Vet Anesthesia Unravelled Course - Lesson # 8 - Non-steroidal anti-inflammatory drugs
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What's up NAVE crew! In this video lesson we'll be talking about the use of “Non-steroidal anti-inflammatory drugs”. This group is certainly the most popular in analgesic therapy, both in medicine and in veterinary. This is because they are great analgesics for mild to moderate pain, can be administered orally and are easily acquired, since there's no need for prescription.
We should remember that inflammation is a natural and important response for the defense of the organism. The problem starts when this process becomes too intense, causing exacerbated inflammation and pain. Hence the need for NSAIDs. This drug group works by blocking the enzyme cycloxygenase (COX), which transforms arachidonic acid into eicosanoids (PGEs, PGI and TBX). The organism produces 2 types of COX: COX-1, considered constitutive, and COX-2, considered inducible, and therefore released in large amounts in case of inflammation. However, it is currently known that COX-2 also participates in physiological protection, especially in renal irrigation. Therefore, it's best to use NSAIDs that inhibit a larger quantity of COX-2 than COX-1, but complete COX-2 inhibition can also be harmful. The most common adverse effects when using NSAIDs are gastrointestinal, renal and coagulation disorders. Mainly gastritis, gastric ulcer, melena, hematoemesis, increased creatinine and increased blood clotting time are observed.
NSAIDs are classified as non-specific, in which there is no preference for COX-2 blocking (even more so for COX-1); prefential , in which COX-2 is blocked more often than COX-1; and selective , also called “coxibes”, in which there is much more affinity to block the COX-2 than COX-1. The use of non-specific NSAIDs is decreasing, since they cause adverse effects more frequently than the others. The main drugs on this group are Flunixim Meglumine, Phenylbutazone and Ketoprofen. Meloxicam and Carprofen represent COX-2 preferential NSAIDs and can be used both in the treatment of acute and chronic pain with relative safety. The most popular coxibes in veterinary are Firocoxib (dogs and horses), Robenacoxib (dogs and cats) and Mavacoxibe (dogs).
We still have dipyrone (metamizole) and paracetamol (acetaminophen), which are non-specific, but with little peripheral effect. Thus, they promote analgesic and antipyretic effects but little anti-inflammatory. They are mostly used as analgesic adjuvants.
Would you like to learn more about it? Watch the video and check out the additional material!
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Additional Material
Autefage A et al. Long-term efficacy and safety of firocoxib in the treatment of dogs with osteoarthritis. Vet Rec.; 168:617, 2011.
Budsberg SC. Drogas anti-inflamatórias não esteroides. In: Gaynor JS, Muir WW. Manual de Controle da Dor em Medicina Veterinária. Ed MedVet. 2ª ed. 2009, 183-209.
Cook VL et al. Effect of firocoxib or flunixin meglumine on recovery of ischemic-injured equine jejunum. AVJR, 70:992-1000, 2009.
Luna SPL, Carregaro AB. Anti-inflamatórios. In: Luna SPL, Carregaro AB. Anestesia e Analgesia em Equídeos, Ruminantes e Suínos. Ed MedVet. 1a ed. 2019, 99-148.
Luna et al. Evaluation of adverse effects of long-term oral administration of carprofen, etodolac, flunixin meglumine, ketoprofen, and meloxicam in dogs. AJVR, 68:258-264, 2007.
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Additional credits
Recording errors theme song - Level Up - Quincas Moreira
Button animation - Savio Ferraz ( / savioferraz )
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