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Musculoskeletal > 3 - Treatment Of Arthritis > Flashcards

3 - Treatment Of Arthritis Flashcards

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1
Q

Most common treatment for OA

A

NSAIDs

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2
Q

Does NSAIDs halt progression of OA

A

No

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3
Q

MOA of grapiprant

A

Inhibitor of PGE2 EP4 receptor

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4
Q

Grapiprant binds with what type of affinity

A

High

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5
Q

Does grapiprant inhibit production of prostanoids

A

No

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6
Q

Grapiprant well tolerated in beagles for 9 months at doses up to

A

15x therapeutic dose

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7
Q

MOA of Firocoxib

A

COX-2 inhibitor, highly selective

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8
Q

What is the bioavailability of previcox

A

38%

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9
Q

What can delay bioavailability of firocoxib

A

Food delays absorption 1-5 hours

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10
Q

Firocoxib is metabolized how

A

By the liver

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11
Q

Firocoxib is not for use in

A

Puppie < 7 months of age at greater than 5 mg/ kg

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12
Q

Half life of firocoxib

A

7.8 hour s

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13
Q

What medicine can control post op pain and inflammation associated with orthopedic urgent

A

Deracoxib

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14
Q

MOA of deracoxib

A

COX - 2 inhibitor

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15
Q

Acute pain dose of deracoxib

A

3 - 4 mg/kg SID

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16
Q

Chronic pain dose of Deracoxib

A

1 - 2 mg/kg Sid

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17
Q

What drug can help control post op pain and inflammation in dogs with soft tissue surgery

A

RObenaxocib

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18
Q

What drug can be used to control post op pain and inflammation in cats with ortho, OVE, castration

A

Robenacoxib

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19
Q

Carprofen

A

Arylpropionic acid class of NSAIDs , reverse inhibitor of COX

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20
Q

What percent of carprofen is absorbed in 1 - 3 hours

A

90%

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21
Q

Half life of carprofen

A

8 hours

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22
Q

What percent of carprofen is bound to plasma proteins

A

99%

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23
Q

How is carprofen processed in the body

A

Bio transformation by the liver, eliminated in the feces and urine

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24
Q

Which receptor does grapiprant block

A

PGE2

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25
Why would you use grapiprant in renal disease dog
Does not block the receptors aociated with renal
26
What does Previcox inhibit
Cox - 2
27
Another name for Robenacoxib
Onsior
28
Half life of onsior in circulating blood
0.5 - 1 hours
29
Onsior accumulates at
Site of inflammation
30
How is onsior eliminated
Biliary route
31
Which drug can improve use of limbs in naturally occurring OA
Carprofen
32
Side effect of carprofen
GI and idiosyncratic hepatopathy
33
Meloxicam useful in
Hyp dysplasia
34
Peak conc of meloxicam
8 hours
35
Meloxicam formulated as
Syrup
36
Meloxicam has some of what action
COX - 2 selectivity
37
Etodolac
Effective inhibitor of PGE2 synthesis by chondrocytes and synoviocytes
38
Etodolac is effective in
Improving lameness of hipdysplasia
39
Etodolac adverse reaction
GI and ulcers
40
Slow acting disease modifying agents are called
Chondroprotective agent
41
Chondroprotective agents have positive effects
Cartilage matrix synthesis , HA synthesis, and inhibit catabolic enzymes in OA joints
42
Adeuqan is made from
Bovine tracheal cartilage
43
Adequan
Injectionable prep of highly updated GAGs
44
Max blood conc of adequan
20 - 40 mins after IM
45
Adequan distributes to
Tissues, body fluids, incl articular cartilage, synovial fluid, skeletal muscle
46
Why is synovial membrane not a significant barrier from blood to synovial fluid
Low molecular weight
47
Adequan highest uptake
Superficial layers of cartilage and lowest uptake near subchondral layer
48
Adequan has predilection for
Inflamed or diseased tissues
49
HA stimulates synthesis of HA by
Fibroblast and synovial cells
50
Is tramadol an opioid
No
51
Does tramadol work well for OA pain
No
52
NMDA receptor anatgonist is used as an
Adjuctive drug to improve the control of pain
53
what is mediated by activation of NMDA receptor
Central sensitization of pain receptors
54
Most common oral NMDA receptor anatagonist
Amantadine
55
Amantadine must be given how
Continual basic
56
How is Amantadine eliminated
Kidneys
57
Side effects of Amantadine
Rare - agitation or diarrhea
58
Gabapentin
Anti convulsant with purported adjuctive analgeic action
59
#1 goal in life long management of OA
Weight control
60
Nutraceuticals purported to have beneficial effects on
Cartilage matrix synthesis, HA synthesis by synovial membrane and catabolic enzymes
61
What should you be cautious of with adequan
Disturbances of blood coagulation
62
What is injectable HA
Nonsulfated GAG made from rooster combs or bacterial culture
63
HA can interact with what in the articular cartilage
Aggrecan monomers
64
Injectable HA may help to restore
Viscosity of synovial fluid
65
HA can have direct inhibition of
White blood cell and enzyme chemotaxis
66
HA can also reduce
Nitric oxide production in the meniscus and synovium
67
Gabapentin is mainly for
Neuropathic pain
68
Gabapentin
Anti convulsant with purported adjuctive analgesic action
69
MOA gaba
Unknown, may involve inhibition of posy synaptic neuron firing
70
Gabapentin is metabolized by
The liver and excreted by the kidneys
71
What are the side effects of Gabapentin
Sedation and weight gain
72
Most common nutritional supplements
Omega 3 fatty acids
73
PUFA competitively inhibit
Conversion of arachnids is acid to eicosanoids by inhibiting cyclooxygenase and lipoxygenase
74
PUFA supplements decrease
Membrane AA levels, decreasing substrates to synthesize eicosanoids
75
PUFA form
Eicosapentaenoic acid - EPa
76
EPA gives rise to
3 series PGs and 5 series leukotrienes which are weakly inflammatory
77
Glucosamine
An amino monosaccharide used in synthesis of disaccharide units of glycosaminoglycans and proteoglycans
78
What forms the side chains of the core protein of Aggrecan of articular cartilage
Glycosaminoglycans
79
What may inhibit cartilage degradation
Glucosamine
80
What is used by synovioctyes to produce HA
Glucosamine
81
Chondroitin sulfates are
Glycosaminoglycans
82
Typical sources
Bovine trachea, nasal septum, and shark cartilages
83
Chondroitin sulfate stimulate synthesis
GAGs
84
Chondroitin sulfate inhibits
Degradative enzymes
85
Chondroitin sulfate has an affinity for
Synovial fluid and cartilage
86
Undenatured type 2 collagen *
Interaction between gut associated lymphoid tissue in the duodenum and orally administered undenatrued type 2 collagen
87
Cold is used to help with
Edema and pain
88
What is heat used for
Decrease pain and increase tissue extensibility
89
Initial excersie of arthritic patient
Several short periods with rest periods throughout the day
90
What is third level arthritic treatment
Platelet rich plasma, stem cells, IA joint injection, surgery , cartilage transplant
91
Biological modalities for all stages of arthritis include
PRP, IRAP, stem cell therapy, prolotherapy, botulinum toxin

Musculoskeletal (17 decks)

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