NSAIDs Flashcards
(1 cards)
Meloxicam
inhibition of cyclooxygenase (COX) and prostaglandin synthesis. Meloxicam is considered COX-2 preferential (not COX-2 specific) because at higher doses, its COX-2 specificity is diminished. This effect would theoretically inhibit production of the prostaglandins that contribute to pain and inflammation (COX-2) and spare those that maintain normal GI, platelet, and renal function (COX-1).
An NSAID of choice for long-term pain management in cats; however, repeat doses of the injectable product are considered contraindicated in cats.
Contraindications include active or history of GI ulcer disease, bleeding disorders, or a history of serious reactions to it or other NSAIDs.
Use with caution in geriatric patients and in those with pre-existing chronic diseases (eg, inflammatory bowel disease, renal or hepatic insufficiency).
Primary adverse effects include GI- and renal-related effects, but idiosyncratic hepatotoxicity has occurred in dogs (rare). Like other COX-2 NSAIDs, meloxicam may have effects on platelet function, although no effect was demonstrated in healthy dogs in a small study. A case report of a dog developing vasculitis with ulcers, vesicles, and erosions has been published.
In field trials, some cats given injectable meloxicam at the label dosage developed elevated BUN, posttreatment anemia, and residual pain at the injection site (rare). Meloxicam has also caused GI effects (eg, vomiting, diarrhea, inappetence), behavior changes, and lethargy. Repeated use of meloxicam in cats is controversial, as repeated doses have been associated with renal failure and death. The FDA warns against repeated doses in cats6; however, a dosage of 0.05 mg/kg daily PO is licensed in some countries for long-term use, and guidelines for long-term NSAID use in cats suggest the benefits of treatment often outweigh the risks. An even lower dosage (0.02 mg/kg daily PO) given to cats with stable International Renal Interest Society (IRIS) stage 2 or 3 chronic kidney disease (CKD) had no apparent effect on the lifespan and did not adversely affect excretory renal function, although in one study urine protein:creatinine ratio was greater in meloxicam-treated cats than in those receiving placebo
