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ACVN - ANAESTHESIA > NSAIDs > Flashcards

NSAIDs Flashcards

1
Q

What is the importance of mananging chronic pain?

A
  • it is maladaptive and of no benefit to the animal
  • pain comprises the sensory discrimination aspect being processed by the brain and then interpreted with both physical and emotional components
  • pain is a welfare issue
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2
Q

What is the definition of pain?

A

nociceptive or neuropathic

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3
Q

What is nociceptive pain?

A

originating in the tissues that are not in the nervous system

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4
Q

What is neuropathic pain?

A

pain that originates in the tissues in the nervous system

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5
Q

Which conditions can have a combination of neuropathic and nociceptive pain?

A

chronic pain conditions such as osetoarthritis and cancer

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6
Q

What patients will you see with neuropathic pain?

A

those that have direct damage to the nervous system

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7
Q

What happens when nerves are damaged?

A

cholecystokinin is released

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8
Q

What happens when cholecystokinin is released?

A

it antagnoises opioid mediated analgesia meaning opioids are less effective

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9
Q

How do NSAIDs work?

A

by inhibiting prostaglandin production from arachidonic acid by inhibiting to clycooxygenase (COX) enzyme

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10
Q

How do NSAIDs affect leukotriene production?

A

inhibits lipoxygenase enzyme

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11
Q

What is the newest NSAID grapiprant?

A

non-cyclooxygenase inhibiting anti-inflammatory drug

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12
Q

What does grapiprant act as?

A

selective antagonist of the EP4 receptor

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13
Q

What is the EP4 receptor?

A

a key prostaglandin E2 receptor that predominant mediates prostaglandin E2-elicited nociception

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14
Q

Where do most NSAIDs work?

A

the periphery

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15
Q

Where can some NSAIDs act?

A

centrally in the dorsal hron by inhibiting COX

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16
Q

What are the adverse effects associated with NSAID administration in relation to?

A
  • protective function that prostaglandins have in the body
  • how easily the NSAID can leave the circulation and cross into the tissues
17
Q

How can prostaglandins be divided?

A

constitutive or ‘housekeeping’

18
Q

What functions to the contitutive prostaglandins have?

A

protective ones which can be blocked by NSAIDs

19
Q

What enzymes are produced by constitutive prostaglandin production?

A

COX-1 isoenzyme

20
Q

What enzyme is produced by inducible prostaglandin production?

A

COX-2 isoenzyme

21
Q

Which drugs are non-specific and block COX-1 and COX-2?

A

older NSAIDs such as aspirin and flunixin

22
Q

What do meloxicam nad carprofen block?

A

COX-2

23
Q

What are prostaglandins essential for in the GI system?

A
  • maintenance of mucosal blood flow
  • bicarbondate and mucous secretion
  • epithelialisation
24
Q

What GI signs can NSAIDs lead to?

A

ulceration and bleeding

25
Q

What do prostaglandins regulate in the renal system?

A
  • glomerular filtration rate
  • renin release
  • sodium excretion
26
Q

What can blockage of the vasodilatory prostaglandin lead to?

A

decreased glomerular filtration rate at times of low circulating blood volume

27
Q

What can NSAIDs lead to in the renal system?

A
  • water retention and oedema
  • hypertension
  • may impair glomerular filtration in patients with renal disease or hypotension
  • may cause renal ischaemia in patients with hypotension
28
Q

What do NSAIDs induce in the hepatic system?

A

liver enzyme

29
Q

What central nervous syem reaction might you see in cats after NSAID administration?

A

idiosyncratic dullness and lethargy

30
Q

How long do newer NSAIDs prolong markers of blood clotting ifgiven for long courses?

A

30-90 days

31
Q

How do you reduce the risk of side effects when NSAIDs are administered chronically?

A
  • do not exceed licensed dose
  • do not give two NSAIDs concurrently
  • do not give NSAIDs and corticosteroids concurrently
  • do not give NSAIDs to animals that are hypotensive/dehydrated
  • warn owners about risks of NSAIDs
  • think about the animal as an individual
32
Q

Why is it important to give NSAIDs wirth food?

A
  • GI ulceration can occur but more common if the pet already has it
  • should always be given with food unless contra-indicated
33
Q

What side effects should you warn owners about to look out for?

A
  • vomiting and diarrhoea
  • signs of blood in faeces
  • fullness
  • anorexia
34
Q

What are the possible causes of hypotension due to NSAID animinstration?

A
  • concurrent disease with vomiting and diarrhoea
  • trauma with blood loss or shock
  • pets that stop eating and/or drinking
35
Q

When are side effects more likely to occur?

A

in the first 2 weeks of therapy

36
Q

When should re-checks be done after prescribing NSAIDs?

A

1-2 weeks after starting treatment

ACVN - ANAESTHESIA (12 decks)

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