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16 Cards in this Set
- Front
- Back
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What are NSAIDs?
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effective analgesics for the management of acute peri-operative pain and chronic pain
drugs are not controlled and mostly palatable with a long duration of action can have many side effects these meds can be given IV,SC and orally |
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What is the efficacy between NSAIDS?
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studies comparing analgesic efficacy of different NSAIDs
fail to show a difference between drugs |
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Wat are the cox1:cox2 ration
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depends on assay (cell, tissue type)
laboratory species in vitro VS in vivo need PK/PD data in target species COX2 selective, preferential COX1 sparing COX 2 selective drugs could "eliminate" gastric side effects but there is no relationship |
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What are the renal effects of NSAIDs?
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prostaglandins regulate
-glomerular filtration rate -renin release -sodium excretion -may impair GRF in patients with renal disease or hypotension -may cause renal ischemia in patients with hypotension |
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What are renal concerns with NSAIDs?
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hypotension
-renal perfusion is PG dependent COX-2 is constitutive in the canine kidney -renal blood flow, fluid balance |
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What is the relationship between hemostasis and NSAIDs?
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COX 1 - causes platelet aggregation and vasoconstriction
COX 2 causes vasodilation and inhibits platelet aggregation NSAIDS increase or decrease blood clotting depending on COX selectivity |
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What is COX - 2?
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constitutive in kidney, GI mucosa, CNS, bone and cartilage
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What are the GI effects of NSAIDs?
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GI ulceration and bleeding
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What are prostaglandins essental for?
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-maintenance of mucosal blood flow
-bicarbonate and mucous secretion -epithelialization |
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What are the benefits and costs of NSAIDs before surgery?
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effective provision of analgesia
risk of GI bleeding and perforation renal ischeima (peri-operative use) hemorrhage more important during peri-operative use |
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What is pre-emptive analgesia?
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antinociceptive treatment that prevents establishment of altered central processing of afferent input from injuries
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When can NSAIDs be given?
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before and after sedation
20 minutes after extubation 2,4,8 and 20 hours after surgery |
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What is the mechanism of action for NSAIDs?
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NSAIDs are predominantly enzyme inhbitors
-true pre-emptive effect should be given 1-2 hours before start |
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Why do some dogs have trouble with NSAIDs?
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- no work up brefore drugs are prescribed
-overdosed -other medical problems -other concurrent medication |
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How long should an animal be on NSAIDs?
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there is no evidence based on recommendations
must provide alternative analgesic in the intervening period |
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What do you do if you don't give NSAIDS re operative what can you do?
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-provide adequate analgesia using opioids
-use a combinations of systemic and local analgesia (local block/epidural) -delayed NSAID administration until the animals is fully awake and normotensive after recovery from anesthesia |
