Pharm 1

Question 1

What are the indications of NSAIDs?

Answer 1

• Minimise musculoskeletal inflammation
• Provide mild to moderate analgesia e.g. in horse for management of abdominal (non-gastric pain and endotoxaemia
• Reduce fever
• Was used to inhibit platelet plug formation (thrombolytic): Very occasionally used in veterinary practice for this purpose; but other more targeted drugs e.g. clopidogrel Plavix is available for this purpose
• Some oncologic uses (inhibits some tumour factors e.g. colo-rectal cancer in people

Question 2

What are the 3 first line groups of analgesics?

Answer 2

• NSAIDs
• Opiods
• Local anaesthetics - block sensory nerves (block pain perception)

Question 3

What are the mechanisms of NSAID activity?

Answer 3

• Inhibits cyclooxygenase (COX)
• PGE2

Question 4

What problem may arise by inhibiting COX1?

Answer 4

Leads to problems with normal physiological processes

Question 5

What happens when COX2 is inhibited?

Answer 5

Leads to a reduciton in pain, inflammation and fever

Question 6

Are selective or non-selective COX2 inhibitors preferred?

Answer 6

Selective COX2 inhibitors are preferred

Question 7

What are the differences in the pathways from arachidonic acid to COX1 and 2?

Answer 7

Question 8

What does PGE2 regulate?

Answer 8

 Immune responses
 Blood pressure
 Gastrointestinal activity
 Fertility
 involved in all pricesses leading to the classic signs of inflamation (redness and swelling -> blood flow into inflamed tissue via PGE2 arterial dilation and increased microvascular permeability. Also pain due to PGE2 on peripheral nervous system and CNS sensory neurones

Question 9

Draw out the pain perception response pathway

Answer 9

Question 10

What is a Coxib?

Answer 10

• A coxib is a NSAID with significant COX2 inhibition
• NSAIDS are marketed by their COX2 inhibition activity as considered to possess greater specific inhibition of inflammation
• BUT COX2 pathway prosanoids have some important housekeeping functions

Question 11

How are NSAIDs different to other veterinary drug groups?

Answer 11

• They are widely administered and highly marketed
• They are very safe in clinically normal animals
• Vets need to be aware of dose/rate and administration frequency for each NSAID and species e.g. NSAID injection for a cat may be a single injection only
• They cause the greatest number of adverse side effects due to the amount prescribed and inappropriate dose in unwell animals

Question 12

Why wouldnt you use NSAIDs in a prolonged surgery?

Answer 12

Risk of gastric ulceration