E3 - Anti-inflammatory/Pain Reducing drugs

Naturally occurring chemicals produced by cells in the body (damaged)

Prostaglandins

Term for Fever stopping / Fever reducing

Antipyretic

The useful, normal response of living tissue to injury, often accompanied by pain

Inflammation

5 signs of inflammation

pain, heat, redness, swelling, decreased function

2 main groups of anti-inflammatory drugs

Steroidal Anti-inflammatory drugs, Nonsteroidal Anti-inflammatory drugs

Which group of anti-inflammatory drugs block the action of phospholipase

Steroidal

Which group of anti-inflammatory drugs blocks the action of cyclooxygenase

NSAIDs

What is naturally produced by the adrenal cortex

Corticosteriods

What are the 2 Exogenous Steroids used a medication in vet med

Glucocorticoids, Mineralcorticoids

Which steroid is used to treat inflammation and cause immunosuppression

Glucocorticoids

Which steroid is used to treat Addison’s disease

Mineralcorticoids

Are Low or High doses of Glucocorticoids used to treat inflammation, pruritis, and allergic responses

Low

Are Low or High doses of Glucocorticoids used to suppress immune system, treat some cancers and immune mediated diseases

High

Glucocorticoid drug names end in ?

-sone

2 Short acting Glucocorticoids (< 12 hrs)

Cortisone, Hydrocortisone

2 Intermediate-acting Glucocorticoids (12-36 hrs)

Prednisone, Prednisolone

3 Long-acting Glucocorticoids (> 36 hrs)

Dexamethasone, Betamethasone, Fluocinolone

Cats must be given ? instead of prednisone

prednisolone

4 benefits of Glucocorticoids

reduce inflammation/pain, relieve pruritis, reduce scaring by delaying wound healing, reduce tissue damage

6 drawbacks of Glucocorticoids

PU/PD/PP, delay wound healing, inc infection risk, GI ulcers/bleeding, Corneal ulcers, induce parturition/abortion

Glucocorticoids do not ? disease, they control ?

cure, inflammation

Glucocorticoids may allow ? to spread in the body

pathogens

Caution should be used in what animals when using Glucocorticoids

pregnant

Whenever possible, use ? or ? forms of Glucocorticoids to avoid exposing entire body

topical, locally acting

What kind and what level of dosing of Glucocorticoids should be used whenever possible to prevent iatrogenic Cushing’s disease

alternate days, lowest

How should animals be taken off of Glucocorticoids to prevent iatrogenic Addison’s disease

tapered

What can higher doses and long usage of Glucocorticoids lead to

iatrogenic Cushing’s disease

What can happen if animals are not tapered off of glucocorticoids

iatrogenic Addison’s disease

Do not use Glucocorticoids in animals that have what?

corneal ulcers

Remember that steroid use can lead to these 3 things (P’s)

PU/PD/PP

NSAIDs work by inhibiting cyclooxygenase (COX) which is an enzyme that promotes

prostaglandin production

Which prostaglandins are responsible for housekeeping functions, stomach health, blood flow to kidneys, and platelet production?

Cox-1

Which prostaglandins are responsible for inflammation and are activated by tissue damage?

Cox-2

NSAIDs are also referred to as

prostaglandin inhibitors

3 side effects of NSAIDs

GI ulceration/bleeding, bone marrow suppression, kidney damage

What is the Cox-1 side effect of NSAIDs

GI ulceration and bleeding

Do steroids or NSAIDs have fewer side effects

NSAIDs

What are 3 functions of Cox-1

produce protective mucous layer of stomach lining, maintain platelet function, promote blood flow through kidneys

3 Cox-2 functions

inflammation, vasodilation, edema

Which Cox should be targeted to manage pain and inflammation?

Cox-2

Many NSAIDs are Cox ?

selective

Cox selectivity ? between species even when using the same NSAID

varies

Does being Cox-1 or Cox-2 selective mean the other Cox is completely spared?

