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214 Cards in this Set
- Front
- Back
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pain |
-an unpleasant sensory or emotional experience associated with actual or potential tissue damage -may occur alone or in combination with inflammation |
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nociceptors |
nerve endings that originate pain sensation, located in every tissue in the body |
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how may pain be activated |
-mechanical stimulation -chemical stimulation -thermal stimulation |
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stress of chronic pain leads to |
-GI lesions -delayed healing -hypertension -immunosuppresion -fatigue -abnormal behavior -dysrhythmias |
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symptoms of pain |
-increased heart rate -increased respiratory rate -mydriasis -salivatoin (ptyalism) -vocalization -changes in expression -aggressive behavior -guarding -restlessness -unresponsiveness -failure to groom -abnormal gait/stance -rolling |
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mydriasis |
squinting |
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ptyalism |
salivation/drooling |
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analgesics |
drugs that control pain |
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major categories of pain control |
-analgesics -non-steroidal anti-inflammatory drugs (NSAIDs) -opioids -alpha 2 agonists -ketamine -others |
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name the chemical mediators of inflammation |
-prostaglandins -leukotrienes -histamine -cytokines (others) |
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which chemicals are involved in the inflammatory process |
-prostaglandins -leukotrienes -histamine -cytokines |
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inflammation is |
-body's response to tissue injury caused by physical, chemical, or biologic trauma -body removes/walls off infection and repairs/replaces tissue |
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5 hallmarks of the inflammatory response |
-redness -heat -swelling -pain -loss of function |
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classes of antiinflammatory drugs |
-NSAIDs -glucocorticosteroids -dimethyl sulfoxide (DMSO) |
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hyperalgesia |
-increased in tissue sensitivity -threshold for subsequent stimuli lowers |
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levels of the pain pathways are |
-transduction -transmission -modulation -perception
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transduction |
part of the pain pathway that occurs at the initial stimuli |
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transmission |
-part of the pain pathway that occurs along peripheral pathways -electrical transmission of pain |
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modulation |
-part of the pain pathway that occurs in the spinal tracts -changes to pain pathway in the spinal cord -suppression or amplification up the spinal cord and eventually to the cerebral cortex |
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perception |
-part of the pain pathway when organism is made aware of pain -occurs within the cerebral cortex -an organism needs to be conscious to experience pain |
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pyrogens |
-substances that cause a resetting of internal thermostat -contribute to/cause fevers |
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"c" fibers are what kind of fibers and what do they do |
unmyelinated fibers that usually transmit dull poorly located pain |
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"a delta" are what kind of fibers and what do they do |
-myelinated -transmit sharp, localized pain |
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where does transduction occur |
int he nociceptors |
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central sensitization (wind up) |
-occurs in spinal cord -repeat stimulation causes sensitization and lower discharges in the spinal cord -less stimulation is required to start pain -pain is learned: becomes a learned behavior and therefore harder to control |
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which enzyme(s) does/do NSAIDs act on |
-cycloxygenase (COX) 2 forms: COX1 and COX2 |
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what are the side effects of NSAIDs |
-GI ulceration -hepatotoxicity -nephrotoxicity -inhibition of cartilage metabolism -bone marrow suppression -reduced platelet aggregation |
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what does COX1 do |
-maintains physiologic functions such as renal function, platelet funciton, GI protection |
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what does COX2 do |
-promotes formation of prostaglandin from cell membrane arachidonic acid -pro-inflammatory |
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apoquel aka |
oclacitinib |
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oclacitinib aka |
apoquel |
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what is apoquel (oclacitinib) used for |
-pruritis -allergic dermatitis |
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how does apoquel (olacitinib work |
-inhibition of janus kinase (JAK 1) enzyme in the signalling pathway of itch/inflammation |
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side effects of apoquel (olacitinib) |
