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POS 2 > NSAIDs FPAs > Flashcards

NSAIDs FPAs Flashcards

1
Q

What do NSAIDs act on?

A

COX

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2
Q

What is COX1 and COX2 responsible for?

A 
> CoX 1 is physiologic
- PGs, thromboxane
- GIT, kidney, platelets 
- muscosal protection, renal blood flow and hemostasis 
> COX 2 is inducible 
- PGs
- inflame sites, macrophages, synovocytes
- inflammation pain andfever
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3
Q

Where do coxibs act?

A
  • COX 2 only
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4
Q

4 main clinical indications for NSAIDs?

A
  • analgesic
  • anti-inflammatory
  • anti-pyretic
  • anti-thrombotic
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5
Q

Which drugs must never be used in FPAs in the UK?

A 
> Phenylbutazone
- causes fata blood dyscrasias in humans
- no safe determined minimum residue limit (MRL) 
> chloramphenicol 
> metronidazole
> Benzyl-penicillin (Crystapen)
> Metoclopramide
> Lidocaine
> Gentamicin/Amikacin
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6
Q

Which drug should not be given to camelids and ruminants?

A

> Phenylbutazone

  • Not legal for FPAs
  • oral powder not bioavailable in ruminant
  • T1/2 in llamas
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7
Q

Which species have no NSAIDs and few drugs licensed specifically for them?

A
  • goats, sheep, camelids
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8
Q

Outline levels of the cascade

A
  • vet med for different psecies or differnet condition
  • human med in UK or vet med authorised in a member state (If for an FPA then for an FPA in the other country) in accordance with an import certificate issued by the VMD
  • medicine prepared extemporaneously
    > FPAs can only be treated with meds containing pharmacologically active substances listed in the table of allowed substances in commission regulation EU
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9
Q

What are the minimum withdrawals for a drug used under the cascade (ie not stated specifically for that species/indication)?

A
  • 7d eggs and milk
  • 28d meat from poultry and mammals
  • 500 degree days meat from fish
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10
Q

What should be done if treating off label@?

A
  • informed consent from the owner written and signed
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11
Q

Which NSAIDs are lic in FPAs? Which animals?

A
  • Meloxicam (cattle, pigs, horses)
  • Flunixin (cattle, pigs, horses)
  • Ketoprofen (Cattle, pigs, horses)
  • Carprofen (Cattle, horses)
  • Tolfenamic acid (Cattle, pigs)
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12
Q

Doses of flunixin meglumine? CLinical uses?

A
  • Cattle IV only 2.2mg/kg SID
  • Pigs (IV or IM) 2.2mg/kg SID
  • Alpacas = Horse dose IV only 1.1mg/kg SID/BID
    > clinical uses
  • visceral and ophthalmic pain
  • systemic inflammation (mastitis, metritis)
  • pain relief after elective Sx (castration, disbudding)
    > v cortisol, ^ feed intake, ^ dialy weight gains `
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13
Q

What is the most commonly prescribed NSAID in FPAs?

A

> Meloxicam

  • preferential COX2
  • prolonged T1/2 esp in cattle
  • pain relef after surgery
  • now LIC “releife of post-op pain following dehorning calves”
  • effective against: systemic inflam (toxic mastitis), visceral and ophthalmic pain, cattle lameness
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14
Q

Doses of Meloxicam on and off label?

A

> label
- Cattle 0.5mg/kg (SC or IV) once, or of label q3d, 5d milk withdrawal
- Pigs 0.4mg/kg IM once or PO SID
Off label
- sheep 0.5mg/kg SID/BID (T1/2 shorter than in cattle)
- goats 0.5mg/kg BID/TID (effective plasma conc for 8 hours)
- alpacas 0.5mg/kg SID IV or 1mg/kg PO q72hrs(oral dose lasted 3d in one study)

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15
Q

What is ketoprofen? Uses? Compared to other NSAIDs?

A
  • non selective COX inhibitor
  • short t1/2 (limits use, requires multiple OFF LABEL doses)
  • some effect on cattle lameness
  • some evidence for short term effects in toxic mastitis
  • LIC to reduce udder oedema cattle
  • NOT as effective for analgesia with elective Sx cf other NSAIDs
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16
Q

Labelled use of ketoprofen?

