Non-Steroidal Anti-Inflammatory Drugs (Nsaids)

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Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) NSAIDs are pain medications. The first drug in this class of medication was aspirin. Aspirin in the Stop NSAID therapy and notify your form of willow bark was known by American Indians to be an effective pain medication but it was veterinarian if your not until 1973 that the mechanism of action was discovered. Since this time, more potent forms pet experiences: of aspirin have been developed that are safer for the stomach and kidneys. Examples of the newer • Decrease in appetite forms of aspirin in people include celebrex and ibuprofen. There have been NSAIDS specifically or vomiting designed for dogs that are safe and effective pain medications (see below). • Dark or NSAIDs are thought in people to have the best pain fighting characteristics relative to side effects bloody diarrhea and addiction potential. A BVNS doctor would prescribe an NSAID anytime a patient is thought to • Increased drinking be painful. We often use pain modulators as well which are not as effective but are safer. Examples or urination would include gabapentin, tramadol and amitriptyline. • Lethargy, yellowing of NSAIDs can cause stomach and intestinal problems, damage the kidneys and less commonly gums, skin, or whites of the liver and bone marrow. These problems are uncommon to rare, especially with the eyes (jaundice) appropriate monitoring. • Bleeding under the skin None of the following medications should be given together: NSAIDs Steroids Aspirin Cortisone Rimadyl/Carprofen Dexamethasone Etogesic/Etodolac Medrol/Methylprednisolone Deramaxx/Deracoxib Prednisone Metacam/Meloxicam Triamcinolone Previcox/Firocoxib Zubrin/Tepoxalin To learn more about neurologic diseases, treatments, medications and our practice, please visit www.bvns.net. Copyright © 2014 Bush Veterinary Neurology Service. All Rights Reserved. 0314.

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Pain Management in Companion Animals
CONTINUING EDUCATION TAP OUR APP Pain Management in Companion Animals Download “NCPA Mobile” Today! by Ann Philbrick, PharmD, BCPS Don’t be left out of the latest news affecting community pharmacy—download our new app, NCPA Mobile! Receive real-time updates, join the conversation on Twitter with a built-in feed, Jul. 1, 2015 (expires Jul. 1, 2018) and never miss out on breaking news affecting community pharmacy. Keep the Activity Type: Application-based app on your phone year-round for updates, news, alerts, and more from NCPA. To earn continuing education credit: ACPE Program 0207-0000-15-007-H01-P; 0207-0000-15-007-H01-T Upon successful completion of this article, the pharmacist should be able to: 1. Describe the process of pain in the dog and cat including identification of ways they express pain. 2. Describe the appropriate use, mechanism of action, and precautions for use of analgesics in the treatment of pain in dogs and cats. 3. Explain the key issues that impair the prevention of diversion in compan- ion animal owners. Upon successful completion of this article, the pharmacist should be able to: 1. Describe the process of pain in the dog and cat including identification of ways they express pain. To get the free NCPA Mobile app: 2. Describe the appropriate use, mechanism of action, and precautions for FREE ONLINE CE. To take advantage use of analgesics in the treatment of pain in dogs and cats. of free continuing pharmacy educa- iPhone and iPad users—search “NCPA 3. Explain the key issues that impair the prevention of diversion in compan- tion (CPE) for this program, pharma- ion animal owners.
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What Are the Acute Treatments for Migraine and How Are They Used?