-vomiting/diarrhea -skin irritations -contributes to development of demodectic mange skin infection -may exacerbate neoplastic conditions |
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atopica aka |
cyclosporine |
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cyclosporine aka |
atopica |
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what is cyclosprine (atopica) used for |
-atopy -inflammatory bowel disease -immunosuppression (IMHA) -preferred treatment for perianal fistulas |
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side effects of cyclosporine (atopica) |
-vomiting and diarrhea -gingival hyperplasia -can increase risk for bacterial and fungal infections and neoplasia |
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what effect does ketoconazole have on cyclosporine (atopica) |
-ketaconazole delays the metabolism of cyclosporine making this a positive drug interaction -this allows us to use less cyclosporine ($$$) and get a longer lasting effect |
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which 2 drugs we talked about interact in a a positive way |
ketaconazole and cyclosporine (atopica) |
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robaxin aka |
methocarbamol |
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methocarbamol aka |
robaxin |
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what is methocarbamol (robaxin) used for |
-intervertebral disc disease (esp. in dogs) -muscle strains/sprains -myositis -bursitis -muscle spasms |
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which species is methocarbamol (robaxin) labeled for use in |
-dogs -cats -horses |
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short term side effects of glucocorticosteroids |
-increased appetitie (polyphagia) -polyuria/polydipsia -mood changes -diabetes |
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long term side effects of glucocorticosteroids |
-thinning of skin and muscle wasting -delayed healing -gastric ulcers -osteoporosis -abnormal behavior -diabetes mellitus (increased blood sugar) -idiopathic cushing's disease (hyperadrenalcorticism) -addison's disease (hypoadrenalcorticism) |
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clinical uses for corticosteroids |
-allergic conditions/reactions -inflammation of musculoskeletal system -shock/toxemia -laminitis (lg. animals) -ocular inflammation -autoimmune dz (IMHA, lupus) -lympocytic neoplasia -addison's dz |
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what were corticosteroids used for in the past but are considered a controversial use today |
-shock |
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administration forms of corticosteroids |
-topical (otic, opthalmic, dermal) -oral (liquid, tablets) -injectable (IV, SQ, IM, depo) |
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common corticosteroids |
-prednisone -prednisolone -dexamethasone (azium) -dexamethosone sodium phosphate -flumetheasone (flucort) -methylprednisolone (medrol) -prednisolone sodium succinate -triamcinalone (vetalog) -betamethasone (betasone) |
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what are the primary immunosuppressive functions of corticosteroids |
-inhibition of antibody production -decrease in the concentration of eosinophils and lymphocytes -suppress the migration of neutrophils -inhibit phagocytosis |
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what are the antiinflammatory actions of corticosteroids |
-blocks phospholipase (enzyme needed for prostaglandins and leukotrienes) -block inflammation earlier than NSAIDs (better antiinflammatory but more side effects) -membrane stabilizaiton -stabilization of lysosomes 0disruption of histamine synthesis -reduciton of exudative process |
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which corticosteroids are used to treat addison's disease |
-desoxycorticosterone pivalate (percorten - V) -fludrocortisone acetate (florinef) |
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what do the mineralcorticosteroids (aldosterone) do |
regulate electrolyte and water balance in the body |
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what is desoxycorticosterone pivalate (percortin - V) |
-mostly injection of synthetic aldosterone -used to treat addison's disease |
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what is fludrocortisone acetate (florinef) |
-an oral mineralcorticoid and glucocorticoid -used to treat addison's |
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what is addison's disease |
-hypoadrenocorticism -not enough circulating corticosteroids |
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desoxycorticosterone pivalate aka |
percortin - V |
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percortin - V is aka |
desoxycorticosterone pivalate |
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fludrocortisone acetate aka |
florinef |
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florinef aka |
fludrocortisone acetate |
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what is HPA and what does it do |
-hypothalamus, pituitary, adrenal axis -maintains a steady level of cortisol on the blood |
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what happens in regards to corticosteroids during stress |
stress timulates the hypothalamus to release CRH as a response to alleviate stress |
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the release of cortisol in the body is managed through which 2 separate systems |
-the stress response -HPA (hypothalamus, pituitary, adrenal axis) |
