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2013-10-04 17:20:21
chapter 13

anti-inflammatory drugs
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  1. in acute inflammation, leukocytes aim to:
    • 1. destroy bacteria at the site
    • 2. direct other cells of inflammatory process to start clean up process by removing dead/dying cells
    • 3. pave way for healing process to start
  2. main leukocyte involved in acute inflammation
    • neutrophil initially
    • lymphocytes follow in time
  3. 5 cardinal signs of inflammation
    • swelling
    • redness
    • heat
    • pain
    • loss of function
  4. degranulate
    leukocytes release the contents of their granules to kill bacteria, neutralize toxins, and breakdown dead/dying tissue
  5. primary conversion of the arachidonic acid
  6. glucocorticoid
    natural steroid in the body
  7. corticosteroids
    group of steroid hormones produced in the adrenal cortex or made synthetically

    blocks the action of phospholipase thus abruptly stopping progression of inflammation
  8. what corticosteroids do?
    • inhibit phospholipase
    • deposits glycogen in liver
    • increase blood glucose levels
  9. mineralocorticoids
    • little or no effect on inflammation
    • associated with water&electrolyte balance

    (an ex. is Aldosterone)
  10. zona glomerulosa produces
  11. zona fasiculata produces 
  12. types of corticosteroids (time)
    • short acting (less than 12 hrs)
    • intermediate acting (12-36)
    • long acting (longer than 48)
  13. example of short acting corticosteroid
  14. example of intermediate acting corticosteroid
    prednisone, prednisolone, triamcinolone
  15. use prednisolone in what species?

    (dog: prednisone) 
  16. example of long acting corticosteroid
    dexamethasone sodium, betamethasone, flumethasone
  17. of the 3 liquid forms of corticosteroids which is ultra short acting?
    aqueous solution
  18. aqueous solution
    corticosteroids combined with a salt to make them soluble in water (sodium phosphate, sodium succinate)

    • uses: shock therapy, CNS trauma
    • advantages: can be given IV in large doses
    • (ex: Solu-Delta-Cortet)
  19. alcohol solution
    • no salt
    • long acting

  20. suspension
    • corticosteroid suspended in a diluent
    • long acting

  21. autacoids or eicosanoids
    prostaglandins, thromboxanes, leukotrienes
  22. 3 things that cause bilateral hair loss
    • hyperadrenocortism
    • hyperestrogenism
    • hypothyroidism
  23. corticosteroid effects
    • reduce inflammation
    • reduce capillary permeability
    • inhibit fibroblasts
    • suppress T-lymphocytes
    • catabolic effect on proteins
    • abortion
    • stress triad
  24. if stressed, the body is producing

    (and therefore, stress triad)
  25. stress triad
    • decrease in lymphocytes, eosinophils, monocytes
    • increase in platelets and neutrophils
  26. contraindications for steroid
    • systemic or fungal infections
    • vaccines
  27. nickname for hyperadrenocortism 
    Cushing's Disease
  28. Hyperadrenocortism
    over production of hormones from adrenal gland

    symptoms: alopecia, muscle wasting, polyuria, polydipsia, polyphagia, pot belly, thin skin
  29. nickname for hypoadrenocortism
    Addison's Disease
  30. Hypoadrenocortism
    not enough hormones being produced by adrenal gland

    usually results from taking animal off steroids after yrs of administration (going from hyper to hypo over night)
  31. blocks MOTB
    Selegiline hydrochloride
  32. MOTB
    Monoamino Oxidase Type B

    chemical produced by body with natural aging
  33. how do most NSAIDs work?
    block activity of cyclooxygenase and subsequent production of prostaglandins
  34. although most NSAIDs do not block formation of leukotrienes, this drug inhibits lipoxygenase preventing production of leukotrienes
    Ibuprofen (Advil)
  35. oldest NSAID
  36. non-proprietary name for Aspirin
    acetylsalicylic acid
  37. long-term use of aspirin (acetylsalicylic acid)
    gastrointestinal toxicity
  38. 1971
    J R Vane discovered NSAIDs block production of prostaglandins from arachidonic acid
  39. 1976
    • cyclooxygenase identified
    • NSAIDs exert their effects by inhibiting production of local tissue cyclooxygenase and its production of prostaglandins
  40. non-proprietary name for Banamine
    flunixin meglumine

    (acts for 24 hrs)
  41. pyrazolones
    • dipyrone
    • phenylbutazone
  42. Rimadyl
  43. Ketofen
  44. Naprosin&Aleve
  45. Advil
  46. oxicams
    • piroxicam
    • meloxicam
  47. proprietary for piroxicam and meloxicam
    • feldene
    • metacam V, mobic H
  48. Toradol
  49. EtoGesic
  50. Previcox
  51. COX1
    role in normal tissue function
  52. COX2
    associated with pain, fever, inflammation
  53. which COX would we ideally like to eliminate and which would we ideally like to leave alone?
    • eliminate COX2
    • leave COX1 alone
  54. Rimadyl is made by
  55. Deramaxx
  56. Metacam
  57. Zubrin
  58. what should you never to give to animals?
  59. Aleve
  60. phenylbutazone tabs&paste can cause
    calcium breakdown in long bones causing osteogenic imperfecta- thin long bones
  61. coxib
    compounds that target inhibition of COX2 only

    *want to leave COX1 alone because protects gastric mucosa--older NSAIDs block COX1 along with COX2 which accounts for their commonly seen gastric side effects*
  62. inhibit COX1 for prolonged periods?
    • GI ulceration/erosion
    • adverse effects on renal function
    • problems with hemostasis (platelet production)
  63. required for sodium homeostasis in kidney
    Prostaglandin E2
  64. eating long-chain fatty acids promotes
    replacing PGE2 with PGE3=less inflammatory effect
  65. no inhibition of COX2 at any time

    always complete COX1 inhibition
  66. major use in horses with colic and off label use in dogs w/ parvo or other GI pain
    Flunixin Meglumine (Banamine)

    includes analgesic, antipyrexia, and anti-inflammation
  67. used mainly as pain relief associated with degenerative joint disease or postoperative pain of soft tissue
    Carprofen (Rimadyl)
  68. why is aspirin not recommended for cats?
    they lack glucuronic acid to (phase 2 of biotransformation) so is not excreted and goes through again
  69. what are chondroprotective agents?
    meds designed to slow the process of arthritis in joints by supporting the health of the joint cartilage
  70. PSGAGs
    Polysulfated Glycosaminoglycans

    • look and act like normal components of normal joint cartilage.
    • these molecules trap water, act as moisturizer for the cartilage preserving its "springy" characteristic and ability to respond to shock

    (ex: Adequan)
  71. Hylauronic Acid
    • natural component of synovial fluid
    • functions to increase the thickness of the joint fluid and, in doing so, acts as a lubricant for contact between cartilage surfaces

    Hyaluronate sodium-acts to reduce inflammation caused by prostaglandins by suppressing its production 

    (ex: Legend, Hyalovet)
  72. Glucosamine and Chondroitin sulfate
    called Nutraceuticals because used like drugs but are found naturally in the body

    presence of both in serum= stimulates production of hyaluronic acid and inhibits destructive enzymes found in diseased cartilage

    (ex: Cosequin)
  73. often grouped with NSAIDs but is not a true member. Why isn't it?
    Acetaminophen (Tylenol)

    does reduce the perception of pain& has antipyretic properties but does NOT block prostaglandins which cause inflammation