Why are opioids not good for some peripheral pain relief?
they need inflammation before opioid receptors activate in the periphery
Break-thru pain is common w/ this class of analgesic.
Opioids have a _____onset time.
A2 agonists are synergistic w/ ______?
Name 3 NMDA receptor agonists.
ketamine, methadone, mepridine
NMDA receptors are found in the _____ and are _______ in the normal animal and ______ by injury.
spinal cord, inactive; activated
Name 3 anesthetics that are good analgesics.
ketamine, dexmedetomidine, nitrous oxide
Name a centrally acting analgesic and how does it work?
tramadol, decreases serotonin and norepi reuptake and weak opioid agonist
What is a limiting factor for gabapentin?
sedation, and takes several weeks to achieve effect
Chronic pain and depression are best treated with these two mood altering drugs.
tricyclic antidepressants (amitriptyline) and MAOI's
What is the drug of choice for management of osteosarcomas? how?
bisphosphates; inhibits osteoclasts
NSAIDS have a ______ and _______ site of action.
central and peripheral
NSAIDS have a synergistic effect w/ ?
NSAIDS have a ______ duration of action.
What do NSAIDS do to the inflammatory response.
T/F NSAIDS are respiratory depressants.
F; they are not
What is the mechanism of action of NSAIDS?
prevent the transformation of arachadonic acid to prostaglandins; inhibit COX 1 and 2 enzymes (one or the other or both)
Which COX enzyme is increased 20 fold with injury, which one is more of the house keeping COX enzyme?
COX 2 = inflam.; 1 = normal body fxn
What happens when the COX 1 enzymes are blocked?
prolonged clotting; GI ulcers and nephrotoxicity via decreased perfusion
What are the only two NSAIDS approved for peri/pre-emptive analgesia?
carprofen, and meloxicam (rimadyl and metacam)
You should try to find the _______ when treating the pain of osteoarthritis with NSAIDS.
lowest possible dose
Corticosteroids ________ the use of NSAIDS.
Carprofen has acute______ toxicity.
Ketoprofen is different from other NSAIDS...why?
COX 1 and 2 activity, anti-thromboxane activity
Which NSAID is mostly used in horses and ruminants? COX 1 and 2?
flunixin meglunine; yes
Aspirin is a COX _____ inhibitor.
Mech of action for sucralfate, misoprostol, ranitidine, omeprazole.
sucralfate = protective barrier, misoprostol = mucosal defense, ranitidine = h2 receptor antagonist, omeprazole = proton pump inhibitor