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how many layers does the adrenal cortex have and what do those layers do |
-3 -produce steroid compounds |
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how are corticosteroids classified |
-mineralocorticoid or glucocorticoid activity -duration of action (short, intermediate, long) |
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what system int he body regulates the secretion of glucocorticosteroids and how |
-the hypothalamic-pituitary-adrenal axis -negative feedback loop |
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true or false: the hypothalamus cannot distinguish between exogenous and endogenous steroids |
true this is why steroids must be weaned off, so the hypothalamus has time to start producing its own |
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what are the 3 compounds produced by the adrenal cortex |
-sex hormones -glucocorticosteroids (cortisol) -mineralocorticosteroids (aldosterone) |
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what is the main glucocorticosteroid |
cortisol |
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what is the main mineralocorticosteroid |
aldosterone |
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what are the main funcitons of glucocorticosteroids |
-anti inflammatory -immunosuppressive -influence carbohydrate metabolism -alters mood |
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what are the main functions of mineralcorticosteroids |
regulate water and electrolyte balance |
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what are the 3 layers of the adrenal cortex |
-zona glomerulosa -zona fasciculata -zona reticularis |
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what does the zona glomerulosa produce |
mineralocorticosteroids |
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what does the zona fasciulata produce |
glucocorticosteroids |
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what does the zona reticularis produce |
sex hormones (androgen and estrogen) |
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all steroid compounds are synthesized from the same molecule, which molecule |
sterol |
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what are the side effects of antihistamines |
-drowsiness -weakness -dry mouth -urinary retention -CNS stimulation with overdose |
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H2 blocking antihistamines are used for |
-treating excessive secretion of stomach acid -animals with gastritis/gastroenteritis |
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examples of H2 blocking antihistamines |
-cimetidine (tagamet) -ranitidine (zantac) -famotidine (pepcid) |
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famotidine aka |
pepcid |
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pepcid aka |
famotidine |
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ranitidine aka |
zantac |
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zantac aka |
ranitidine |
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what type of drug is famotidine (pepcid) |
h2 blocking antihistamine |
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what type of drug is ranitidine (zantac) |
h2 blocking antihistamine |
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what are h1 blocking antihistamines used to treat |
-skin allergies, allergic reactions -pruritus -acute allergic reactions (angioneurotic edema and urticaria) -laminitis -motion sickness -downer cow -reverse sneeze syndrome -anaphlactic shock -upper respiratory conditions
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examples of h1 blocking antihistamines |
-chlorpheneramine (chlortrimeton) -cetirizine (zyrtec) -dimenhydrinate (draminine) -diphenhydramine (benadryl) -fexofenadine (allegra) -hydroxyzine (atarax) -loratadine (claratin) meclizine (bonine, antivert) -trimeprazine (temaril-P) |
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what do anithistamines do |
stop histamine from binding to cells starting the inflammation cascade |
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what are the 2 types of histamine receptors |
H1 and H2 |
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what is the difference between the H1 histamine receptors and the H2 histamine receptors |
-H1 is involved in allergic response, motion sickness, nausea, sedation -H2 increases stomach acid |
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lidocaine |
-pain med which can be used as a transdermal patch, cream, injection or splash |
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gabapentin aka |
neurontin |
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neurontin aka |
gabapentin |
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why should gabapentin (neurontin) be avoided in dogs |
the oral solution contains xylitolwhich is toxic to dogs |
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what is gabapentin (neurotin) used for |
-neuropathic pain -osteoarthritis -cancer pain |
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what are the side effects of gabapentin (neurontin) |
-sedation -ataxia |
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polysulfated glycosaminoglycan aka |
adequan |
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adequan aka |
polysulfated glycosaminoglycan |
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what is polysulfated glycosaminoglycan (adequan) used for |
-reducing degenerative joint changes in horses and dogs |
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how is polysulfated glycosaminoglycan (adequan) administered |
