Nsaid

Front 1

NSAID. How does it work and what are the side effects?

Back 1

MOA: block the production of COX-2 >> COX-1.

 Highly bound protein.

 Side effects: “Good” PGs (PGI2 and PGE) normally inhibit acid secretion, mucosal blood flow, increase mucous production. NSAID blocks it causing ulceration and haemorrhage.

 ↓Thromboxane (TXA2) & ↓ PGI2 = outcome of decreasing a platelet aggregator and a potent inhibitor of platelet aggregation is: a net decrease in platelet aggregation potentially resulting in abnormal bleeding

 potential for:
• ↓PGE2 = Water retention → hypertension
• ↓ PGI2= Decreased renal blood flow leading to interstitial papillary necrosis and nephritis

>Analgesia
>Anti-inflammatory
>anti-pyretic

Front 2

Name the 9 NSAID

Back 2

Meloxicam, Peroxicam, Ferocoxib, Ketoprofen,Carprofen, tolfunamic acid, flunixin, phenylbutazone,

Front 3

Acetaminophin

Back 3

MOA: Interferes with endoperoxide intermediates produced from Arachidonic Acid conversion.
 High peroxide concentrations in inflammatory lesions, so alleviates inflammation
 These same high levels of peroxides often inactivate Paracetamol!

Used to prevent more clotting i.e. saddle thrombus in cats.

 Hepatic glucuronidation. If not (eg a cat), phase I metabolism kicks in creating cytotoxic intermediates. Hepatic glutathione is scavenging system for these intermediates. If depleted, intermediate groups bind to hepatic proteins > hepatic necrosis.

Front 4

Meloxicam

Back 4

COMMONLY used
good analgesia (peri-operative)
 good for exotics
 cat friendly preparations (lower concentration)

Front 5

Peroxicam

Back 5

Analgesic

Front 6

Ferocoxib

Back 6

COMMONLY used
 lowest side effects (COX-2 selective)
 good analgesia (esp chronic therapy)

Front 7

Ketoprofen

Back 7

frequently used and “cat friendly”

Front 8

Carprofen

Back 8

VERY COMMONLY used
 good analgesia (peri-operative)

Front 9

Tolfenamic Acid

Back 9

For production animals
 Less side effects.
 established withholding periods (WHPs)

Front 10

Flunixin

Back 10

 old, cheap, established WHPs, trusted
 Excellent analgesic for horses
Binds to inflammatory proteins = long DOA

Front 11

Name the alternative NSAID

Back 11

ditary FA, pentosan polysulphate, glucosamine, chondroitin sulphate, green lipped mussel , polysulfated glycosaminoglycans.

Front 12

Phenylbutazone

Back 12

VERY COMMONLY used
excellent analgesic for lame horses
 no COX1 / COX2 selectivitiy = side effects

Front 13

Dietary FA

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Mechanism of Action (= Competitive Inhibition)
>Provide alternate substrate for phospholipase to target
>New products are generally less inflammatory, inactive and sometimes anti-inflammatory

Front 14

Pentosan polysulphate

Back 14

MOA
1. Stimulates synovial fibroblasts to produce hyaluronic acid
2. Inhibition of soluble mediators (eg proteases, collagenase, elastase) of inflammation
3. Fibrinolysis and lipolysis thus improving subchondral blood flow

Front 15

Glucosamine

Back 15

MOA: Stimulation of hyaluronic acid production and collagen and proteoglycan synthesis. Cartilage matrix therefore improves

Front 16

Chondroitin sulphate

Back 16

MOA: The main glycosaminoglycan found in cartilage

Front 17

Green Lipped Mussel

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Synergistic combination of glycosaminoglycans, Omega-3 FAs, amino acids, vitamins and minerals.

Front 18

Polysulfated Glycosaminoglycans

Back 18

Inhibition of soluble mediators (eg proteases, collagenase, elastase) of inflammation