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Clinical Pharmacology > Small Animal NSAIDs > Flashcards

Small Animal NSAIDs Flashcards

1
Q

what are the effects of NSAIDs?

A

anti-pyretic
anti-inflammatory
analgesic
anti-platelet
anti-endotoxemic
anti-cancer

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2
Q

what type of pain are NSAIDs most efficacious and primarily indicated in?

A

inflammatory pain

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3
Q

what do NSAIDs need to do to have a direct central effect?

A

enter CNS

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4
Q

why do NSAIDs have a longer peripheral anti-inflammatory effect than their plasma half life suggests?

A

tend to stay in inflammatory exudate

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5
Q

can acetaminophen be used in dogs?

A

yes, cautiously

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6
Q

what are the primary clinical uses of NSAIDs?

A

musculoskeletal conditions
soft-tissue surgery

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7
Q

which NSAIDs have an improved adverse effect profile?

A

COX-2 selective

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8
Q

how is the evidence of NSAID efficacy in osteoarthritis?

A

good evidence

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9
Q

what do we use NSAIDs for in osteoarthritis?

A

to get mobility back, then reduce to lowest effective dosage

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10
Q

what are the best choices for osteoarthritis in a dog?

A

meloxicam
firocoxib
carprofen

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11
Q

which NSAID has data for osteoarthritis in cats?

A

meloxicam
not approved for chronic use in US

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12
Q

what is the bioavailability of robenacoxib in a fed and fasted state in a cat?

A

fed: 10%
fasted: 50%

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13
Q

what is the dose of meloxicam for a cat (chronic use)?

A

0.1mg/kg and then 0.05mg/kg

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14
Q

have studies shown that response to NSAIDs is variable depending on the nature of the condition and patient?

A

yes, in animals other than dogs and cats
no data on dogs and cats

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15
Q

how long of a wash-out period is recommended for switching NSAIDs?

A

one week no drug

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16
Q

is the analgesic dose and the anti-inflammatory dose the same for NSAIDs?

A

not necessarily

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17
Q

why is application of NSAIDs preoperatively demonstrated to reduce anesthetic requirements?

A

anti-inflammatory effect that reduces central sensitization

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18
Q

should you use NSAIDs with other peri-operative analgesics?

A

yes, for immediate post-operative period

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19
Q

for which types of surgery should you not use NSAIDs?

A

gastrointestinal
bladder

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20
Q

is there conclusive evidence for superior efficacy of one NSAID over another in soft tissue surgery in dogs?

A

no

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21
Q

which NSAIDs have strong evidence in soft tissue for dogs?

A

carprofen
firocoxib

22
Q

which NSAID are people in thee US more comfortable with using for soft tissue in cats?

A

robenacoxib over meloxicam (history of over-dosing)

23
Q

does evidence support use of NSAIDs as the sole post-operative analgesic in orthopedic surgery?

A

no

24
Q

which NSAID has strong evidence for dogs with orthopedic immediate post-operative analgesia?

A

carprofen at 4.4mg/kg

25
Q

which NSAIDs are shown to be efficacious in cats getting neutered an an onychectomy?

A

robenacoxib
meloxicam

26
Q

what pain pathways do prostaglandins primarily upregulate?

A

mechanical pain pathways

27
Q

what are the drugs of choice for mechanical pain?

A

opioids

28
Q

how do NSAIDs reduce mechanical pain?

A

decrease/prevent central sensitization
central effects (COX 1)
alternative mechanisms

29
Q

which NSAIDs are permitted in dogs?

A

aspirin
carprofen
deracoxib
firocoxib
meloxicam
phenylbutazone
robenacoxib

30
Q

what are the primary clinical uses of NSAIDs in dogs and cats?

A

musculoskeletal conditions
soft-tissue surgery
orthopedic surgery
back dogs
ophthalmic disorders
anti-pyretic
anti-cancer
anti-thrombotic

31
Q

what are the best choices for osteoarthritis in dogs?

A

meloxicam
firocoxib
carprofen

32
Q

what are the best choices for osteoarthritis in cats?

A

meloxicam
not approved for long term in US

33
Q

which NSAID should you not give with food or only minimal food?

A

robenacoxib

34
Q

which NSAID should be given as a loading dose to a dog (or cat)?

A

meloxicam

35
Q

is the analgesic dose for robenacoxib in a cat the loading dose?

A

no- no loading dose

36
Q

which drugs have long half lives and a one week no-drug period might not be sufficient for switching?

A

meloxicam
carprofen

37
Q

when might dose reduction strategies be relevant?

A

chronic use

38
Q

what dose reduction strategies are used for NSAIDs?

A

50%, then to 48h, then to 25%, then off

39
Q

when should you give an NSAID for surgery?

A

if short procedure, can give pre-op
usually preferred immediately post-op

40
Q

what is the adverse effect of greatest concern for COX 2 NSAIDs given perioperatively?

A

renal toxicity

41
Q

what NSAIDs are labeled for peri-operative use in soft issue surgery?

A

carprofen
firocoxib
robenacoxib

42
Q

which drug is preferred in cat soft tissue surgery?

A

robenacoxib safer than meloxicam

43
Q

which dose of carprofen is shown to be effective for immediate post-op analgesia in orthopedic surgery for dogs?

A

4.4 mg/kg

44
Q

which NSAIDs have good data supporting post-operative analgesia in dog orthopedic surgery?

A

carprofen

45
Q

why is robenacoxib the preferred drug for cat orthopedic surgery?

A

one efficacy study
safety profile

46
Q

what toxicity does giving an NSAID with food decrease?

A

gastroduodenal toxicity
not intestinal toxicity

47
Q

what are the intrinsic toxicities of acetaminophen?

A

hematotoxicity
hepatotoxicity

48
Q

what are the pharmacological toxicities of NSAIDs?

A

gastroenteropathies
renal toxicity
delayed soft tissue healing

49
Q

which drug has idiosyncratic hepatopathy associated with long term use?

A

carprofen
robenacoxib
rare

50
Q

which drug should not be used in young dogs?

A

firocoxib

51
Q

which drug has caused acute renal failure in cats?

A

meloxicam

Clinical Pharmacology (19 decks)

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