IM and intraarticular injections |
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which of the drugs we discussed has recently become a controlled substances because the human body synthesizes it into codeine |
tramadol |
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what is tramadol/how does it work |
-synthetic mu receptor, opioid-like agonist -inhibits the reuptake of norepiniphrine and serotonin acting like an alpha 2 agonist |
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tramadol is labelled for use in which species |
dogs and horses |
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what is tramadol used for |
adjunct in post op and chronic pain |
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what are the side effects of tramadol |
-anxiety -tremor -vomiting -constipation -diarrhea -sdeation |
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what is ketamine |
-dissociative anesthetic -n-methyl-d-asparate (NMDA) receptor antagonist |
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how does ketamine work/what is it used for in analgesia |
-prevents "wind up" preventing severe and chornic pain -allows for a lower dose of opioids -can be used as part of a CRI |
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what is a side effect of ketamine |
tachycardia |
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name some main alpha 2-adrenergic agents |
-xylazine (rompun, anased)* -demedetomidine (dexdomintor)* -clonidine (duraclon) -medetomidine (domitor) -romifidine (sedivet) -detomidine (dormosedan) |
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xylazine aka |
-rompun -anased |
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rompun and anased are the brand names of |
xylazine |
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dexmedetomidine aka |
dexdomintor |
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dexdomintor aka |
dexmedetomidine |
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what class of drugs does xylazine (rompun, anased) belong to |
alpha 2-adrenergic agents |
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what group of drugs does dexmedetomidine (dexdomitor) belong to |
alpha 2-adrenergic agents |
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what are the side effects of alpha 2-adrenergic agents |
-hypertension* -bradycardia* -hypothermia* -hypotension -muscle tremors -AV block -vomiting |
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what are alpha 2-adrenergic agents and how do they work |
-group of sedative, analgesic drugs -interact with alpha 2 adrenergic receptors in the CNS |
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what is the name of the opioid partial agonist we discussed in pain management |
buprenorphine (buprenex) |
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which opioid we discussed in pain management has both agonist and antagonist functions |
butorphanol (torbugesic) |
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name some opioid agonists used in pain management |
-morphine -hydromorphone -oxymorphone -codein -fentnyl |
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which of the opioid agents we discussed can be used for pain management in small mammals |
buprenorphine (buprenex) |
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what is buprenorphine (buprenex) used for |
-mild to moderate pain in cats, dogs, horses, small mammals |
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how is buprenorphine (buprenex) administered |
As labelled: -injectable Extra label: -in cats administered transmucosally -can be compounded as a sustained release buprenorphine injection |
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which of the opioid agents we discussed can be administered to cats transmucosally |
buprenorphine (buprenex) |
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what is important to remember/tell owners about administered buprenorphine (buprenex) to cats orally |
since it is absorbed through the mucous membranes it must be put directly into the mouth so it comes in contact with one of these membranes - not squirted into the back of throat or mixed with food |
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which receptor(s) does buprenorphine (buprenex) act on |
-binds with mu but only partially activates -partial agonist |
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which receptor(s) does butorphanol (torbugesic) act on |
-agonist at mu receptors -antagonist at kappa receptors |
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what are the side effects of opioid agonists used for pain management |
-respiratory depression -sedation -addiction (humans) -excitatory effects (cats) |
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which receptors do morphine, hydromorphone, oxymorphone, codeine, and fentanyl act on |
-mu receptors -agonists at mu |
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butorphanol aka |
torbugesic |
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torbugesic aka |
butorphanol |
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what type of drug is buprenorphine (buprenex) |
-opioid partial agonist -mu receptor |
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what type of drug is butorphanol (torbugesic) |
-opioid agonist-antagonist -agonist at mu -antagonist at kappa |
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what are the side effects of butorphanol (torbugesic) as used for pain management |
-few -sedation -ataxia -salivation |
