Small Animal NSAIDs Flashcards
what are the effects of NSAIDs?
anti-pyretic
anti-inflammatory
analgesic
anti-platelet
anti-endotoxemic
anti-cancer
what type of pain are NSAIDs most efficacious and primarily indicated in?
inflammatory pain
what do NSAIDs need to do to have a direct central effect?
enter CNS
why do NSAIDs have a longer peripheral anti-inflammatory effect than their plasma half life suggests?
tend to stay in inflammatory exudate
can acetaminophen be used in dogs?
yes, cautiously
what are the primary clinical uses of NSAIDs?
musculoskeletal conditions
soft-tissue surgery
which NSAIDs have an improved adverse effect profile?
COX-2 selective
how is the evidence of NSAID efficacy in osteoarthritis?
good evidence
what do we use NSAIDs for in osteoarthritis?
to get mobility back, then reduce to lowest effective dosage
what are the best choices for osteoarthritis in a dog?
meloxicam
firocoxib
carprofen
which NSAID has data for osteoarthritis in cats?
meloxicam
not approved for chronic use in US
what is the bioavailability of robenacoxib in a fed and fasted state in a cat?
fed: 10%
fasted: 50%
what is the dose of meloxicam for a cat (chronic use)?
0.1mg/kg and then 0.05mg/kg
have studies shown that response to NSAIDs is variable depending on the nature of the condition and patient?
yes, in animals other than dogs and cats
no data on dogs and cats
how long of a wash-out period is recommended for switching NSAIDs?
one week no drug
is the analgesic dose and the anti-inflammatory dose the same for NSAIDs?
not necessarily
why is application of NSAIDs preoperatively demonstrated to reduce anesthetic requirements?
anti-inflammatory effect that reduces central sensitization
should you use NSAIDs with other peri-operative analgesics?
yes, for immediate post-operative period
for which types of surgery should you not use NSAIDs?
gastrointestinal
bladder
is there conclusive evidence for superior efficacy of one NSAID over another in soft tissue surgery in dogs?
no
which NSAIDs have strong evidence in soft tissue for dogs?
carprofen
firocoxib
which NSAID are people in thee US more comfortable with using for soft tissue in cats?
robenacoxib over meloxicam (history of over-dosing)
does evidence support use of NSAIDs as the sole post-operative analgesic in orthopedic surgery?
no
which NSAID has strong evidence for dogs with orthopedic immediate post-operative analgesia?
carprofen at 4.4mg/kg
which NSAIDs are shown to be efficacious in cats getting neutered an an onychectomy?
robenacoxib
meloxicam
what pain pathways do prostaglandins primarily upregulate?
mechanical pain pathways
what are the drugs of choice for mechanical pain?
opioids
how do NSAIDs reduce mechanical pain?
decrease/prevent central sensitization
central effects (COX 1)
alternative mechanisms
which NSAIDs are permitted in dogs?
aspirin
carprofen
deracoxib
firocoxib
meloxicam
phenylbutazone
robenacoxib
what are the primary clinical uses of NSAIDs in dogs and cats?
musculoskeletal conditions
soft-tissue surgery
orthopedic surgery
back dogs
ophthalmic disorders
anti-pyretic
anti-cancer
anti-thrombotic
what are the best choices for osteoarthritis in dogs?
meloxicam
firocoxib
carprofen
what are the best choices for osteoarthritis in cats?
meloxicam
not approved for long term in US
which NSAID should you not give with food or only minimal food?
robenacoxib
which NSAID should be given as a loading dose to a dog (or cat)?
meloxicam
is the analgesic dose for robenacoxib in a cat the loading dose?
no- no loading dose
which drugs have long half lives and a one week no-drug period might not be sufficient for switching?
meloxicam
carprofen
when might dose reduction strategies be relevant?
chronic use
what dose reduction strategies are used for NSAIDs?
50%, then to 48h, then to 25%, then off
when should you give an NSAID for surgery?
if short procedure, can give pre-op
usually preferred immediately post-op
what is the adverse effect of greatest concern for COX 2 NSAIDs given perioperatively?
renal toxicity
what NSAIDs are labeled for peri-operative use in soft issue surgery?
carprofen
firocoxib
robenacoxib
which drug is preferred in cat soft tissue surgery?
robenacoxib safer than meloxicam
which dose of carprofen is shown to be effective for immediate post-op analgesia in orthopedic surgery for dogs?
4.4 mg/kg
which NSAIDs have good data supporting post-operative analgesia in dog orthopedic surgery?
carprofen
why is robenacoxib the preferred drug for cat orthopedic surgery?
one efficacy study
safety profile
what toxicity does giving an NSAID with food decrease?
gastroduodenal toxicity
not intestinal toxicity
what are the intrinsic toxicities of acetaminophen?
hematotoxicity
hepatotoxicity
what are the pharmacological toxicities of NSAIDs?
gastroenteropathies
renal toxicity
delayed soft tissue healing
which drug has idiosyncratic hepatopathy associated with long term use?
carprofen
robenacoxib
rare
which drug should not be used in young dogs?
firocoxib
which drug has caused acute renal failure in cats?
meloxicam
