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29 terms

NSAIDs

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What are the 3 pharmacological properties all NSAIDs share, except acetaminophen?
analgesia, anti-inflammatory, antipyretic
How do NSAIDs reduce production of PGs and thromboxanes?
inhibits the enzyme cyclooxygenase
Which type of pain are NSAIDs best at treating: pain of the integument or deep, visceral pain?
pain of the integument
How do NSAIDs cause antipyresis?
Block production of PGE2 in hypothalamus
How do NSAIDs cause GI ulceration and bleeding?
Block PGE2 from inhibiting the proton pump in parietal cells and from stimulating mucosal secretions (thus there is more acid and less protection in the stomach)
How do NSAIDs block platelet function?
Block TxA2 synthesis so there is more vasodilation and less coagulation (due to PGI2)
NSAID prevention of PGE2 in the kidneys and GI tract can lead to what?
ischemic renal tube injury and ischemic intestinal damage
Which cyclooxygenase isoform is constitutively produced and is vital for protecting the stomach lining and preventing ulcers?
COX-1
Which cyclooxygenase isoform is an inducible enzyme only expressed in inflammed tissues?
COX-2
Why did COX-2 inhibitors not work?
Did not know that COX-2 was involved in PGI2 production by vascular endothelium (created increased vasoconstriction, platelet aggregation, and decreased remodeling ability of blood vessels) and that it plays a role in healing of GI ulcers
How are aspirin and salicylate related?
Aspirin is absorbed from the stomach and rapidly deesterfied to salicylate in plasma, liver, and erythrocytes
What drug is used in cats occasionally for anti-platelet effects and can be given with an antacid (Maalox)?
Aspirin
Which drug should be avoided in patients with renal or liver disease, or any known GI problems, should not be given with aminoglycoside Abx or with in 2 weeks of a major surgical procedure?
Aspirin
What drug can be used in conjunction with codeine, is analgesic and antipyretic but has little anti-inflammatory properties?
Acetaminophen
What drug should be avoided in cats, and for which signs of overdose include hemolysis, methemoglobinemia, and hepatic and renal damage?
Acetaminophen
What drug is used to treat acetaminophen overdoses?
Acetylcystine
What two NSAIDs are at risk for drug interactions due to their high protein binding properties?
Aspirin, Phenylbuatzone
What drug is used widely in equine medicine to treat laminitis and nonarticular rheumatism?
Phenylbutazone
What drug accumulates with chronic dosing, high incidence of fluid retention and GI ulceration, including oral and esophageal ulcers, and has a narrow therapeutic range?
Phenylbutazone
Name the 4 propionic acid derivative drugs:
naproxen, ketoprofen, flurbiprofen, carprofen
Which propionic acid derivative is approved for IV use in horses and to treat osteoarthritis in dogs?
Ketoprofen
Which propionic acid is used topically to prevent miosis during surgery?
Flurbiprofen
What propionic acid derivative is widely used in dogs to treat osteoarthritis and post-op pain?
Carprofen
What propionic acid derivative is somewhat less ulcerogenic but hepatotoxicity has been reported with use?
Carprofen
What NSAID is an excellent agent to relieve pain in colic horses and to treat endotoxic shock and to reduce post-surgical ocular inflammation in dogs and cats?
Flunixin (Banamine)
What NSAID is potent, long-acting, and is approved for parenteral use in horses?
Flunixin
What NSAID is a good anti-inflammatory agent in dogs for osteoarthritis, has a long DOA, a lower incidence of GI effects, and is a moderately selective COX-2 inhibitor?
Etodolac
Which NSAID is a relatively nonselective COX inhibitor and a 5-lipoxygenase inhibitor, is available in rapidly-disintegrating tablets, and has shown to provide good relief with less GI symptoms?
Topoxalin
What NSAID is a parenteral agent with analgesic properties comparable to opioids?
Ketorolac