Pharm 1 - NSAIDs Q&As

naxucazo's version from 2017-12-11 01:47


Question Answer
What causes ulcers in the mouth, stomach, cecum, and right dorsal colon?Phenylbutazone
What things are cats sensitive to because they can't Glucoronidate (lack glucoronyl transferase)?Tylenol, Aspirin
Weird things Flunixin Meglumine can do?Tx visceral pain, Tx end toxemia
What is inflammation?(1) Inflammation is the vascular and cellular response of living tissue to injury
(2) It is the main defense mechanism of the body against all types of injury
What are the cardinal signs of inflammation?Redness, Swelling, Heat, Pain, Loss of function
What are the 2 vascular responses leading to inflammation?(1) Dilation of blood vessels leading to redness and heat at site of injury
(2) ↑ Permeability of venules, capillaries and arterioles leads to leakage of fluid from vasculature to interstitial fluid (edema)
What is chemotaxis?↑ Permeability leads to leukocytes being able to immigrate to the site of inflammation - this process is called chemotaxis. (Attraction of leukocyte by endogenous and exogenous agents)
What are the effects of Histamine?Histamine comes from basophils, mast cells and blood platelets, Cause transient dilation of blood vessels and a ↑ in vascular permeability
What does the enzyme Phospholipase A2 catalyze?(1) Membrane phospholipids release arachidonic acid resulting from interaction with the enzyme phospholipase A2
(2) Phospholipase A2 is activated and now arachidonic acid can enter the arachidonic acid cascade (membrane phospholipids → (via phospholipase A2) → Arachidonic acid (this is then converted by COX or LOX) )
How do COX-2 selective NSAIDs spare the GI tract?Only blocking COX-2 this will allow COX-1 to be maintained, COX-1 is for housekeeping functions, protect gastric mucosa and regulate blood flow to the kidneys while COX-2 only ↑ during inflammation
Which NSAID is associated with treating visceral pain?Flunixin Meglumine (weird name, weird place to treat)
Which NSAID can be used against endotoxemia?Flunixin Meglumine (Meg kills bacteria!)
Why would lipoxygenase inhibition potentially protect the GI?(1) Lipoxygenase enzymes convert arachidonic acid into leukotrienes (Leukotriene B4 – gastric ulceration)
(2) LOX-inhibition by certain NSAID (Protect GI from inflammation/ulceration)
Why is the prostaglandin E1 analog administered?Given to NSAID using patients to treat and prevent gastric ulcerations (As prostaglandin E1 help regulate gastric acid secretions and has cytoprotective effects on the gastric mucosa)
Why is there increased risk of GI ulceration when NSAIDs and corticosteroids are administered concurrently? (2)(1) NSAIDs decrease prostaglandins, mucus and bicarbonate
(2) Glucocorticoids increase acid, pepsin and trypsin (Therefore NSAIDs and glucocorticoids = ulcers)
Why are cats particularly sensitive to Tylenol?Cats are slow at glucuronide conjugation (have fewer enzymes to perform glucuronide conjugation) → This results in more drug left for sulfation pathway → When sulfation pathway capacity is reached the drug is converted to toxic metabolite NAPQI by cytochrome p450
What is the toxic metabolite in Tylenol metabolism?NAPQI
What conjugates NAPQI so that it can be eliminated?Treated by n-acetyl-cysteine mucomyst (NAPQI is a toxic byproduct of acetaminophen metabolism- can cause methemoglobin which causes Heinz bodies)
How is Ketoprofen metabolized?Eliminated by kidneys as unchanged drug and conjugated metabolites (Keto Kidney)
Carprofen is most COX-2 specific in which species?Dogs (dogs love cars)
In the first pass effect Aspirin is metabolized into what?Salicylic acid
For how many days after Aspirin is administered can platelets aggregating ability is compromised?Platelets aggregating ability is compromised for the life of the platelet at 10 days (irreversibly destroys the COX-1 in the platelet, platelet has no nucleus so it cant make more, so permanent for its 10 day life)
Why do cats have prolonged Aspirin half-lives?Salicylate is metabolized in the liver by conjugation with glucuronic acid and glycine (enzyme used is glucoronyl transferase) (Cats being deficient in glucoronyl transferase result in prolonged Aspirin half-lives)