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what is butorphanol (torbugesic) used for |
mild to moderate pain |
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what type of drug is morphine |
-opioid agonist -mu receptor |
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what type of drug is hydromorphone |
-opioid agonist -mu receptor |
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what type of drug is oxymorphone |
-opioid agonist -mu receptor |
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what type of drug is codeine |
-opioid agonist -mu receptor |
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what type of drug is fentanyl |
-opioid agonist -mu receptor |
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how is fentanyl administered |
-transdermally -orally -IV |
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what are the main side effects of opioid analgesics |
-respiratory depression -nausea/vomiting |
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in general, opioid analgesics are used to control what type of pain |
-moderate to severe |
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how do opioid analgesics work |
-inhibit pain by binding to receptors int he central nervous system and peripheral tissue -alter impulse formation and transmission at many levels within the CNS (block or inhibit pain impulses to higher CNS centers) |
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meloxicam aka |
-metacam -loxicam -oroCAM |
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metacam, loxicam, oroCAM are all brand names for which drug |
meloxicam |
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what type of drug is meloxicam (metacam, loxicam, orocam) |
-NSAID -COX2 preferential inhibitor |
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meloxicam (metacam, loxicam, orocam) is labeled for use in which species |
-dogs and cats |
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which 2 NSAIDs we discussed are labeled for use in cats |
-meloxicam (metacam, loxicam, orocam) -robenacoxib (onsior) |
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what is meloxicam (metacam, loxicam, orocam) used for |
-pain from surgical procedures -arthritis -etc. |
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how is meloxicam (metacam, loxicam, orocam) administered |
-injectable -oral (liquid or tabs) |
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how often can meloxicam (metacam, loxicam, orocam) be administered |
-1x use in cats -chronic use in dogs |
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robenacoxib aka |
onsior |
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onsior aka |
robenacoxib |
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what is robenacoxib (onsior) used for |
-chronic osteoarthritis in dogs and cats -acute musculoskeletal pain in cats |
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what are the side effects of robenacoxib (onsior) |
GI signs |
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which species is robenacoxib (onsior) labeled for use in |
dogs and cats |
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how is robenacoxib (onsior) administered |
-injectable -oral* |
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what type of drug is robenacoxib (onsior) |
-NSAID -COXIB class |
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which drugs are in the COXIB class of the NSAIDs |
-deracoxib (deramaxx) -firocoxib (previcox) -robenacoxib (onsior) |
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how does the COXIB class of NSAIDs work |
-preferential COX 2 inhibitors -administered orally SID |
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deracoxib aka |
deramaxx |
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deramaxx aka |
deracoxib |
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firocoxib aka |
previcox |
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previcox aka |
firocoxib |
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what is firocoxib (previcox) used for |
osteoarthritis in dogs |
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what is deracoxib (deramaxx) used for |
-after orthopedic surgery in dogs greater than 4# -for osteoarthritis in dogs greater than 14# |
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carprofen aka |
-rimadyl -novox -norocarp |
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rimadyl, novox, and norocarp are all brand names for |
carprofen |
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what type of drug is carprofen (rimadyl, novox, norocarp) |
-NSAID -preferential COX 2 inhibitor -proprionic acid derivative |
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what type of drug is ketoprofen |
-NSAID -preferential COX 2 inhibitor -proprionic acid derivative |
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what is carprofen (rimadyl, novox, norocarp) used for |
-degenerative joint dz -post op pain (soft tissue/orthopedic surgery) |
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how is carprofen (rimadyl, novox, norocarp) administered |
-oral or SQ -SID or BID dosing -approved in dogs |
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side effects of carprofen (rimadyl, novox, norocarp) |
rare GI ulcerations and bleeding |
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what is ketaprofen used for |
-analgesic, antipyretic, antiinflammatory -musculoskeletal pain |
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how is ketaprofen administered |
-injection -human capsules |