2. Acute Treatment CQ II-2-1 What are the acute treatments for migraine and how are they used? Recommendation The mainstay of acute treatment for migraine is pharmacotherapy. The drugs used include (1) acetaminophen, (2) non-steroidal anti-inflammatory drugs (NSAIDs), (3) ergotamines, (4) triptans and (5) antiemetics. Stratified treatment according to the severity of migraine is recommended: use NSAIDs such as aspirin and naproxen for mild to moderate headache, and use triptans for moderate to severe headache, or even mild to moderate headache when NSAIDs were ineffective in the past. It is necessary to give guidance and cautions to patients having acute attacks, and explain the methods of using medications (timing, dose, frequency of use) and medication use during pregnancy and breast-feeding. Grade A Background and Objective The objective of acute treatment is to resolve the migraine attack completely and rapidly and restore the patient’s normal functions. An ideal treatment should have the following characteristics: (1) resolves pain and associated symptoms rapidly; (2) is consistently effective; (3) no recurrence; (4) no need for additional use of medication; (5) no adverse effects; (6) can be administered by the patients themselves; and (7) low cost. Literature was searched to identify acute treatments that satisfy the above conditions. Comments and Evidence The acute treatment drugs for migraine generally include (1) acetaminophens, (2) non-steroidal anti-inflammatory drugs (NSAIDs), (3) ergotamines, (4) triptans, and (5) antiemetics. For severe migraines including status migrainosus and migraine attacks refractory to treatment, (6) anesthetics, and (7) corticosteroids (dexamethasone) are used (Tables 1 and 2).1)-9) There are two approaches to the selection and sequencing of these medications: “step care” and “stratified care”.
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Efficacy and Safety of Celecoxib
ORIGINAL PAPER Nagoya J. Med. Sci. 77. 81 ~ 93, 2015 EFFICACY AND SAFETY OF CELECOXIB COMPARED WITH PLACEBO AND ETODOLAC FOR ACUTE POSTOPERATIVE PAIN: A MULTICENTER, DOUBLE-BLIND, RANDOMIZED, PARALLEL-GROUP, CONTROLLED TRIAL NAOKI ISHIGURO1, MD, PhD; AKIO HANAOKA2, MS; TOSHIYUKI OKADA2, MS; and MASANORI ITO3, PhD 1Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan 2Clinical Development 1, Astellas Pharma Inc., Tokyo, Japan 3Global Data Science, Astellas Pharma Global Development Inc., Northbrook, IL, US ABSTRACT Celecoxib is a nonsteroidal anti-inflammatory drug (selective cyclooxygenase-2 inhibitor) that is widely used. The efficacy and safety of celecoxib for treatment of acute postoperative pain were evaluated in Japanese patients. The objective was to assess whether celecoxib showed superiority over placebo treatment and non-inferiority versus etodolac (another selective cyclooxygenase-2 inhibitor) that has been widely used for the management of acute pain. A multicenter, double-blind, randomized, parallel-group, controlled study was performed, in which 616 patients with postoperative pain received celecoxib, etodolac, or placebo. Their impressions of study drug efficacy (overall assessment) and pain intensity were evaluated. Based on each patient’s overall assessment of pain, the efficacy rate was 63.7% in the placebo group, 76.2% in the celecoxib group, and 68.0% in the etodolac group, with these results demonstrating superiority of celecoxib to placebo and noninferiority versus etodolac. The efficacy rate was significantly higher in the celecoxib group than in the etodolac group. There were no adverse events specific to celecoxib, and the safety of celecoxib was similar to that of placebo. Celecoxib was superior to etodolac for controlling acute postoperative pain.
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Colonoscopy Instructions
Colonoscopy Checklist Five days before your colonoscopy: Stop any medications that thin the blood (see list below) Discuss the discontinuation of these medications with your primary care physician to ensure that it is safe to stop them Three days before your colonoscopy: Stop eating high fiber foods including nuts, corn, popcorn, raw fruits, vegetables, and bran Stop fiber supplements The day before your colonoscopy: Have a normal breakfast If your colonoscopy is scheduled before noon the following day, do not have any lunch If your colonoscopy is scheduled after noon, have a light lunch Have clear liquids for the rest of the day (see below) Start prep as instructed by your physician Do not have anything to eat or drink after midnight The day of your colonoscopy: Take your blood pressure medications with a sip of water Make sure you bring your driver’s license or photo ID and leave valuables and jewelry at home Clear Liquid Diet Water Any kind of soft drink (ginger ale, cola, tonic, etc) Gatorade Apple Juice Orange Juice without pulp Lemonade Tea/Coffee (without milk) Dietary supplements (Ensure, Boost, Enlive, etc) Clear broth (vegetable, chicken, or beef) Jell‐O (stay away from red, blue, or purple colors) Ice pops without milk or fruit bits Honey or sugar NO DAIRY PRODUCTS Medications to stop prior to colonoscopy Below is a list of many medications (but not all) that fall into these categories. It is important to remember that there are hundreds of over‐the‐counter medications that contain NSAIDs or aspirin, so it is important to carefully read the label of any medication that you are taking (prescription or over‐the‐counter).
