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NSAIDs 2 Flashcards

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1
Q

Which drug is preferred for the treatment of colic in horses?

A

Flunixin

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2
Q

Flunixin is COX__-selective in horses.

A

COX2

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3
Q

Flunixin is COX__-selective in dogs.

A

COX1

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4
Q

Flunixin is the only NSAID effective verses _____ pain.

A

Visceral pain

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5
Q

Flunixin is the NSAID with the longest t1/2 in which species?

A

The horse

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6
Q

In which species is the use of Flunixin FDA-approved?

A

Bovine & swine

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7
Q

Besides its use verses visceral pain, what are the 3 main effects of Flunixin?

A
  1. Analgesia
  2. Anti-inflammatory
  3. Anti-pyretic
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8
Q

What is the preferred NSAID versus endotoxicosis?

A

Flunixin

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9
Q

True or False: Flunixin binds strongly to LPS and endotoxi.

A

FALSE: Flunixin does NOT bind LPS or endotoxi

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10
Q

True or False: Polymyxin binds to LPS.

A

TRUE

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11
Q

What two drugs would you combine versus endotoxicosis in the horse?

A

Ketamine + Flunixin

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12
Q

How does Flunixin work versus endotoxicosis?

A

Flunixin blocks the PG-related events activated by LPS.

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13
Q

Acetaminophen is selective or non-selective?

A

Non-selective

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14
Q

To which COX does Acetaminophen bind?

A

COX2 & COX3

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15
Q

Acetaminophen does NOT inhibit ____ COX2.

A

Peripheral

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16
Q

Acetaminophen does inhibit ____ COX2 and COX3.

A

Central

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17
Q

What makes Acetaminophen a weak anti-inflammatory?

A

Lack of peripheral COX2 inhibition.

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18
Q

What is the primary COX involved in the inflammatory process?

A

COX2

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19
Q

Anti-COX2 activity of Acetaminophen provides the ____ effect.

A

Analgesic

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20
Q

Anti-COX3 activity of Acetaminophen provides the ____ effect.

A

Anti-pyretic

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21
Q

Acetaminophen’s lack of anti-COX1 activity spares the ____ and the ____.

A

Stomach and platelets

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22
Q

____ at the site of inflammation are able to inactivate Acetaminophen.

A

Peroxides

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23
Q

What are the two clinical uses for which Acetaminophen would be used?

A
  1. Anti-pyresis

2. Analgesia (reduces the pain associated with inflammation without eliminating the cause)

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24
Q

True or False: Acetaminophen has minimal GI effects.

