Questions with complete solutions
Three-Way Safety Check - ✔✔Check the drug label for the correct drug and dosage when:
1. you dispense the medication
2. you remove it from pharmacy
3. you replace the medication
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) - ✔✔Uses: provide analgesia, reduce fever, and
control inflammation (no sedation); useful for mild to moderate pain control
Mechanism of action: work by inhibiting cyclooxygenase (COX); NSAIDs that selectively inhibit COX2
are though to produce fewer GI effects
Side effects/contraindications: GI ulceration, vomiting, diarrhea, liver and kidney toxicity; always give
with food; avoid in dehydrated animals; IV fluids when given as pre-med; never give with aspirin,
steroids, or other NSAIDs
*All patients need an annual physical exam and blood work prior to and 2-3 weeks after starting
NSAIDs*
Aspirin (Acetylsalicylic Acid) - ✔✔NSAID
Uses: analgesic, antipyretic, anti-inflammatory, reduces clot formation; used in feline
cardiomyopathy & arthritis (rarely)
Mechanism of action: inhibits cyclooxyrgenase; inhibits prostaglandin production (prostaglandins
lead to pain, fever, inflammation)
Side effects/contraindications: gastric irritation, ulceration and bleeding, caution in cats
Phenylbutazone - ✔✔NSAID
Uses: anti-inflammatory and antipyretic for horses
,Side effects: GI ulceration, renal toxicity
*Not used in small animals*
Advil (Ibuprofen) - ✔✔NSAID
Not used in dogs/cats; serious GI ulceration
Rimadyl (Carprofen) - ✔✔NSAID
Uses: DJD pain, post-op pain, dental post-op pain, pre-anesthetic combined with a narcotic
Mechanism of action: primarily COX2 inhibitor
Side effects/contraindications: rare; kidney, liver, GI, as with all NSAIDs
Metacam (Meloxicam) - ✔✔NSAID
Uses: post-op pain, arthritis
Mechanism of action: COX2 inhibitor
Previcox - ✔✔NSAID
Uses: arthritis and pain control
Mechanism of action: COX2 inhibitor
Galliprant - ✔✔NSAID (non-COX inhibitor)
,Uses: arthritis in the dog
Mechanism of action: EP4 receptor antagonist (primary editor of canine pain/inflammation)
*May have less renal/liver toxicities than the COX inhibitors*
NSAIDs in Cats - ✔✔-Metacam is an approved NSAID for use in cats as a single injection post-
operatively
-Useful for post-op pain and long-term use for arthritis
Onsior (Robenacoxib) - ✔✔NSAID approved for oral and injectable use in cats
Mechanism of action: COX2 inhibitor
*Eliminated via the liver, not kidneys*
Tylenol (Acetominophen) - ✔✔Not an NSAID
Uses: analgesic with limited antipyretic and anti-inflammatory activity; "escape drug" for severe DJD
in dogs only
*Never give to cats! Causes cyanosis, anemia, liver failure.*
DMSO - ✔✔Clear liquid noted for anti-inflammatory properties and its ability to carry other drugs
through the skin
Uses: acute swelling from trauma topically applied; IV to reduce cerebral edema; treat
chemotherapy perivascular injection sites topically; ear inflammation
Principles of Administering Analgesics - ✔✔The best way to treat pain is to prevent it.
, Multimodal analgesia often produces better pain relief than single agents.
Avoid "wind-up"
(when nerve receptors are repeatedly stimulated, they become over-sensitized and discharge pain
sensation at a lower threshold)
General and Clinical Signs of Pain - ✔✔behavioral changes
vocalization
escape attempts
pacing/anxiousness
restlessness/insomnia
aggression
lack of use
nocturia with joint pain
poor grooming with dental pain in cats
insomnia/unwilling to lay down with abdominal pain
increased HR, BP, RR
peripheral vasoconstriction
pupil dilation/mydriasis
Signs of Pain in Cats - ✔✔holding head down;
squinting eyes or hiding head;
hunched back;
reluctant to move;
don't respond to people;
less social;
urinating outside the box;
overgrooming;
self-trauma;
displacement behaviors