NSAIDS, Behavior and AED Drugs

Question 1

Ibuprofen

Answer 1

NSAIDs
No safe doses established in dogs/cats AVOID USE!
High GI ulceration risk
Neither ibuprofen nor naproxen are recommended for veterinary patients, safer alternatives exist

Question 2

Naproxen

Answer 2

Extra label
Very potent NSAID
Serious GI ulceration can occur
Human OTC dose forms are overdoses for most small animals!
Neither ibuprofen nor naproxen are recommended for veterinary patients, safer alternatives exist

Question 3

Carprofen

Answer 3

Approved for dogs
Can be used extralabel for cats, but safety of long-term use in cats not established
GI ulceration
Has been used safely long-term for osteoarthritis in dogs

Question 4

Meloxicam

Answer 4

NSAID, some COX2 selectivity
Approved for pain,inflammation, and osteoarthritis in dogs. Approved in cats for post op pain/inflammation from orthopedic and neutering surgery
Long-term use in cats is controversial, conflicting data suggesting renal toxicity
AE: GI ulcers

Question 5

Deracoxib

Answer 5

NSAID, some COX2 selectivity
Approved in dogs, post-op orthopedics, dental, and for osteoarthritis inflammation/pain
Conflicting recommendations in vet formularies, Plumb’s recommends not using in cats.

Question 6

Robenacoxib

Answer 6

NSAID, some COX2 selectivity
Approved for use in cats and dogs for post-op pain/inflammation
Newer drug, relatively little clinical data

Question 7

Acetaminophen (e.g., Tylenol)

Answer 7

over-the-counter drug
mechanism of action is still unclear-generally believed to inhibit prostaglandin production in the CNS, but not in peripheral tissues–>believed to act at the arachidonic acid pathway
ANALGESIC AND NOT AN NSAID
AE:
-When administered above therapeutic levels it can cause potentially fatal liver injury
-Dogs do not efficiently metabolize acetaminophen, thus canine dosing recommendations must be followed carefully, or hepatic toxicity can occur
-Acetaminophen should never be used in cats because of their inability to safely metabolize the drug. Clinical signs include methemoglobinemia, Heinz body hemolysis, hepatic failure, and swelling in distal limbs.

Question 8

Grapiprant (trade name: Galliprant)

Answer 8

relatively new drug->FDA approved in dogs for pain and inflammation of osteoarthritis
Not a true NSAID–>Grapiprant DOES NOT block prostaglandin-mediated inflammation and pain by inhibiting prostaglandin synthesis
MOA: is an antagonist at one of the prostaglandin receptors, the EP-4 receptor->the receptor that is believed to be primarily responsible for the prostaglandin-mediated pro-inflammatory effect, and the prostaglandin-mediated pain amplification

Adverse effects: reported in drug-approval studies were vomiting/diarrhea/inappetence
In those studies dogs tolerated high doses for 9 months with mild GI adverse effects (data from manufacturer)