Quiz 11 Flashcards
COX
Cyclooxygenase
COX-1
Maintains physiologic functions such as renal blood flow, platelet function and, gastric mucosal integrity.
COX-1 Negative affects
Reduced renal blood flow, bleeding, GI ulceration.
NSAID most common side effects
GI ulceration and bleeding
Less common NSAID Side effects
Hepatotoxicity, nephrotoxicity, inhibition of cartilage metabolism, bone marrow supression and, bleeding tendencies
Where are NSAIDS well absorbed?
The stomach
NSAIDS don’t block what pain?
Severe somatic or visceral pain
PgE Would Normally Do All of The Following:
1) Decrease volume/acidity/pepsin content of gastric secretions.
2) Stimulate secretion of HCO-3 t neutralize acid entering stomach.
3) Increase perfusion of gastric mucosa : stimulate gastric & enteric mucus production.
4) Stimulate turnover & repair of GI epithelial cells.
PgE is?
Prostaglandin E2 (PGE2) is a potent inflammatory mediator that is generated by cyclooxygenase 2 (COX2) conversion of arachidonic acid.
COX 2 Inhibition
Beneficial effects
Suppression of inflammation
Alleviation of pain
Reduction of fever
Propionic Acids
Ibuprofen Naproxen Carprofen Ketoprofen (cox & lox) Vedaprofen
Salicylates
Aspirin
Enolic Acids
Phenylbutazone
dipyrone
Pyranocarboxylic
Etodolac
Ketorolac
Oxicams
Meloxicam
Piroxicam
Nicotinic acid
Flunixin meglumine
Fenamtes
Meclofenamic acid
Tolfenamic acid
Coxib-class
Deracoxib
Fibrocoxib
Robenacoxib
Para-aminophenol
Acetaminophen
1st Generation
Aspirin , Phenylbutazone , Meclofenamic acid
2nd Generation
Carprofen , Etodolac , Meloxicam , Tolfenamic acid , Ketoprofen
3rd Generation
Tepoxilin , Deracoxib , Firocoxib , Mavacoxib , Robenacoxib , Cimicoxib
COMMON NSAID’s: Phenylbutazone
BUTAZONE®️ , BIZOLIN®️ , CENTRIBUTE®️ , EQUIPALAZONE®️ ……
(Trade Names)
Musculoskeletal lameness , pyrexia associated with viral* infection
Prolonged half life in ruminants = every 2-3 days
COMMON NSAID’s: Naproxen
ANAPROX®️ , NAXEN®️ , APO-NAPROXEN®️
(Trade Names)
HORSES are only used for BUTE but are said to be better than BUTE.
Extremely effective for muscle pain & soft tissue injuries in horses
Has enterohepatic circulation in dogs and therefore this extends the half life , 3 days
COMMON SAID’s: Carprofen
RIMADYL ®️ (Trade Names)
Preferentially inhibits COX-2 , therefore the adverse effects of NSAID’s is decreased, first one licensed as such.
Antipyretic , analgesic , anti-Infl. , anti-platelet function.
COMMON SAID’s: Ketoprofen
ANAFEN®️ (Trade Names)
COX-1 AND LIPOXYGENASE inhibitor
Does not mix well with other drugs
Do not use with other NSAID’s / steroids
COMMON SAID’s: Flunixin meglumine
BANAMINE®️ (Trade Names)
Licensed for use in horses: colic, uveitis
Potent , effects comparable to the opioids
Sequesters in inflammatory sites*
Oral – paste or IV (optimal)
Muscle injections associated with clostridial myositis
Common NSAIDs: Meloxicam
METACAM®️
Preferentially inhibits COX-2
Musculoskeletal disorders in dogs cats*
*indications of use
Common NSAIDs: Etodolac
ETOGESIC®️
Osteoarthritis in dog
Removed from the market.
Still can order generic compounds
of the active ingredient.
Common NSAIDs: Vedaprofen
Vetprofen®️ & Quadrisol®️ 100(Trade Names)
Osteoarthritis in dogs
Pain and inflammation in horses (+/- colic)
Paste
It is not a permitted medication for Equine Canada or
FEI.
Withdrawal Time: 72 hours
COMMON NSAIDs: Acetysalicyclic acid
Human Preparations:
Aspirin , Ecotrin , Entrophen (Trade Names) Controls mild to moderate pain. DJD , Saddle thrombus in cats , heartworm disease. Significantly lower doses used for cats GIT ulceration , von Willebrand’s , asthma
NSAID - Acetominophen
Tylenol
Poisonous in cats
Rarely used in veterinary medicine unless combined with codeine
Reduces fever and likely reduces the perception of pain (not inflammation)
Gastrointestinal side effects are rare but it can cause liver and kidney dysfunction in all animals
Poisonous in cats: liver damage, methemoglobin (chocolate-colored mucous membranes) and dark urine caused by methemoglobin in the blood and urine
DOMOSO™
DMSO
Compound is dimethyl sulfoxide
Anti-infl. , analgesic ; interferes with neutrophil chemotaxis , potent diuretic
Many uses , many off label!!!
DMSO Cautions
Wear gloves!!
Thoroughly cleanse area to avoid absorption of Bacterial toxins, Chemicals, Oils, grease, insecticides
Applied topically: Erythema, Edema, pruritus Horses it can cause hemolysis Hemoglobinuria IV injections <20% Not considered safe in pregnant animals
MSM: Flexagen®
{Methylsulfonylmethane}
A metabolite of DMSO
…expected to scavenge oxygen radicals, and provide analgesic effects
PSGAG: Adequan®
{Polysulfated Glycosaminoglycan}
A potent proteolytic enzyme inhibitor that diminishes or reverses the processes that result in the loss of cartilaginous mucopolysaccharides.
Noninfectious degenerative and/or traumatic joint dysfunction and associated lameness
Hyaluronase®
Hyaluronic Acid:
A linear polydisaccharide (glucuronic acid + glucosamine) , it is an essential component of synovial fluid.
Acts as a lubricant by increasing viscosity of synovial fluid
Antiinflammatory action comes from suppression of PG
Persists in joints for several days if given IA
Half life in horses is 96 hours if given IV
Oral Nutraceuticals: Cosequin®
Synthesized glucosamine
Chrondroitin sulfates
Manganes ascorbate
Oral Nutraceuticals: Glyco-flex®
Mucopolysaccharides
Mixed glycosaminoglycans
Chelating metals
Nutraceuticals:
Non-drug substance
Purified and extracted
Administered orally
Provides nutritional building blocks for normal body structure and function
Intent is to improve health and well being
