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Pharm-NSAIDs
Pharm
42
Veterinary Medicine
Undergraduate 3
05/24/2012

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Term
therapeutic uses of NSAIDs =
Definition
anti-inflam
anti-pyrexic
analgesic
Term
primary mech of NSAIDs =
Definition
inhibit COX
Term
How are NSAIDs better than glucocorticosteroids?
Definition
steroids inhibit PLA2 = inhibits leukotrienes as well as inflam mediators = decr WBCs - not gd if got severe infection where want WBCs to be activated and functioning efficiently.

NSAIDs only inhibit COX = only decr imflam mediators = more specific :)
Term
half life of eicosanoids =
Definition
short
Term
COX1 =
Definition
constitutive enzyme, always there in most cells, = produce homeostatic PGs

maintains tissue homeostasis

some cox1 upreg in inflam
Term
COX 1 enzymes homeostatic functions =
Definition
regulate kidney perfusion (vasodilation)

gut protection (local BF, cell turnover, mucous production, HCO3-production)

platelet aggregation by TXA2
Term
inhibit cox 1 get what side effects?
Definition
1. acute renal failure (decr perfusion of kidneys)
2. gastric ulcer & bleeding(decr PG)
3. bleeding as got decr clotting (decr TXA2)
4. skin reactions
5. liver disorders
6. BM disturbances
Term
cox2=
Definition
inducible in inflam cells

large upreg in inflam

produce protanoid mediators of inflam

drugs want to target COX2
Term
cox3 =
Definition
recently found

not present in all sp

splice varient of cox1 (v similar)
Term
Vioxx =
Definition
specific cox2 inhibitor taken off market due to dangerous CVS side effects (heart attack and stroke)
Term
meaure cox slectivity via...
Definition
...in vitro isolated cells or whole blood, therefore cant compare NSAIDs as may not refelct in vivo safety!
Term
IC50=
Definition
[NSAID] that inhibits 50% of cox enzymes
Term
IC90
Definition
[NSAID] that inhibits 90% of cox enzymes
Term
Ideally want IC50 of cox1 to be...(a)

and IC50 of cox2 to be...(b)
Definition
(a) high

(b) low

want cox2 selectivity!
Term
NSAIDs side effects with peri-op use =
Definition
kidney damage
blood clotting (incr by inhibition of PG and PGI)
GIT ulcers & bleeding
Term
NSAIDs side effects with long term use =
Definition
GIT (ulcers & bleeding)
effects on s=arthritic cartilage - decr healing
hepatopathy
Term
diameter of
a)cox1
b)cox2
enxyme tunnel =
Definition
a) narrow
b)wide

(so small aspirin gets into cox1 but bigger carprofen wont fit, and aspirin too small for cox2 but carprofen =right fit for cox2 to reach both sides)
Term
more cox1 selective NSAIDs =
Definition
aspirin
indomethocin
Term
more cox2 selective NSAIDs =
Definition
carprofen
deracoxib
tepoxalin
meloxicam
nimuselide
Term
what prostanoids cause inhibition of platelet aggregation?
Definition
PGD2 and PGI
Term
what prostanoids cause vasodilation?
Definition
PGE2, PGD2 and PGI
Term
what prostanoids cause hyperalgesia?
Definition
PGE2 and PGI
Term
what prostanoids cause myometrial contraction and bronchoconstriction?
Definition
PGF2alpha
Term
what prostanoids causes vasoconstriction and platelet aggregation?
Definition
TXA2
Term
balance of what two prostanoids is v imp?
Definition
TXA2 and PGI
Term
only irreversible NSAID =
Definition
aspirin
Term
mainly cox 1 selective but less so than aspirin =
Definition
ibruprofen
flubiprofen
nabumetone
Term
NSAID toxicity related to...
Definition
...cox selectivity
Term
NSAID with strong anti-inflam effect =
Definition
indomethacin
Term
NSAIDs commonly used in vetmed=
Definition
relatively cox 1 selective:
aspirin
flunixin
ketoprofen

reletively cox2 selective:
carprofen
meloxicam
phenylbutazone
deracoxib
Term
why is tepoxalin not a v gd NSAID?
Definition
cox1 selective and LOX inhibitor (decr WBCs) :(
Term
some cox2 enzymes have homeostatic roles therefore can get the following side effects with inhibition of cox 2 :(
Definition
decr healing of GIT & bone
thrombosis
renal dz
Term
antipyrexic effects of NSAIDs
Definition
inhibit production PG in hypothalamus which cause an incr in the body temp set point causing pyrexia)

Only has this efefct in pyrexic animals, doesnt decr temp in normal animal
Term
analgesic effects of NSAIDs
Definition
NSAIDs inhibit PGE2 and PGI2 which would otherwise sensitize nociceptive neurones to actions of mediators of inflam such as bradykinin = pain.
Term
analgesic effect of NSAID most effective against pain associated with...
Definition
...inflam and tissue damage
Term
anti-inflam effects of NSAIDs...
Definition
inhibit synth of prostanoids (= mediators of inflam)

in particular:
decr vasoldilation
decr bv perm = decr oedema
decr pain
Term
has does aspirin irreversibly inhibit cox1?
Definition
by acetylating Serine-350 in active site of cox1
Term
commonly used NSAIDs in vetmed =
Definition
salicylates (aspirin)
carprofen
phenylbutazone
Term
what blood cells release TXA2?
Definition
platelets
Term
how does aspirin (at low doses) inhibit platelet aggregation?
Definition
targets and inhibits platelets releasing TXA2
Term
how does aspirin (at high doses) activate platelet aggregation?
Definition
inhibits PG release (PGE2 and PGD2) from epi (PGs inhibit platelet aggregation so by inhibiting PGs =activate platelet aggregation)
Term
DONT want platelet aggregation if...
Definition
... had heart attack!
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