A

TRUE - lack of COX1 activity

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25
Why is Acetaminophen rarely used in veterinary medicine?
Hepatotoxicity
26
What is the most nephrotoxic NSAID group?
The "profens"
27
What are profens?
Propionic acid derivatives
28
What are the 4 profens?
1. Ibuprofen 2. Ketoprofen 3. Carprofen 4. Naproxen
29
Which of the "profens" are non-selective?
1. Ibuprofen 2. Ketoprofen 3. Naproxen
30
Which of the "profens" are selective?
1. Carprofen
31
Ketoprofen is a ____ inhibitor and a partial ____ inhibitor.
Ketoprofen is a COX inhibitor and a partial LOX inhibitor.
32
Which of the "profens" is only approved in the U.S. for use in horses?
Ketoprofen
33
Ketoprofen is for short or long-term use?
Short-term use
34
Carprofen is a COX__ inhibitor used in dogs.
COX2
35
Which two "profens" are contraindicated in pregnant animals?
1. Carprofen | 2. Ketoprofen
36
Why are Carprofen and Ketoprofen contraindicated in pregnant animals?
Due to the inhibition of PGF2-alpha, pregnancy can be prolonged.
37
Carprofen is (more expensive or cheaper) than coxibs?
Cheaper
38
Which of the "profens" is approved for use in horses against myositis?
Naproxen
39
What is the disadvantage to Naproxen?
Expensive
40
When is really the only time Naproxen should be used versus myositis in a horse?
When the myositis is first unresponsive to Phenylbutazone.
41
Aspirin is a selective COX__ inhibitor.
COX1
42
What are the 4 therapeutic effects of Aspirin?
1. Analgesia 2. Anti-inflammatory 3. Anti-pyretic 4. Anti-coagulant
43
Aspirin irreversibly acetylates the COX1 enzyme. This irreversibility causes 2 dramatic side effects. What are they?
1. Prolonged bleeding time | 2. GI ulcers
44
What is the moiety that "falls off" the NSAID after leaving the acetyl group on COX1?
Salicylate
45
Salicylate is a reversible ____ inhibitor.
COX
46
Canine chondrocytes are very sensitive to the complete absence of COX__ activity.
COX1
47
In sheep, aspirin causes what unwanted side effect?
Pulmonary edema
48
Is Phenylbutazone a selective or non-selective NSAID?
Selective
49
Phenylbutazone is a COX__ inhibitor.
COX2
50
What is the NSAID with the longest t1/2 in the horse?
Flunixin
51
What is the most commonly used NSAID in horses?
Phenylbutazone
52
Phenylbutazone is a ____ analgesic versus ____, such as laminitis.
Phenylbutazone is a MUSCULOSKELETAL analgesic versus LAMENESS, such as laminitis.
53
Which NSAID is banned in food-producing animals, especially lactating dairy cattle?
Phenylbutazone
54
How does Phenylbutazone cause tolerance to build up in the horse?
Phenylbutazone induces microsomal enzymes that accentuate its metabolism.
55
Phenylbutazone is banned in food-producing animals because it causes what in humans?
Blood dyscrasias
56
In which species can Meloxicam be used?
Cats & dogs
57
In which species can Piroxicam be used?
Dogs
58
Meloxicam and Piroxicam are selective ____ inhibitors.
COX2
59
Put the following in order of least to most expensive: Carprofen, Meloxicam, Coxibs, Etodolac
Etodolac
60
Meloxicam interferes with ____ inhibitors.
ACE
61
For what is Meloxicam approved in the cat?
As a single injection
62
What is the adverse effect of long-term Meloxicam use in the cat?
Renal failure
63
What is Piroxicam most commonly used to treat in the dog?
Bladder cancer (specifically Transitional cell carcinoma)
64
What is specific about bladder cancer that allows Piroxicam able to treat it?
The neoplastic cells overexpress COX2 and are dependent on that. By blocking the COX2, you decrease their lifespan.
65
With what 3 things should Piroxicam be combined when treating bladder cancer?
1. Misoprostol 2. Chemotherapy 3. Surgery
66
Which drug can be used as an alternative to Piroxicam?
Deracoxib
67
What is the advantage of Deracoxib over Piroxicam?
Deracoxib would not have the nasty effects on the stomach.
68
Which NSAIDs have the highest affinity/selectivity for COX2?
Coxibs
69
Which drug was withdrawn from use in humans because of its CV issues?
Rofecoxib
70
What are the BEST drugs for long-term use against the pain and inflammation of osteoarthritis?
Deracoxib & Firocoxib
71
True or False: Deracoxib & Firocoxib can be used in dogs with renal insufficiency.
TRUE
72
Why are you able to use Deracoxib & Firocoxib in dogs with renal insufficiency?
These drugs are eliminated via the bile/feces. (Downside: if you have a dog that likes to eat its own feces, they are taking in double the dose.)
73
Firocoxib: low or high Vd?
High Vd
74
NSAIDs: low or high Vd?
Low Vd
75
Robenacoxib appears to be tissue specific. Which tissue does it target?
Joints
76
True or False: Robenacoxib is approved for use in cats.
TRUE
77
Robenacoxib is approved for daily oral use in cats for how long?
3 days
78
What is the cheapest selective COX2 inhibitor?
Etodolac
79
What is the adverse side effect associated with Etodolac?
Keratoconjunctivitis sicca
80
What does Tepoxaline inhibit? (Ex: COX1? COX2? COX3?)
COX1, COX2, LOX
81
DMSO works by inhibiting what?
Inhibits PGs and scavenges free radicals
82
How is DMSO administered?
Topically, orally, IV
83
What is DMSO used against in dogs?
Lick granulomas
84
In which animal(s) is DMSO banned?
Dairy cattle
85
True or False: DMSO is not to be used in conjunction with corticosteroids.
FALSE - DMSO can be combined with corticosteroids.
86
True or False: Dipyrone is approved for use in food animals.
FALSE - Dipyrone is BANNED in food animals.
87
What are the only 3 NSAIDs that can be used in cats?
1. Aspirin 2. Meloxicam 3. Robenicoxib
88
Which NSAID can be used in swine?
Flunixin
89
Which 2 NSAIDs can be used in cattle?
Flunixin & aspirin
90
Which 5 NSAIDs can be used in horses?
1. Flunixin 2. Phenylbutazone 3. DMSO 4. Naproxen 5. Fibrocoxib

Pharmacology (21 decks)

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