Why isn’t Phenylbutazone a good NSAID choice in dogs?Due of side effects (CNS, GIT and respiratory) (but not phenyl for dogs)
Phenylbutazone is associated with ulceration at what location in the GI?Ulcerations occur in the mouth, stomach, cecum and *right dorsal colon (having ulcerations makes me wanna SCRM, it's no phenyl)
What are the two (three) ways in which Meloxicam can be administered to dogs? **Unique way tooIV, SC and oral. Unique= oral SPRAY (oral suspension)
**What are two NSAIDs that can be given to a cat?Meloxicam and Rubenacoxib (Mel the cat loves rubens)
How many times and in what administration route can a cat be given Meloxicam?Approved for a single one time injection SC (Mel visited me once, but she got under my skin)
What are the directions for giving Rubenacoxib or Onsior to a cat?For oral use in cats only and use for no more than 3 days, For use in cats weighing more than 5.5 pounds and older than 6 months of age (CAN'T have just one ruben - need at least three)
Why was Rofecoxib (Vioxx) removed from the market?Due to cardiovascular side effects related to reduced PGI2 formation (heart stopped because was given rofe's)
Deracoxib or Deramax is approved in the US in what species?Dogs (dogs say derrr)
Tepoxaline or Zubrin has a unique administration quality what is it?Oral administration rapidly disintegrating tablets “melts in mouth” (melt-in-your-mouth tep-dancing good)
DMSO does what, and is a scavenger of what?Inhibits prostaglandins and is a free radical scavenger (Dimethyl sulfoxide- topically, IV. smells terrible)
Why should you use gloves when you administer DMSO?Used topically and IV and must wear gloves when administering as causes garlic taste (smell awful)
Most NSAIDs are weak acids or weak bases?Weak acids
Most NSAIDs are metabolized by which organ?The liver
(Not an official Q) What is another use for peroxisome?Can possibly be used to Tx bladder cancers (neoplasty) (bladder and pe)
What is Boswellia?An anti-inflammatory tree resin, for use in equine. (Horses from botswanaaaa)
What is the name of the prostaglandin E1 analogue given?Misoprostol (miso soup will help your stomach feel better)
Name which animals Flunixin Meglumine is given for, and how.Horse (IV, IM, PO paste). Cattle (slow IV to prevent anaphylaxis) Swine (IM, one time)
name which animals Ketoprofin is given to, and how.IN THE US: horses. IN CANADA/UK: horse, cattle (if Tx at 3mg/kg for 3 days, wait 24hrs before slaughter), swine (if Tx at 3mg/kg for 3 days, wait 7days before slaughter), dog/cat
Name which animals Carprofen is given toIN THE US: dogs. IN THE UK: dog, cat, horse, pony, cattle
Name which animal’s diclofenac is given toHorses (HORSES JUST DI.). NO FOOD HORSES
Name which animals Phenylbutazone is given to, and howHorses. IN THE US, dogs (but many side effects). DONT USE IN CATTLE older than 20 mo (or ever, really)
Name which animals Meloxicam is given to, and howDog (IV, SC, PO **oral spray). Cat (SC)
Name which animals Deracoxib is given to, and howDogs (chewable tablets) (Derrr i eated the treat yey)
Name which animals Firocoxib is given to, and howDogs (PO). Horse (PO- dont use more than 14 days (dogs ride the horses out of the burning barn -we eat dinner in celebration)
Name which animals Rubenacoxib is given to, and howCats only (oral)
Name which animals Tepoxaline is given to, and howDogs (PO rapidly melt in your mouth tablets) (tep dancing dogs are happy)
Name which animals Etodolac is given toDog (in the eto era, the dogs were given etodolac)
What does Ibuprofen doNo vet use. Non-selective COX inhibitor, dogs sensitive
What does Naproxen do?Myostisis and soft tissue inflammation. Dogs more sensitive. Horses= equiproxen
What does Vedaprofen do?Horse and dog. Pain/inflammation with MS and COLIC
What does Piroxicam do?Adjuvent for neoplasia therapy (transitional carcinoma)
what does Mavacoxib do?Dogs- DJD (inflammation and pain). LONG HALF LIFE OF THEM ALL (17 DAYS). After first 2 doses, only once per month. Do not exceed 7 doses.
What does Meclofenamic and tolfenamic do? Meclo is for horses. Tol for others. Slow onset. More side effects so not used commonly.