Term
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Definition
-important component of poly-modal therapies aimed at peri-op analgesia in D+C and mgmt of chronic pain, esp osteoarthritis
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Term
| Factors when choosing NSAIDS |
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Definition
| -analgesic efficacy of most vet. NSAIDs is similar
-most important factor is safety
-difference in side effects of diff. NSADs are apparent, esp. when used peri-op |
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Term
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Definition
-antiinflam, antipyretic, antihyperalgesic, antiendotoxaemic, analgesic
-inhibit COX enzymes - decr. production of PGs, prostacyclins, TXA2
-PGs important in inflam pain in periphery, in production of primary hyperalgesia and in the transmission of noxious stimuli in the SC and higher centres |
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Term
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Definition
related to PG production inhibition:
-impairment of renal function
-GI irritation and ulceration
-antithrombotic effects due to TXA2 inhibition (most NSAIDs do not do this at therapeutic levels - aspirin is exception)
-dec. liver function (related to long term use in indiv. animals - low reported incidence) |
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Term
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Definition
-in kidney, locally produced PGs are continually active in maintaining afferent arteriolar dilation - esp. important in periods of hypotension in maintaining normal kidney haemodynamics
-NSAIDs inhbit these PGs and so hypoperfusion of kidney can result w. degree of renal failure |
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Term
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Definition
-GI ulceration most common and important side effect
-PGs normally promote mucus secretion, maintain mucosal BF, and help in modulation of gastric acid secretion - NSAIDs inhibit this |
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Term
| Risk factors for GI ulceration |
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Definition
-history of GI ulceration
-geriatric and so dec. capacity for drug clearance
-biochem evidence of liver dysfunction |
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Term
| clinical significance of COX selectivity |
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Definition
-GI side effects less common w. NSAIDs that selectively inhibit COX2
-potent COX1 inhibitors are highly ulcerogenic
-COX2 selectivity may be a useful predictor or GI safety but can not be used to predict general safety
-COX2 selectivity has little relevance in renal toxicity
-liver toxicity is rare and does not correlate w. COX selectivity
-COX selectivity does not effect efficacy |
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Term
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Definition
| -can provide effective analgesia in orthopaedic and soft tissue procedures in D+C
-Meloxicam, Carprofen, Robenacoxib licensed in D+C for peri-op admin
-all COX2 preferential w. minimal effects on renal VF in normal animals
-admin of all other NSAIDs should be delayed until the animal has fully recovered from anaes. and is normotensive
-strongly advised to avoid peri-op NSAIDs in animals w. impaired renal function |
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Term
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Definition
| -ensure animal is fully recovered from anaes. and normotensive |
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Term
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Definition
-appear to be more at risk of side effects
-may relate to metabolic pathway / dec. metabolism or relative ease of OD |
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Term
| Clinical recommendations fo peri-op admin of NSAIDs |
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Definition
-only admin NSAIDs licensed for pre-op admin in the peri-op period
-only admin NSAIDs pre-op to healthy animals undergoing routine procedures, in which hypotension is not anticipated
-do not give to trauma or shocked patients or until they are normotensive and CV stable
-do not give to animals w. pre-existing renal dz. or w. disorders of haemostasis
-use carefully in animals w. pre-existing liver dysfunction - may lead to incr. in half life and so inadvertent OD
-do not combine different NSAIDs or give NSAIDs and corticosteriods together
-min. wash-out period of 5-7 days is recommended when switching between NSAIDs or between NSAID and corticosteroid to avoid inadvertent drug interactions |
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