vet tech anti-inflammatory/pain reducing drugs

steroidal anti-inflammatory drug

group of anti-inflammatory drugs that have the steroid configuration of carbon atoms in four interlocking ring (ex: glucocorticoids -cortisol) block enzyme action of phospholipase

nonsteroidal anti-inflammatory drug (NSAID)

drug that reduces inflammation by inhibiting prostaglandin production (aspirin, phenylbutazone); block enzyme action of cyclooxygenase

corticosteroids

hormones produced by the adrenal cortex; include both glucocorticoids and mineralocorticoids

glucocorticoids

type of corticosteroid that raises the concentration of liver glycogen and blood sugar in the body

mineralocorticoids

corticosteroids that function primarily to help the body retain sodium and the kidneys secrete postassium

iatrogenic

caused by treatment

antipyretic

fever reducing

clinical signs of inflammation

pain, heat, redness, swelling, decreased range of motion

The inflammation pathway step 1 - _____ in the cell membrane are broken down by the enzyme ______. This results in the production of ________ acid.

phospholipids; phospholipase; arachidonic

The inflammation pathway step 2 - The enzyme ______ breaks down arachidonic acid to _______ and ______.

cyclooxygenase; prostaglandins and thromboxanes;

The inflammation pathway: another enzyme _______, can also break down arachidonic acid producing ______.

lipoxygenase; leukotrienes

______ and _____ are chemicals that induce inflammation. _______ causes aggregation of platelets.

Prostaglandins and leukotrienes; Thromboxanes

two groups of corticosteroids synthesized by the adrenal cortex are important in vet med:

glucocorticoids and mineralocorticoids

the main glucocorticoid in animals is:

cortisol

the main mineralocorticoid in animals is:

aldosterone

mineralocorticoids mainly help the body retain ____ and ____; and help the body maintain ____ and _____ balance.

sodium and water; fluid and electolyte

glucocorticoids have an anti-inflammatory effect because they inhibit______. Thus glucocorticoids help stabilize ____ ________.

phospholipase; cell membranes

glucocorticoids raise the concentration of liver glycogen and increase blood glucose levels; they also affect carbohydrate, protein, and fat metabolism. They are produced by the ______ in response to ______ hormone which is secreted by the ______.

adrenal cortex; ACTH - adrenocorticotropic hormone; anterior pituitary gland

glucocorticoid drugs are used to treat:

inflammation, allergic reactions, systemic diseases (Addisons)

benefits of glucocorticoid drugs:

reduce inflammation; reduce pain; relieve pruritus; reduce scarring; reduce tissue damage;

cons of glucocorticoid drugs:

delay wound healing; increase risk of infection by decreasing attraction of leukocytes to site; GI upset/bleeding; risk of corneal ulceration; induce abortion in some species

short acting drugs have a duration of ______; intermediate acting drugs between __ and ___ hours; long acting ____

less than 12; 12-36; over 48

glucocorticoids can be given:

oral, parenteral, topical

Use of systemic glucocorticoids can result in iatrogenic Cushings disease which is _____

hyperadrenocorticism - overproduction of gluccocorticoids

clinical signs of Cushings:

PU, PD, lethargy, bilateral symmetrical alopecia; pendulous abdomen;

side effects of glucocorticoids:

PU, PD, polyphagia, suppressed healing; gastric ulcers, thinning of skin, muscle wasting

systemic glucocorticoid use side effects:

lymphopenia, eosinopenia, monocytopenia, neutrophilia, thrombocytopenia

short duration of action glucocorticoids

cortisone, hydrocortisone (Cortone; Cortef; Solu-Cortef)

intermediate duration of action glucocorticoids:

isoflupredone; methylprednisolone (Medrol); methylprednisolone acetate (Depo-Medrol); prednisone/prednisolone; triamcinolone (Vetalog)

long duration of action glucocorticoids:

betamethasone (Betasone); dexamethasone (Azium); flumethasone (flucort); fluocinolone (synalar)

prednisone is converted to prednisolone by the _____

liver; so prednisolone saves the liver a step

chronic diseases glucocorticoids help

arthritis, tendonitis, bursitis; conjunctivitis, dermatitis

taper animals off glucocorticoid drugs to prevent iatrogenic ______

Addison's (hypoadrenocorticism)

glucorticoid drugs should not be used in animals with _____ ______.

corneal ulcers

NSAIDS work by inhibiting_____

cyclooxygenase (the enzyme that converts arachidoic acid to prostaglandin); also called prostaglandin inhibitiors

Side effects of NSAIDs:

gastric ulceration and bleeding, bone marrow suppression, tendency to bleed

functions of NSAIDs

analgesia, inhibition of platelet aggregation, and fever reduction

significant side effect of NSAID use in animals with hypotensive condition=

renal papillary necrosis

oldest anti-inflammatory category

Salicylates

most common salicylate

aspirin

salicylate drug that is analgesic, antipyretic, anti-inflammatory, and reducer of platelet aggregation

aspirin

aspirin is used to treat:

osteoarthritis; pain relief, reduce fever, some forms of shock

do not give aspirin to _____

cats; they can't metabolize it (if necessary - lower doses and less frequency - 48-72hrs;

to reduce gastric side effects, give aspirin:

with food

signs of salicylate toxicity:

