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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?

24
Q

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

A

carprofen at 4.4mg/kg

25
which NSAIDs are shown to be efficacious in cats getting neutered an an onychectomy?
robenacoxib meloxicam
26
what pain pathways do prostaglandins primarily upregulate?
mechanical pain pathways
27
what are the drugs of choice for mechanical pain?
opioids
28
how do NSAIDs reduce mechanical pain?
decrease/prevent central sensitization central effects (COX 1) alternative mechanisms
29
which NSAIDs are permitted in dogs?
aspirin carprofen deracoxib firocoxib meloxicam phenylbutazone robenacoxib
30
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
31
what are the best choices for osteoarthritis in dogs?
meloxicam firocoxib carprofen
32
what are the best choices for osteoarthritis in cats?
meloxicam not approved for long term in US
33
which NSAID should you not give with food or only minimal food?
robenacoxib
34
which NSAID should be given as a loading dose to a dog (or cat)?
meloxicam
35
is the analgesic dose for robenacoxib in a cat the loading dose?
no- no loading dose
36
which drugs have long half lives and a one week no-drug period might not be sufficient for switching?
meloxicam carprofen
37
when might dose reduction strategies be relevant?
chronic use
38
what dose reduction strategies are used for NSAIDs?
50%, then to 48h, then to 25%, then off
39
when should you give an NSAID for surgery?
if short procedure, can give pre-op usually preferred immediately post-op
40
what is the adverse effect of greatest concern for COX 2 NSAIDs given perioperatively?
renal toxicity
41
what NSAIDs are labeled for peri-operative use in soft issue surgery?
carprofen firocoxib robenacoxib
42
which drug is preferred in cat soft tissue surgery?
robenacoxib safer than meloxicam
43
which dose of carprofen is shown to be effective for immediate post-op analgesia in orthopedic surgery for dogs?
4.4 mg/kg
44
which NSAIDs have good data supporting post-operative analgesia in dog orthopedic surgery?
carprofen
45
why is robenacoxib the preferred drug for cat orthopedic surgery?
one efficacy study safety profile
46
what toxicity does giving an NSAID with food decrease?
gastroduodenal toxicity not intestinal toxicity
47
what are the intrinsic toxicities of acetaminophen?
hematotoxicity hepatotoxicity
48
what are the pharmacological toxicities of NSAIDs?
gastroenteropathies renal toxicity delayed soft tissue healing
49
which drug has idiosyncratic hepatopathy associated with long term use?
carprofen robenacoxib rare
50
which drug should not be used in young dogs?
firocoxib
51
which drug has caused acute renal failure in cats?
meloxicam

Clinical Pharmacology (19 decks)

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