Anti inflammatory drugs, inflammation

1. Inflammation
•Inflammation is the complex pathophysiological response of
vascularized tissue to injury
•The injury may result from various stimuli, including thermal,
chemical, or physical damage; ischemia; infectious agents and
antigen-antibody interactions

5. NSAIDS
•NSAIDs have the potential to relieve pain and inflammation
without the potential metabolic, hemodynamic, and
immunosuppressive adverse effects associated with corticosteroids
•However, all NSAIDs have the potential for other adverse effects
that should be considered

6. Mode of action
•NSAIDs act primarily to reduce the biosynthesis of prostaglandins
by inhibiting Cyclooxygenase (COX)
•ln general, NSAIDs do not inhibit the formation of 5-lipoxygenase
(5-LOX) and hence leukotriene, or the formation of other
inflammatory mediators
•The novel NSAID tepoxalin is an exception in that it inhibits both
COX and 5-LOX

7. Pharmacologic effects
•All NSAlDs, except for acetaminophen ( also named paracetamol),
are antipyretic, analgesic, and anti-inflammatory
•They are routinely used for the relief of pain and inflammation
associated with osteoarthritis in dogs and horses and for colic,
navicular disease, and laminitis in horses
•As analgesics, they are generally less effective than opioids

8. Common NSAIDS
Flunixin
Ketoprofen
Naproxen
Meloxicam
Piroxicam
Phenylbutazone
Aspirin
Ketorolac
Acetaminophen

9. Flunixin
Uses/Indications:
Alleviation of inflammation and pain associated with
musculoskeletal disorders and alleviation of visceral pain
associated with colic
In cattle for the control of pyrexia associated with BRD and
endotoxemia, and control of inflammation in endotoxemia
In ruminants, flunixin is a better analgesic for visceral pain rather
than musculoskeletal pain
May improve hemodynamics in animals with septic shock

10. Contraindications
•Flunixin should be used cautiously in animals with renal, hepatic,
or hematologic diseases
•When using to treat colic, flunixin may mask the behavioral and
cardiopulmonary signs associated with endotoxemia or intestinal
devitalization
•In horses with known or suspected EGUS, use should be
avoided; repeated doses can exacerbate gastric ulcers
•Flunixin is usually considered contraindicated in cats

11. Adverse effects
•In horses following IM injection, reports of localized swelling,
induration, stiffness, and sweating have been reported
•Do not inject intra-arterially as it may cause CNS stimulation
(hysteria), ataxia, hyperventilation, and muscle weakness
•Flunixin appears to be a relatively safe agent for use in the horse, but
the potential exists for GI intolerance, hypoproteinemia, and
hematologic abnormalities to occur

12. •IM injections may rarely be associated with clostridial myonecrosis
•Hematochezia and hematuria have been reported in cattle treated
for longer than the 3-day recommendation.
•In dogs, GI distress is the most likely adverse reaction
•Clinical signs may include, vomiting, diarrhea, and ulceration
•In birds, flunixin has been shown to cause significant renal ischemia
and nephrotoxicity

13. Brand names