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Diclofenac Sodium Enteric-Coated Tablets) Tablets of 75 Mg Rx Only Prescribing Information
® Voltaren (diclofenac sodium enteric-coated tablets) Tablets of 75 mg Rx only Prescribing Information Cardiovascular Risk • NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk. (See WARNINGS.) • Voltaren® (diclofenac sodium enteric-coated tablets) is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery (see WARNINGS). Gastrointestinal Risk • NSAIDs cause an increased risk of serious gastrointestinal adverse events including inflammation, bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events. (See WARNINGS.) DESCRIPTION Voltaren® (diclofenac sodium enteric-coated tablets) is a benzene-acetic acid derivative. Voltaren is available as delayed-release (enteric-coated) tablets of 75 mg (light pink) for oral administration. The chemical name is 2-[(2,6-dichlorophenyl)amino] benzeneacetic acid, monosodium salt. The molecular weight is 318.14. Its molecular formula is C14H10Cl2NNaO2, and it has the following structural formula The inactive ingredients in Voltaren include: hydroxypropyl methylcellulose, iron oxide, lactose, magnesium stearate, methacrylic acid copolymer, microcrystalline cellulose, polyethylene glycol, povidone, propylene glycol, sodium hydroxide, sodium starch glycolate, talc, titanium dioxide. CLINICAL PHARMACOLOGY Pharmacodynamics Voltaren® (diclofenac sodium enteric-coated tablets) is a nonsteroidal anti-inflammatory drug (NSAID) that exhibits anti-inflammatory, analgesic, and antipyretic activities in animal models. The mechanism of action of Voltaren, like that of other NSAIDs, is not completely understood but may be related to prostaglandin synthetase inhibition.
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The Pathophysiology of Pain, Our Veterinary Patients, and You… What Can Or Should Be Done?
The Pathophysiology of Pain, Our Veterinary Patients, And you… What Can or Should Be Done? Andrew Claude DVM, Dipl ACVAA Michigan State University College of Veterinary Medicine [email protected] Objectives • Definitions. • Process of Nociception. • What is pain? • AVMA/ACVAA regarding pain. • Patient – client considerations • Pain management in medicine • Clinical signs of pain in dogs/cats • Preemptive analgesia options • Pain scores in dogs and cats (if time) Definitions • Anesthesia = analgesia = analgesic? Clinician's Brief • General anesthesia: General vs. local and regional anesthesia • Analgesia: the inability to feel pain • Analgesic: any member or group of drugs used to achieve analgesia or relief from pain. • Analgesia →Nociception • Acute vs. Chronic pain, neuropathic pain Process of nociception • Transduction • Aβ, Aδ, c-Fibers, silent • Transmission • Dorsal horn, CNS • Primary Modulation • Segmental reflexes • Projection • Perception • Conscious Pain • Autonomic (SNS) • Memory • Emotions • Central/peripheral • Humans/animals What is pain? • Definition: “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” • Sensory component (nociception) • Affective component (experience) • Considered the 5th clinical sign • HR • RR • Temp • BP • Pain assessment What is pain? • Requires conscious perception of a noxious event • Do unconscious patients perceive pain? • Nociception: “the neurophysiological process whereby noxious mechanical, chemical, or thermal stimuli are transduced into electrical signals (action potentials) by high-threshold nociceptors.” These action potentials follow a series of pathways that ultimately end in the brain • The conscious result is “pain” AVMA • Pain in Animals • Animal pain is a clinically important condition that adversely affects an animal's quality of life. Drugs, techniques, or husbandry methods should be used to prevent, minimize, and relieve pain in animals experiencing or expected to experience pain.