No

3 main functions of NSAIDs

Antipyretic, Anti-inflammatory, Analgesic

4 main adverse effects of NSAIDs

V/D, GI ulceration, Nephrotoxicity, Platelet issues

1 example of a Salicylate

Aspirin

What drug is a non-selective inhibitor of prostaglandin synthesis and is a Salicylate

Aspirin

Aspirin inhibits what Cox/Coxs

Cox-1, Cox-2

4 functions of Aspirin

analgesia, antipyretic, anti-inflammatory, reduce platelet aggregation

Is Aspirin used often in vet med?

no

5 side effects of Aspirin

GI upset, V/D, panting, neurological, inability to clot

What animal cannot metabolize Aspirin as rapidly as other species

cats

Aspirin in cats must be given at ? doses with a ? frequency

low, low

1 example of a Pyrazolone Derivative

Phenylbutazone

Whats the shortened name for Phenylbutazone

Bute

Is Phenylbutazone a selective or non-selective Cox inhibitor?

Non-selective

Phenylbutazone is used for what animals for analgesia for musculoskeletal issues, antipyretic, and anti-inflammatory

Horses

What is a side effect of Phenylbutazone

GI ulcers

What can be given with Phenylbutazone to decrease risk of GI ulcers

omeprazole

Phenylbutazone is banned for use in what animals by the FDA

dairy cows

Proprionic Acid Derivative drugs end in what

-fen

What Proprionic Acid Derivative is used in dogs

Carprofen

What Proprionic Acid Derivative is used in horses

Ketoprofen

What 2 Proprionic Acid Derivatives are not approved for animal use in the US

Ibuprofen, Naproxen

What Cox does Carprofen work on?

Cox-2

Ketoprofen functions works on what 2 things

Cox, Lipoxygenase

4 side effects of Proprionic Acid Derivatives

GI ulcers, V/D, anorexia, rare liver tox in labs

Selevtive Cox-2 Inhibitor drugs end in what 2 endings depending on the group their in

-coxib, -oxicam

3 examples of -coxib group of NSAIDs (Selective Cox-2 inhibitors)

Deracoxib, Firocoxib, Robenacoxib

Which -coxib group of NSAIDs in used in cats only

Robenacoxib

-coxib group of NSAIDs target ? to a more significant degree than ?

Cox-2, Cox-1

2 side effects of -coxib group of NSAIDs

V/D, Liver and kidney enzyme elevation

1 side effect of Robenacoxib

GI ulceration

2 examples of -oxicam group of Selective Cox-2 inhibitors

Meloxicam, Piroxicam

-oxicam group drugs preferentially inhibit ?

Cox-2

2 routes of administration of Meloxicam in dogs

oral, injectable

What route of administration of Meloxicam is FDA approved in cats

injectable

What is the only NSAID approved for beef and dairy cattle by IV

Flunixin Meglumine

Is Flunixin Meglumine a selective or non selective inhibitor of Cox

non selective

Flunixin Meglumine should never be given via this route

IM

Flunixin Meglumine should only be given via these two routes

IV, PO

IM administration of Flunixin Meglumine can lead to what 2 things

tissue necrosis, clostridial myositis

1 example of a Prostaglandin receptor antagonist for dogs

Grapiprant

Grapiprant is an NSAID that doesn’t block ?

Cox

This anti-inflammatory drug penetrates the skin and serves as a carrier of other drugs, causes vasodilation, and inactivates superoxide radicals produced by inflammation

DMSO

This pain reliver is a non-narcotic, non NSAID, non steroid and can be used in dogs

Acetominophen

Does Acetaminophen control inflammation?

no

Acetaminophen is very toxic to what animal

cats

Can 2 NSAIDs or NSAIDs and glucocorticoids be used together?

no

what 3 types (conditions) of patients should not be given NSAIDs

dehydrated, hypovolemic, hypotensive

Cyclosporin is a highly effective ? drug

immunosuppressive

Cyclosporin is approved for treatment of ? in dogs and cats

atopic dermatitis

Cyclosporin can be used off label to suppress immune system in cases of what 4 things

IMHA, ITP, IBD, perianal fistula

This immunosuppressive drug is a topical ointment used in dogs as a component of treatment for perianal fistula, cutaneous lupus erythematous

Tarcolimus

This immunosuppressive drug is FDA approved to treat atopic dermatitis in dogs

Oclacitinib

what 2 things are at an increased risk when usin gimmunosuppressive drugs

infection, neoplasia