anti-inflammatory agents

Question 1

acute inflammation

Answer 1

initial response to injury, release of pro-inflammatory mediators, precedes immune response

Question 2

pro-inflammatory mediators examples

Answer 2

histamine, seratonin, bradykinin, prostaglandin, leukotrienes

Question 3

chronic inflammation

Answer 3

different mediators than acute inflammation, causes pain, destruction of tissue and disability

Question 4

what do non-steroidal drugs block?

Answer 4

they do not allow cyclooxygenase to have effect, preventing prostaglandin formation

Question 5

what to steroidal drugs inhibit?

Answer 5

steriods inhibit phospholipase production

Question 6

Arachidonic acid

Answer 6

first precursor to all inflammatory mediators

Question 7

COX 1 functions

Answer 7

present in stomach cells and aid in mucous production in the stomach. when it is inhibited, ulcers may occur

Question 8

effect of eicosanoids on muscle

Answer 8

vascular: vasoconstriction or vasodilation, GI:contraction or colic Uterus:contraction (may cause abortion in mares) pulmonary:constriction

Question 9

Non-steroidal anti-inflammatory drugs (NSAIDS) mode of action

Answer 9

activity of the drug is mediated by inhibition of prostaglandin, during treatment inflammation is reduced by decreasing the release of mediators from granulocytes, basophils and mast cells.

Question 10

NSAID characteristics

Answer 10

analgesic, anti-inflammatory, antipyretic and inhibit platelet aggregation (aspirin is irreversible). they are gastric irritants (cuts mucous production) and can cause kidney problems (by prolonged use or too long of a dose)

Question 11

analgesic

Answer 11

treat pain

Question 12

antipyretic

Answer 12

treats fever

Question 13

common NSAIDs used in horses

Answer 13

flunixin meglumine (banamine), phenylbutazone,ketoprofen, naproxen,firocoxib (like prevacox, used for arthritis), aspirin, dypirone

Question 14

uses for NSAIDs

Answer 14

relieving pain, reducing fever, counteracting endotoxemia, reducing excessive blood clotting

Question 15

how do NSAIDs relieve pain?

Answer 15

prostaglandins produce pain, by reducing prostaglandins, pain is reduced

Question 16

how do NSAIDs reduce fever?

Answer 16

prostaglandins produced during both infection and inflammation cause fever, while high fever is a way to fight infection, high fever can denature proteins and cause irreversible brain damage

Question 17

how do NSAIDs counteract endotoxemia?

Answer 17

endotoxemia is when bacteria toxins reach the bloodstream. these toxins can be life threatening. generally flunixin melglumine (ban amine) is the preferred NSAID for endotoxic effects

Question 18

how do NSAIDs reduce excessive blood clotting?

Answer 18

by blocking thromboxane production, NSAIDs help maintain blood flow in situations where excessive blood clotting causes problems ex. thromboembolic colic

Question 19

thromboembolic colic

Answer 19

clots in the blood vessels that supply GI tract can lead to necrosis of portions of the intestine

Question 20

phenylbutazone

Answer 20

potent pain reliever, antipyretic and anti-inflammatory, commonly used for lameness, resulting from soft tissue injury, muscle soreness, bone and joint problems and laminitis, may be given IV or orally, pain relief and fever reduction usually within 1-2 hours. if a horse needs bute for more than a few days,use drugs that protect the GI tract

Question 21

fluxinin Meglumine

Answer 21

used for pain relief in the treatment of colic, used for protection from the septic/endotoxic shock due to any gastrointestinal insult, used as an anti-inflammatory in the treatment of painful conditions of the eye (corneal ulcers, uveitis,conjunctivitis,and before/after eye surgery), may be used to reduce or control fevers due to viral or bacterial infection, may be given IV, IM or PO. can cause GI Ulcers

Question 22

cortisol production

Answer 22

stress hormone, produced by the adrenal cortex and synthesized from cholesterol

Question 23

actions of cortisol

Answer 23

aids in proper glucose metabolism, regulation of blood pressure, insulin release for blood sugar maintenance, immune function (decreases immune activity), inflammatory response (impedes immediate pain with huge surges)

