Anti-Inflammatory Drugs

Question 1

When are mediators recruited

Answer 1

Within the first 24 hours

Question 2

Pruritis

Answer 2

Itchy skin

Question 3

Cytokines

Answer 3

Peptides that often work in the medium-long term. Cause production of acute-phase proteins when released into the circulation (inflammatory proterties) and elevate temp through liver

Question 4

Chemokines

Answer 4

Chemoattractant cytokines that cause inflammatory cell recruitment

Question 5

Cytokine and chemokine action

Answer 5

Increase blood flow and vascular permeability but MAINLY cause cell recruitment and activation

Question 6

Stored in Mast Cells

Answer 6

Histamine

Question 7

Histamine inflammation receptor type and anti-inflammatory drug type

Answer 7

H1 histamine receptor. Anti-histamine antagonist

Question 8

Emetic

Answer 8

Vomiting

Question 9

Lipid Mediators causing inflammation

Answer 9

Prostaglandin, leukotrienes, and Platelet-activating factors (PAF)

Question 10

Prostaglandin Synthesis

Answer 10

Cell membrane phospholipid + phospholipase A2 -> arachidonic acid, this is acted on by COX to create prostaglandin

Question 11

NSAIDs

Answer 11

Non-Steroidal Anti-Inflammatory Drugs

Question 12

How do NSAIDs block inflammation

Answer 12

They block COX from acting on arachidonic acid, the last step in prostaglandin synthesis

Question 13

Synthesis of Leukotrienes (LTs)

Answer 13

Arachidonic acid acted on by 5-LO

Question 14

How to block leukotrienes (LTs) Inflammation

Answer 14

Leukotriene D4 (LD4) receptor antagonist

Question 15

What are the main Leukotriene receptor antagonists

Answer 15

Monolukast and Zafirlukast. Reduce bronchoconstriction/asthma

Question 16

Analgesia

Answer 16

Relieves pain

Question 17

What does COX inhibition lead to

Answer 17

Decreased vasodilation/swelling/fever, analgesia, and has little effect on the cellular changes in inflammation

Question 18

Cox-1

Answer 18

Constitutive type that drives the physiological response. Does not specifically target the inflammatory response

Question 19

Selective Cox-2 inhibitors

Answer 19

Inducible type. Block inflammation at specific sites

Question 20

Examples of NSAIDs used in Large and Small Vet Med

Answer 20

Carprofen, ketoprofen, meloxicam

Question 21

Pharmacokinetic considerations of NSAIDs

Answer 21

Highly protein plasma bound. Do not use an NSAID within 24 hrs of another NSAID. Avoid use in dehydrated patients

Question 22

Side Effects of NSAID

Answer 22

Damage to GIT, Nephrotoxicity, Hepatotoxicity

Question 23

What do glucocorticoids mimic

Answer 23

The actions of cortisol

Question 24

What is cortisol

Answer 24

The natural inhibitor of the inflammatory response

Question 25

Glucocorticoids mechanism of action

Answer 25

Decrease the production of pro-inflammatory mediators, release of inflammatory mediators/cells, and circulating complement components

Question 26

Clinical uses of corticosteroids

Answer 26

Allergic disease or anaphylaxis, topical, or chronic inflammation. Immunosuppression

Question 27

Contra-indicators using corticosteroids

Answer 27

Renal disease or diabetes mellitus

Question 28

Avoid corticosteroid use in...

Answer 28

Pregnant animals, immediately after surgery, or without being paired with an antibacterial in animals with bacterial infections

Question 29

#1 Side effect of Corticosteroids

Answer 29

Suppression of wound healing, induction of iatrogenic Cushings syndrome in long term use

Question 30

#2 Side Effects of Corticosteroids

Answer 30

Suppression of endogenous steroid production.

Question 31

Attention Points of Lecture

Answer 31

Most anti-inflammatory drugs only provide symptomatic relief. They have long-term side effects. Focus and treat the underlying causes of the clinical problem