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pharm II > NSAIDS + other Analgesics > Flashcards

NSAIDS + other Analgesics Flashcards

1
Q

Where on the pain pathway do NSAIDs work?

A
  1. Transduction
  2. Modulation
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2
Q

List the selective COX-2 inhibitors

A
  1. Carprofen
  2. Deracoxib
  3. Robenacoxib
  4. Firocoxib
  5. Meloxicam
  6. Piroxicam
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3
Q

List the selective COX-1 inhibitors

A

Aspirin (ASA)

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4
Q

List the NON-selective COX-1 and COX-2 inhibitors

A
  1. Phenylbutazone
  2. Flunixin meglumine
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5
Q

What are the main effects of NSAIDs?

A
  1. Prevent inflammation by inhibiting cyclooxygenase (COX) enzymes
  2. Most commonly used analgesic
  3. Anti-pyretic (anti-fever)
  4. Inhibits tumor growth (anti-angiogenesis)
  5. Possible anti-endotoxic effects
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6
Q

NSAIDs should not be used concurrently with __________

A

Corticosteroids

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7
Q

What organ specific side effects do NSAIDs and corticosteroids have in common?

A
  1. GI ulceration
  2. Renal injury
  3. Hepatic injury
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8
Q

How are NSAIDs normally administered?

A

PO or IM

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9
Q

Why do NSAIDs have good oral bioavailability?

A

Weak acid in acidic environment (non-ionized) that can be absorbed

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10
Q

What can affect the oral bioavailability of NSAIDs?

A

Food in stomach

adsorbs to feed and causes reduced GI absorption

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11
Q

NSAIDs have a ________ volume of distribution

A

LOW

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12
Q

What should be considered when giving NSAIDs with other drugs?

A

Highly protein bound, can knock off other drugs and make them more available/potent

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13
Q

What NSAID has the shortest half life, making it more appropriate for use in cats?

A

Robenacoxib

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14
Q

What NSAID has the longest half life?

A

Meloxicam

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15
Q

If you want and anti-thrombotic effect, a _____ dose of aspirin should be used

A

LOW

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16
Q

If you want and pro-thrombotic effect, a _____ dose of aspirin should be used

A

HIGH

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17
Q

__________ is a human NSAID that is extremely toxic in dogs

A

Naproxen

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18
Q

________ is an NSAID commonly used for its anti-neoplastic effects

A

Piroxicam (anti-angiogenic)

blocks COX-2 expressed by a number of tumor types

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19
Q

________ is an NSAID commonly used for its anti-thrombotic effects at low doses

A

Aspirin

Inhibits thromboxane A2

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20
Q

What general adverse effects can be seen with NSAIDs?

A

Vomiting, diarrhea, anorexia

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21
Q

How do NSAIDs work on the renal system?

A

Inhibition of prostaglandin decreases blood flow to the kidney, which can result in ischemic necrosis

risk is higher in cats

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22
Q

_________ is a non-NSAID with the greatest risk of hepatotoxicity in cats

A

Acetaminophen

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23
Q

What is the result of use of phenylbutazone in dogs?

A

Toxicity leading to bone marrow suppression/agranulocytosis?

24
Q

What must be considered when switching from an NSAID to a corticosteroid?

A

Washout period!!! (1-2 weeks)

25
Q

What must be considered when switching from a corticosteroid to an NSAID?

A

ALWAYS WEAN STEROIDS

26
Q

How can you tell what an appropriate washout period is?

A

Based on half life

27
Q

Approved uses of Meloxicam in cats and dogs?

A
  1. Cats - single injection after a spay
  2. Dogs - Osteoarthritis
28
Q

COX-2 inhibitors that are most commonly used in small animals?

A
  1. Carprofen
  2. Meloxicam
  3. Deracoxib
29
Q

Firocoxib is approved for use in _________

A

Dogs and horses

30
Q

____________ is the 1st NSAID approved for multiple doses in cats (SID for up to 3 days)

A

Robenacoxib

31
Q

MOA of Flunixin Meglumine?

A

Non-selective COX inhibitor

32
Q

Main clinical uses for flunixin meglumine?

A
  1. Analgesic for colic and endotoxemia in horses
  2. Visceral pain in cattle
  3. Antipyretic in swine with resp disease

LA USE ONLY

33
Q

Considerations when choosing what route of admin for flunixin meglumine?

A

Never give IM in horses - muscle necrosis

  • Intracarotid artery injections can cause seizures/CNS stimulation (Admin IV into jug vein!!)
34
Q

Flunixin meglumine should be avoided in what species?

A

Specifically birds due to renal toxicity

but dont use in small animals either

LA only

35
Q

MOA for phenylbutazone?

A

Non selective COX inhibitor

36
Q

Main clinical uses for phenylbutazone?

A

Musculoskeletal pain in horses

BANNED IN DAIRY CATTLE

37
Q

Phenylbutazone should not be given in what routes of admin?

A

Do not give IM or SC tissue necrosis

38
Q

_________ can mask lameness in race horses, so a withdrawal time may be required

A

Phenylbutazone

39
Q

MOA of grapiprant?

A

PGE2 EP4 receptor antagonist

non-cox inhibiting NSAID

40
Q

Why might grapiprant be used over other NSAIDs?

A

Blocks PGE2 EP4 specifically, without blocking PGE2 totally

less renal and GI side effects

41
Q

Main clinical uses for grapiprant?

A

Dogs Only

  • Pain and inflamm associated with osteoarthritis
42
Q

True or False: Acetaminophen is used for its anti-inflammatory, antipyretic, and analgesic properties

A

FALSE

Good for pain and fever but not good for inflammation

43
Q

A cat comes into your clinic with facial swelling and cynotic coloring of the tongue. Respiratory distress was ruled out. What do you suspect?

A

Acetaminophen toxicity due to methemoglobinemia

44
Q

Which drugs target nerve growth factor?

A
  1. Frunevetmab
  2. Bedinvetmab

biologics - monoclonal antibody

45
Q

Clinical use for Frunevetmab and Bedinvetmab?

A

Control of chronic osteoarthritis pain in dogs and cats

46
Q

Gabapentin and Amantadine work on what parts of the pain pathway?

A

Modulation

47
Q

True or False: Gabapentin is a GABA receptor agonist

A

False

48
Q

MOA of Amantadine?

A

Analgesic effects through NMDA receptor antagonist

49
Q

Main clinical use for Gabapentin?

A
  1. Control of neuropathic pain
  2. Stress reduction
  3. Seizures in rabbits
50
Q

What adverse effects can Gabapentin have?

A
  1. Can cause ataxia and sedation
  2. Caution with existing renal dz (excreted by kidneys)
  3. Human oral gaba contains xylitol (toxic)
51
Q

Which of the following has a narrow therapeutic index in small animals?

A. Gabapentin
B. Amantadine

A

Amantadine

52
Q

Main clinical use for amantadine?

A
  1. Neuropathic pain
  2. Good adjunct for chronic pain
53
Q

What route of administration is Amantadine given?

A

PO (oral)

54
Q

List the non-COX analgesics

A
  1. Acetaminophen
  2. Frunevetmab
  3. Bedinvetmab
  4. Gabapentin
  5. Amantadine
55
Q

What formulation of gabapentin is contraindicated in dogs?

A

Human oral version containing xylitol

56
Q

Aspirin has the longest half life in what species?

A

Cats

pharm II (23 decks)

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