Question 24

when are there higher levels of cortisol in the body

Answer 24

in the morning, stressed horses have higher level of cortisol

Question 25

functions of cortisol in a fight or flight situation

Answer 25

gives quick burst of energy for survival reasons, heightened memory functions (remember tiny details of an event), burst of increased immunity (then immunity decreases afterwards), lowers sensitivity to pain, helps maintain homeostasis in the body

Question 26

effects of prolonged levels of cortisol in the bloodstream

Answer 26

impaired cognitive performance, suppressed thyroid function (makes people tired), blood sugar imbalances such as hyperglycemia, decreased bone density, higher blood pressure, lowered immunity and inflammatory responses in the body, slowed wound healing and other health consequences

Question 27

what type of feedback does cortisol have

Answer 27

negative feedback, when levels of cortisol are high, cortisol is not produced, dexamethasone and prednazone cause the body to think there is increased levels of cortisol in the body so CRH and ACTH are not produced

Question 28

Metabolic effects of Glucocorticoids

Answer 28

carbohydrate protein and fat metabolism. increase serum glucose, stimulate insulin release and lipogenesis (production of fat tissue)

Question 29

catabolic effect of glucocorticoids

Answer 29

supra physiologic amounts o steroids lead to decreased muscle mass and weakness..catabolic effect on bones is osteoperosis

Question 30

anti-inflammatory effects of glucocorticoids

Answer 30

effects on concentration, distribution and function of peripheral leukocytes. reduces leukotrienes, prostaglandin etc.

Question 31

immunosuppressive effects of glucocorticoids

Answer 31

inhibit functions of macrophages and antigen presenting cells, inhibits the ability of macrophages to phagocytise and kill microorganisms, antibody production is reduced by large doses on steroids

Question 32

side effects of glucocorticoids

Answer 32

chronic administration suppresses the pituitary release of ACTH, growth hormone, thyroid suppressing hormone and leutenizing hormone, increases body fat(visceral, facial nuchal and supraclavicular), antagonizes effects of vitamin D on calcium absorption (bones become frail)

Question 33

use of synthetic corticosteroids

Answer 33

used in treatment of inflammatory, allergic and other disorders, great for allergies, tendon injuries, heaves etc

Question 34

types of synthetic corticosteroids

Answer 34

``` short and medium acting (works 1-12 hours):cortisone, hydrocortisone, prednisone,prednusolone,meprednisone long acting (lasts 24 hours): dexamethasone, betamethasone ```

Question 35

uses of corticosteroids

Answer 35

used to diagnose cushings syndrome, given for allergies (hives, heaves->give lowest possible dose), recurrent uvitis, dex may be used in joint injections to reduce swelling, may be given PO,IV,IM or aerosol, should not be used in horses with cushings because the horse already has a high level of cortisol.

Question 36

cushings syndrome symptoms

Answer 36

fat deposition, obesity, excessive hair coat, poor wound healing, osteoporosis, insulin resistance and laminitis. caused by a tumor in the pituitary gland that results in excessive ACTH production

Question 37

dexamethasone suppression test

Answer 37

used to test for cushings, if the horse does not have cushings, the horse will not produce ACTH. In true cushings cases, negative feedback does not occur so ACTH continues to be produced even when dex is given

Question 38

Side effects of synthetic corticosteroids

Answer 38

usually occur with long term use of the drug, especially when high doses are used. Alternate day therapy with short acting preparations is preferred. withdraw drug slowly by tapering the dosage and prolonging interval between doses. corticosteroids suppress the immune system response so animals are more susceptible to infection, may mask signs of infection such as fever. polyuria, polydipsia and muscle wasting can be seen with prolonged use, may cause or worsen gastric ulcers, laminitis

Question 39

dexamethasone

Answer 39

used in high doses in emergencies for anaphylactic reactions, spinal cord injuries or shock, used in lower doses to treat allergic reactions such as heaves, hives itching and inflammatory diseases like arthritis

Question 40

prednisone and prednisolone

Answer 40

horses do not absorb prednisone so use prednisolone when choosing a short term steroid

Question 41

fluticasone

Answer 41

used to control heaves, given as aerosol