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side effects of ketoprofen |
-GI bleeding/ulcerations -renal dysfunction -generalized bleeding |
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which species is ketoprofen labeled for use in |
-horses |
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naproxen is only labeled for human use in the US, in other parts of the world it is labeled for |
-horses |
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what is naproxen used for |
-relief of pain -inflammation -lameness (myositis, soft tissue) |
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which species is naproxen used off label for and why is it not often used |
-dogs because of GI ulcerations -technically in the US horse-use is off label as well |
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which species should never be given acetaminophen (tylenol) and why not |
-cats -ferrets -one dose can be fatal |
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side effects of administering acetaminophen (tylenol) to animals |
-methemoglobinemia -cyanosis -anemia -liver damage |
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which species can acetaminophen (tylenol) be used in (rarely) with caution and under the direct supervision of a veterinarian |
dogs |
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which species should ibuprofen (advil, motrin) not be given to and why |
-dogs -cats -due to gastric toxicity -one dose can be fatal |
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what type of drug is dimethyl sulfoxide (DMSO) |
NSAID |
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what is the labeled use of dimethyl sulfoxide (DMSO) |
-topical application to reduce acute swelling from trauma in horses and dogs |
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what is the off label use of dimethyl sulfoxide (DMSO) |
-IV: intestinal surgery, cerebral edema/spinal cord injury -IV: perivascular chemo agents -carrier of drugs across the skin |
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what is dimethyl sulfoxide (DMSO) most commonly used for in small animals |
-ears -acral granulomas |
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flunixin meglumine aka |
banamine |
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banamine aka |
flunixin meglumine |
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what type of drug is flunixin meglumine (banamine) |
NSAID |
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which species is flunixin meglumine (banamine) labeled for use in |
-horses -cattle |
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which species is flunixin meglumine (banamine) used off-label in and why is it rarely used |
-dogs -rarely used because of GI and renal side effects |
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what are the main uses for flunixin meglumine (banamine) |
-analgesia -antiinflammatory -antiprexia -musculoskeletal and colic -good for visceral pain |
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what are specific uses for flunixin meglumine (banamine) |
-disk disease -endotoxic shock -calf diarrhea -parvovirus -heat stroke -opthalmic conditions -post surgical pain |
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how is flunixin meglumine (banamine) administered |
-injection (IV, IM) -oral paste/granules |
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what are the side effects of flunixin meglumine (banamine) |
-swelling at the injection site -sweating |
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what type of drug is phenylbutazone (bute) |
-NSAID -pyrazolone derivative |
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what is phenylbutazone (bute) used for |
-analgesia in mild-moderate pain -antiinflammatory -antipyrexia -lameness and colic in horses -musculoskeletal pain relief in horses, dogs, and cattle |
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how is phenylbutazone (bute) administered |
-injection (IV only) -tablets, boluses, paste, gel, powder |
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what are the side effects of phenylbutazone (bute) |
-bone marrow suppression -GI bleeding |
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name a pyrazolone derivative NSAID |
phenylbutazone (bute) |
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what type of drug is aspirin |
-NSAID -salicylate |
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name a salicylate NSAID |
aspirin |
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side effects of aspirin |
-decreased platelet aggregation -GI irritation (ulceration, bleeding) |
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what are the main uses of aspirin |
-analgesia -antipyrexia -antiinflammatory -blood thinning |
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what are the specific uses of aspirin |
-mild to moderate musculoskeletal pain relief -blood thinning: post heartworm treatment. cardiomyopathy in cats. every 2-3 days for IMHA -analgesia/antipyrexia -treatment of endotoxic shock
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which species is aspirin used in |
-horses, cattle, dogs -use with care in cats |
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how is aspirin administered |
-with enteric coated tablets |
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name different types of pain |
-physiologic pain -pathologic pain -visceral pain -somatic pain -neuropathic pain |
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how is pain classified |
-intensity -duration -location -quality |
