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Anesthesiology > NSAIDs > Flashcards

Flashcards in NSAIDs Deck (47):
1

What does NSAID stand for?

Non-steroidal anti inflammatory analgesic

2

What are the effects of NSAIDs? (3)

1. Analgesia
2. Anti-inflammatory
3. Antipyretic

3

T/F: NSAIDs have a shorter duration of effect than opioids.

False- NSAIDs have a longer duration compared with opioids

4

Do NSAIDs have a sedative effect?

No- opioids do

5

What are NSAIDs suitable for?

Mild to moderate post op pain or management of long term inflammatory pain (arthritis, otitis, cystitis, dermatitis, etc)

6

Can NSAIDs be combined with other drugs to control pain?

Yes- commonly combined with opioids post op for synergistic effect

7

What is the MOA of NSAIDs?

Inhibition of COX enzymes (inflammatory mediators)

Down regulation of inflammatory mediators reduces inflammation and prevents pain

8

What are the two main types of COX enzymes?

COX-1: constitutive
COX-2: inducible

9

Which COX enzyme is important for normal function of the GIT, platelets, and kidneys?

COX-1

10

Which COX enzyme is produced in response to inflammation and leads to development of pain?

COX-2

11

Which COX enzyme should be selectively managed for relief of pain?

COX-2

12

T/F: The less COX-2 selective the NSAID is, the more side effects are expected to develop.

True- down regulation of COX-1 interferes with normal organ function

13

What is COX-3 and do we care yet?

COX-3: identified in CNS of dogs but not humans

Selectively inhibited by acetaminophen

We don't really care

14

Do selective COX-2 inhibitors have zero side effects?

No, COX-2 does serve some constitutive function and can produce some side effectss

15

T/F: Inhibition of COX may increase LOX activity.

True

16

T/F: Monitoring effects/side effects of NSAIDs is limited and makes accurate dosing difficult.

True- wide range of side effects that can not be accurately monitored

17

What are some main side effects of NSAIDs?

- GI ulceration, perforation, vomiting, or diarrhea
- Inhibition of platelet function
- Renal impairment
- Hepatotoxicity (carprofen)
- Impair cartilage synthesis

18

What is the mechanism for renal damage in NSAID use?

With decreased perfusion, PGs mediate vasodilation and keep blood flow and GFR up. NSAIDs inhibit this mechanism

Particularly concerning under anesthesia

19

Should NSAIDs be given peri or post operatively for best analgesic effect?

Peri operatively

20

What is a concern with giving NSAID perioperatively?

If excessive bleeding occurs, chances of renal damage are high.

21

Is it safer to give NSAIDs peri or post operatively?

Post operatively

22

What is given instead of NSAIDs to provide analgesia during surgeries?

Opioids

23

What are contraindications to NSAID use?

- Hypovolemia or hypotension
- Organ disease (esp kidney)
-Hemostatic abnormality
- Pregnancy, lactation, conception
- Age extremes
- Concomitant steroid therapy

24

What are suitable NSAIDs for chronic therapy in dogs and cats?

Dogs: carprogen, meloxicam, coxibs

Cats: meloxicam

25

T/F: Regular labwork should be performed on animals on chronic NSAIDs.

True- monitor potential kidney or liver damage

26

What should chronic NSAID dosages be calculated based on?

Lean body weight for the lowest dose necessary and for the shortest possible duration

27

Should NSAID therapy continue in anorexic animals?

No

28

Are liquid or pill formulations preferred for cats?

Liquid- easier dosing and feeding

29

Do cats metabolize NSAIDs faster or slower compared to other animals?

Slower- leads to longer half life and potential for accumulation

30

What does carprofen do and what are it's adverse side effects?

Preferential COX-2 inhibitor

Mainly GI effects, rarely renal damage, fatal hepatotoxicity reported

31

What are the clinical uses for carprofen?

- Perioperative analgesia
- Chronic therapy for dogs

Not approved for catss

32

What does meloxicam do and are it's adverse side effects?

Preferential COX-2 inhibitor

Similar side effects to carprofen

33

What are the clinical uses for meloxicam?

Chronic treatment in cats (injections should only be given once)

Approved for dogs

34

What does robenacoxib (onisor) do and what are it's adverse side effects?

Selective COX-2 inhibitor with minimal side effects

35

What are the clinical uses for robenacoxib?

Cats: post op analgesia up to 3 days

Dogs: Post op analgesia, chronic treatment

36

What are the other coxib drugs?

Deracoxib and fibrocoxib

Similar to robenacoxib

37

What does phenylbutazone do and what are it's adverse side effects?

Non-selective COX inhibitor

Side effects: GI ulceration, nephrotoxicity, residues toxic to humans

38

What species is phenylbutazone used in?

Horses and cattle

No approved for small animals

39

What does flunixin meglumine do and what are it's adverse side effects?

Similar to phenylbutazone

40

What species is flunixin meglumine?

Horses and cattle

41

What does ketoprofen do and what are it's adverse side effects?

Non-selective COX inhibitor'

Side effects: hemostatic abnormality, GI effects

42

What species is ketoprofen used for?

Horses primarily

Can be used in SA but not best choice

43

What does acetylsalicylic acid (asprin) do and what are it's adverse side effects?

Non-selective COX inhibitor

Side effects: GI and hemostatic abnormailiy COMMON

44

Is acetylsalicylic acid FDA approved for vet med?

No

45

What is acetylsalicylic acid used for in vet med?

Cheap analgesic in dogs and antithrombotic in cats with HCM

46

What does acetaminophen cause in cats?

Methemoglobinemia- can be fatal

47

Is acetaminophen approved for veterinary use?

No- do not use