A
  • cattle and pigs 3mg/kg IV/IM SID for 3d

- NO milk withdrawal! YAY

17
Q

What is carprofen? Uses? Compared to other NSAIDs?

A
  • non selective COX inhibitor in largies

- prolonged T1/2 in cattle (even greater in young

18
Q

Labelled use of carprofen?

A
  • cattle 1.4mg/kg IV/SQ once

- NO milk withdrawal YAY!

19
Q

Which NSAID is not used commonly in cattle?

A

> Tolfenamic acid

- bovine respiratory disease and acute mastitis (anti-inflam)

20
Q

Labelled use of tolfenamic acid?

A
  • cattle 2mg/kg IV only in dairy cattle q48hrs [never IM] milk withdrawal 24hrs
  • pigs 2mg/kg IM in neck once (used for tx of metritis-mastitis-agalactiae (MMA) syndrome
21
Q

Adverse effects opotentially of NSAIDs?

A
  • anomasal ulceration
  • renal toxicity
  • care w/ hepatic dz
22
Q

Which NSAIDs are lic in horses?

A
  • meloxicam
  • flunixin
  • phenylbutazone
  • suxibuzone
  • ketoprofen
  • carprofen
  • Firicoxib
  • Vedaprofen
23
Q

What is phenylbutazone used for in horses? Dose?

A
  • non selective COX1/2
  • no evidence for tissue specificity (bone v visceral pain)
  • less analgesic than flunixin
    > 4.4mg/kg IV SID
    > 8.8mg/kg PO SID for 1d then 4.4mg/kg/day (can be split BID) then 2,2mg/kg/day
24
Q

What is suxibuzone?

A
  • pro-drug of phenylbutazone given orally
  • more palatable
  • more $$$
25
Q

What is flulnixin meglumine used for in horses? Dose?

A
  • non-selective COX1/2
  • no evidence tissue specificity
  • good analgesic
  • effective against systemic inflammation
    > 1.1mg/kg IV/PO SID
    > clinically used BID
26
Q

What is meloxicam used for in horses? LIC? Dose?

A
  • COX2 preferential
  • LIC: colic, acute and chronic musculo-skeletal disorders
  • pharmacokinetics show BID dosing regimen would improve efficacy
  • supposedly good for use in foals
    > 0.6mg/kg IV once and 0.6mg/kg PO SID (label)
27
Q

What is ketoprofen used for in horses? Dose?

A
  • non selective
  • suppose to also inhibit lipoxygenase (though no evidence for this action in horses)
    > 2.2mg/kg IV SID
28
Q

What is carprofen used for in horses? Dose?

A
  • non selective
  • LIC: musculoskeletal disorders and surgery
    > 0.7 mg/kg IV SID or PO
29
Q

What is firocoxib used for in horses? Dose?

A
  • only LIC COX2 specific inhibitor in horses
  • long T1/2 (takes 3d to reach steady plasma level and affect lameness levels, 7d to reach peak plasma levels)
  • LIC: OA and reduction in lameness
  • achieves high levels in the eye
    > 0.09mg/kg IV SID or 0.1mg/kg PO SID
30
Q

Adverse effects of NSAIDs in horses?

A

> GIT
- gastric and oral ulcers sign of toxicity (dose too high)
- ulceration small/large intestinal mucosa
- RDC (ridght dorsal colitis) at regular doses and short-term use -> hypoalbumenaemia, neutropenia, D+, colic [PGs have a cytoprotective effect in the mucosa esp PGE2 and PGI2)
renal
-papillary necrosis
- dehydration, colume depletion -> renal vasoconstriction -> PG synthesis and 2* compensatory vasodilation
Phlebitis
- perivascular injection -> sever phlebitis and tissue necrosis

31
Q

Define detection time

A
  • approx. period of time for which a drug or its metabolites can be detected in a horse’s system
32
Q

Define withdrawl time

A
  • decided by vet, based on detection time + safety margin

- safety margin d/t differences in size, metabolism, fitness, illness/dz

33
Q

What is EHSLC?

A
  • comprises the racing authoritis of frnace, Ireland, UK, Germant, Italy and Scandanavia
34
Q

See lecture for detection times of lots of drugs!

A

~

POS 2 (28 decks)

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