NSAIDs

Question 1

Meloxicam

Answer 1

• COX 2 selective
• oral syrup, chewable or injectable
• long half life in dogs and cats
• safe but expensive
• common use: osteoarthritis
• also used for postoperative pain
• can be used in dogs, cats, calves, horses, pigs, birds (higher dose needed)
• need to be careful with production animals because there needs to be a withdrawal time before it can be used for meat

Question 2

Aspirin (acetylsalicylic acid)

Answer 2

• mainly COX 1 inhibitor
• NEVER USE IN CATS
• very large differences in species elimination rate
• least expensive choice for anti-inflammatory and analgesics in dogs
• CAUTION: irreversible antiplatelet therapy/fxn
• commonly causes subclinical and clinical GI irritation or ulceration
• tx overdose with NaHCO3

Question 3

Acetaminophen (Tylenol)

Answer 3

• COX 3 inhibitor and possible serotonin inhibition
• analgesic only, not an antiimflammatory
• NEVER GIVE TO CATS!

Question 4

Carprofen (Rimadyl)

Answer 4

• COX 2 selective
• tablets or injectable
• can use single doses in cats but not chronic use
• can be used in horses
• racemic mixture (50:50) - S=COX inhibition, R = analgesica
  
  • with dogs they can’t convert it but it is OK because they have both within the mixture
• hepatic metabolism with enterohepatic recirculation therefore high concentrations within the duodenum. but GI toxicity is infrequent. Need to monitor live enzymes because idiosyncratic hepatotxicity (esp labs)
• risk of ulceration with high doses
• stimulates glucosaminoglycan synthesis when low concentrations and inhibits it when high concentrations

Question 5

Flunixin meglumine (Banamine)

Answer 5

• DO NOT INJECT INTO MUSCLE WITH ANY SPECIES
• COX 1 selective
• injectable and oral (can be added to food)
• used in equine, approved for cattle and swine
• less GI and renal toxicity than phenylbutazone (bute)

Question 6

Naproxen and Ibuprofen

Answer 6

• toxicity in dogs because long 1/2 life, high GI absorption and enterohepatic recirculation
• no longer available in horses

-more of a human drug

Question 7

Ketoprofen (Anafen)

Answer 7

• COX 1 and COX 2 inhibitor (relatively non specific)
• approved for the cat
• racemic mixture… S dominates in horses, dogs, cats and cattle and R in sheep; S=antiinflammatory and R=analgesic
• species specific kinetics
• may be chondroprotective
• assocaition with bleeding and acute renal failure when used pre surgically (b/c COX1)
• no milk withdrawal time for cattle but 24 hour meat

Question 8

Phenylbutazone

Answer 8

• COX 1 and COX 2
• well absorbed orally but delayed by feeding
• # 1 NSAID used in horses
• has long 1/2 life so recommended to use every second day to decrease the toxic effects
• may cause GI ulcers, kidney problems (renal papillary necrosis) and suppresses T4 concentration with long term use
• dont give to sick animals or food animals

Question 9

Deracoxib (Deramxx)

Answer 9

• COX2 specific
• SID use because action is longer than 1/2 life
• if overdose animal can reach toxic levels quickly

Question 10

Firocoxib (Previcox)

Answer 10

• COX2 specific
• good choice for horses, cats and dogs (lower availability than horses and cats)
• hepatic metabolism and urinary eliminations (monitor liver enzyme levels)
• most COX 1 sparing!
• takes longer to be eliminated from the body than bute

Question 11

Robenacoxib (Onsior)

Answer 11

• highly COX 2 specific
• will replace Dermaxx
• cats and dogs - injectable and oral
• good for osteoarthritis
• well tolerated in cats

Question 12

Topical NSAIDs

Answer 12

• Indomethacin, flubiprofen, suprofen, diclofenac and ketorolac
• improve ocular availability of drug and decrease the systemic effects
• potentially delay healing because decreasing angiogenesis in eye