(aspirin)GI problems (anorexia, ab pain, gi upset, vomiting, diarrhea, melena, lethargy); respiratory problems, neurological, bleeding problems, kidney failure

a Pyrazolone derivative NSAID

phenylbutazone or "bute"

frequently used in equine medicine for pain associated with the musculoskeletal system such as laminitis and bone pain

phenylbutazone

comes in paste, tablet, powder, and bolus forms for oral use; and gel and injectable forms;

phenylbutazone

phenylbutazone is what category?

pyrazolone derivative

2003 banned by FDA for use in dairy cattle because this drug is known to cause blood disorders in humans

phenylbutazone

main side effect of phenylbutazone_______; how to help this?

gastric ulcers; give with anti-ulcer agent; should also have proper pasture time and hay

oral and gastrointestinal erosions and ulcers, diarrhea, and renal necrosis are side effects of

phenylbutazone

group of NSAIDs that end in -fen

Propionic Acid Derivatives

proprionic acid derivatives (4)

ibuprofen (Motrin, Advil); ketoprofen (Ketofen, Orudis); carprofen (Rimadyl); naproxen (Equiproxen, Aleve)

generic Rimadyl =

carprofen

proprionic acid derivatives for use in horses: (2)

ketoprofen and naproxen

proprionic acid derivative for use in dogs:

carprofen

side effects of Rimadyl (proprionic acid derviatives) are:

GI ulceration, vomiting, anorexia

before giving _____, blood work should be run to test for _____ enzymes. Especially for what breed?

carprofen (Rimadyl); labrador

which propionic acid derivative may cause perforated gastric ulcers in dogs? (listed in book, not in notes)

naproxen

a cox-2 inhibitor indicated for the control of postoperative pain and inflammation associated with orthopedic surgery in dogs

deracoxib (Deramaxx)

deracoxib brand name =

Deramaxx

side effects are vomiting, anorexia, diarrhea, and blood abnormalities such as elevated kidney and liver values

Deramaxx (deracoxib)

Metacam generic name:

meloxicam

cox-2 inhibitor used mainly in small animals. in dogs given orally in food for musculoskeletal disorders; cat given SQ prior to surgery

meloxicam (Metacam)

used to treat mastitis in dairy cows

meloxicam (Mobic)

do not use in conjunction with other NSAID's or glucocorticoid drugs

meloxicam (Mobic)

anorexia, vomiting, diarrhea, lethargy are side effects; death with overdose

meloxicam (Mobic)

meloxicam will ____ healing time by hindering WBC going to tissue

delay

NSAID given IM or IV used mainly in horses and cattle

flunixin meglumine

flunixin meglumine names:

Banamine; Finadyne

flunixin meglumine treats

musculoskeletal and colic pain mainly. also for shock, intervertebral disc disease, and surgery pain, parvovirus infection (mainly cattle and horses)

onset of analgesia for flunixin is in ____ minutes

15

DMSO =

dimethyl sulfoxide

well known to penetrate skin and serve as a carrier for other drugs

dimethyl sulfoxide - DMSO

anti inflammatory commonly used in dogs ears

DMSO

treatment for CNS swelling

DMSO - dimethyl sulfoxide

ppe used for applying DMSO

rubber gloves; and bandage over application site

causes a garlic taste in mouth

DMSO

name brand EtoGesic; generic = etodolac; category=

Indol Acetic Acid Derviative

Fenamates are used for osteo arthritis treatment in ?

horses

quick dissolve tablet for dogs; dual pathway nsaid

Zubrin

Brand name for Diclofenac sodium used in horses for joint pain and inflammation

Surpass

Surpass (diclofenac sodium) is applied _____; ppe =?

topically; rubber gloves

2nd drug of choice after Rimadyl

Deracoxib (Deramaxx)

antihistamines do not block histamine production, but compete with histamine for its _______ ____

receptor site

histamine causes:

dilation of blood vessels, increased capillary permeability ;smooth muscle spasming, and increased glandular secretion

cetirizine -=

zyrtec

clemastine

Tavist

chlorpheniramine

Chlor-trimeton

dimenhydrinate =

Dramamine

diphenhydramine

Benadryl

drugs that relieve pain without causing loss of consciousness =

analgesics

These are also called H1 blockers

antihistamines

cause bronchoconstriction and inflammatory changes

anti-hsitamines

histamine is released from ___ cells

mast

to work, antihistamines have to be given before/after exposure?

before

Anti-histamines are considered dual purpose, as they have ----, ----, and --- effects

anti-emetic, anti-inflammatory, analgesic

side effects of anti-histamines are:

dry mouth; urinary retention, CNS depression

Temaril-P is a combination drug that contains:

anti-histamine and steriod