NSAIDS

Question 1

NSAID: Types (3)

Answer 1

Non-selective - inhibits both COX-1 and COX-2

COX-preferential - primarily inhibits COX-2

COX-selective - almost entirely inhibits only COX-2

Question 2

NSAIDs: Uses (2)

Answer 2

Acute - post surgical, trauma

Chronic - osteoarthritis

Question 3

NSAID Potential side effects (3)

Answer 3

GI - v/d, mucosal ulceration/perforation

Hepatopathies - idiosyncratic liver failure

Nephropathy

Question 4

NSAID Contraindications (5)

Answer 4

Liver or kidney disease

Anemia or thrombocytopenia

GI inflammation/ulceration

Dehydration

Concurrent therapy with a glucocorticoid/different NSAID

Question 5

Washout period: when and why?

Answer 5

Wait between discontinuing one NSAID and starting another/GC

Minimize the risk of adverse effects

Question 6

NSAID species differences: cats

Answer 6

Deficiency of glucuronyl transferase, pathways gets easily overwhelmed

Many NSAIDS are not safe to use in cats

Question 7

NSAID Administration (2)

Answer 7

Oral - most should be given with food

Parenteral

Question 8

NSAID Monitoring: lab work and at home monitoring

Answer 8

Regular lab work for chronic treatment - hepatic, renal, CBC values

Monitor for signs of GI upset

Question 9

Phenylbutazone (“bute”): type, use, ban

Answer 9

Non-selective COX Inhibitor

Horses

Banned in nursing age cows

Question 10

Flunixin Meglumine: brand name, type, effect, use

Answer 10

Banamine

Non-selectove COX Inhibitor

Also provides good visceral analgesia

Large animals - most common analgesic for horses

Question 11

Aspirin: type, uses (2), caution

Answer 11

Non-selective COX Inhibitor

Cats: reduce risk of thromboembolism in hypertrophic cardiomyopathy pt

Dogs, horses, pocket pets: NSAID

Dogs: GI mucosal damage occurs in a majority of dogs after just a few doses

Question 12

Carprofen: brand name, type, species

Answer 12

Rimadyl

COX-preferential Inhibitor

Dogs, pocket pets, exotics

Question 13

Meloxicam: type, species, formulation (3)

Answer 13

COX-preferential Inhibitor

SA, LA, some exotics

PO - oral suspension, human tablets (large dog only)

Injectable

Question 14

Meloxicam: black box warning

Answer 14

FDA’s strongest warning

Repeated dosing can lead to renal failure or death

Question 15

Deracoxib: brand name, type, species

Answer 15

Deramaxx

COX-selective inhibitors

Dogs

Question 16

Robenacoxib: brand name, type, species , administration

Answer 16

Onsior

COX-selective inhibitor

Cats

Oral, injectable

Question 17

Firocoxib: brand names (2), type

Answer 17

Previcox: dogs

Equioxx: horses

COX-selective inhibitor

Question 18

EP4 Recpetor triggers

Answer 18

Only inflammatory prostaglandins

Question 19

Gapriprant: brand name, effect, use, adverse effects

Answer 19

Galliprant

Blocks EP4 Recpetor –> reduces pain and inflammation associated with musculoskeletal inflammation

Manage pain and inflammation from osteoarthritis in dogs

Wide therapeutic index, mild GI signs

Question 20

Chondro-protective agents: effect (3), use

Answer 20

Reduce joint inflammation and degradation

Supply precursor molecules

Increase hyaluronate in joints

Reduce inflammation in osteoarthritis

Question 21

Polysulfated Glycosaminoglycans: brand name, species

Answer 21

Adequan

Dogs and horses

Question 22

Glucosamine, Chondroitin Sulfate: regulation, species

Answer 22

Supplement, not regulated by the FDA

Many species