunixin FLU, ketoprofen KET (also in horses)

20
Q

give 7 horse NSAIDs

A

meloxicam MXM (used in all species)
aspirin, flunixin FLU, ketoprofen KET (also in cattle)
firocoxib FIR (also in dogs)
dipyrone, phenylbutazone PBZ (horse only)

21
Q

in compromised patients, must balance ____ and ___ of using NSAIDs

A

risks and benefits.

22
Q

should you give NSAIDs after GI surgery in small animals? why or why not

A

no! delay tissue healing, so increases risk of dehiscence

23
Q

should you give NSAIDs for soft tissue surgery in small animals?

A

yes, after weighing risks and benefits.

24
Q

what are the 2 best NSAID choices for dog soft tissue surgery

A

carprofen and meloxicam

25
Q

what is the best evidence NSAID for cat soft tissue surgery

A

robenacoxib (also labelled for dogs, but not as much evidence as there is for meloxicam and carprofen). meloxicam is also possible for kitties but not as much evidence

26
Q

what NSAID to give for doggie ortho sx

A

carprofen is best evidence

27
Q

what NSAID to give for kittiecat ortho sx

A

robenacoxib (also what you give for soft tissue sx)

28
Q

what to give for OA or MSK pain in dogs? 3 choices

A

meloxicam, firocoxib, carprofen. and be sure to titrate to lowest dose and lowest frequency of dose

29
Q

what to give for OA or MSK pain in kitty cats?

A

meloxicam

30
Q

what NSAID can you give to horses PO in Canada

A

firocoxib (also meloxicam and aspirin but not approved)

31
Q

what 3 drugs can you give to horses for MSK pain? which is best for chronic

A

phenylbutazone and flunixin, firocoxib for chornic

32
Q

what NSAID can you give to horses for GI pain/sx

A

flunixin

33
Q

what NSAIDs should you not give in cattle? 5

A

phenylbutazone (never in production animals), carprofen, dipyrone, firocoxib, ibuprofen

34
Q

grapriprant is labelled for what, in what species

A

dog OA pain (if not responding well to meloxicam, carprofen, or firocoxib)

35
Q

what drugs should you not give simultaneously with NSAIDs? 2 categories

A

other NSAIDs (highly protein bound may displace causing too much drug in blood) and steroids (act at different points in arachidonic acid pathways, so increases adverse effects)

36
Q

what are the unapproved NSAIDs to know about?

A

aspirin (ASA), ibuprofen, and acetaminophen )not technically an NSAID). also naproxen and piroxicam
aspirin can help with OA in dogs but not labelled
ibuprofen do not give–toxicity
acetaminophen (toxic to cats0

37
Q

gabapentin is not an NSAID, but often used as a non-NSAID analgesic option. is there evidence of its efficacy as an analgesic in vet med

A

no

38
Q

main psychotropic compound in cannabis

A

THC tetrahydrocannabinol

39
Q
  • Major non‐psychotropic component of Cannabis
  • Has been suggested to be anxiolytic, antidepressant, antipsychotic, anticonvulsant, antinausea, antioxidant, anti‐ inflammatory, anti‐arthritic, antineoplastic
  • In CNS is protective in animal models of epilepsy, anxiety, psychosis, Parkinson’s and Huntington’s disease
A

CBD cannabidiol

VETM 443 Clin Pharm Tox (18 decks)

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