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(Ketorolac Tromethamine Tablets) Rx Only WARNING TORADOL
TORADOL ORAL (ketorolac tromethamine tablets) Rx only WARNING TORADOLORAL (ketorolac tromethamine), a nonsteroidal anti-inflammatory drug (NSAID), is indicated for the short-term (up to 5 days in adults), management of moderately severe acute pain that requires analgesia at the opioid level and only as continuation treatment following IV or IM dosing of ketorolac tromethamine, if necessary. The total combined duration of use of TORADOLORAL and ketorolac tromethamine should not exceed 5 days. TORADOLORAL is not indicated for use in pediatric patients and it is NOT indicated for minor or chronic painful conditions. Increasing the dose of TORADOLORAL beyond a daily maximum of 40 mg in adults will not provide better efficacy but will increase the risk of developing serious adverse events. GASTROINTESTINAL RISK Ketorolac tromethamine, including TORADOL can cause peptic ulcers, gastrointestinal bleeding and/or perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Therefore, TORADOL is CONTRAINDICATED in patients with active peptic ulcer disease, in patients with recent gastrointestinal bleeding or perforation, and in patients with a history of peptic ulcer disease or gastrointestinal bleeding. Elderly patients are at greater risk for serious gastrointestinal events (see WARNINGS). CARDIOVASCULAR RISK NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk (see WARNINGS and CLINICAL STUDIES). TORADOL is CONTRAINDICATED for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery (see WARNINGS).
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Arthritis Treatment Comparison Arthritis Treatment Comparison
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Download Product Insert (PDF)
PRODUCT INFORMATION Deracoxib Item No. 27371 CAS Registry No.: 169590-41-4 O H2N Formal Name: 4-[3-(difluoromethyl)-5-(3-fluoro- S O 4-methoxyphenyl)-1H-pyrazol-1- yl]-benzenesulfonamide F Synonym: SC-59046 O MF: C17H14F3N3O3S 397.4 FW: N Purity: ≥98% N UV/Vis.: λmax: 256 nm Supplied as: A solid Storage: -20°C F Stability: ≥2 years F Information represents the product specifications. Batch specific analytical results are provided on each certificate of analysis. Laboratory Procedures Deracoxib is supplied as a solid. A stock solution may be made by dissolving the deracoxib in the solvent of choice, which should be purged with an inert gas. Deracoxib is soluble in organic solvents such as ethanol, DMSO, and dimethyl formamide (DMF). The solubility of deracoxib in ethanol is approximately 3 mg/ml and approximately 10 mg/ml in DMSO and DMF. Deracoxib is sparingly soluble in aqueous buffers. For maximum solubility in aqueous buffers, deracoxib should first be dissolved in DMF and then diluted with the aqueous buffer of choice. Deracoxib has a solubility of approximately 0.1 mg/ml in a 1:8 solution of DMF:PBS (pH 7.2) using this method. We do not recommend storing the aqueous solution for more than one day. Description Deracoxib is a non-steroidal anti-inflammatory drug (NSAID) and selective inhibitor of COX-2 1 (IC50s = 0.63 and 23 μM for COX-2 and COX-1, respectively). In vivo, deracoxib (0.3-10 mg/kg) increases weight bearing and decreases lameness and joint effusion in a canine model of urate crystal-induced intraarticular synovitis.2 Deracoxib induces less lesion formation in the gastric mucosa of healthy canines than aspirin (Item No.
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S1 Table. List of Medications Analyzed in Present Study Drug
S1 Table. List of medications analyzed in present study Drug class Drugs Propofol, ketamine, etomidate, Barbiturate (1) (thiopental) Benzodiazepines (28) (midazolam, lorazepam, clonazepam, diazepam, chlordiazepoxide, oxazepam, potassium Sedatives clorazepate, bromazepam, clobazam, alprazolam, pinazepam, (32 drugs) nordazepam, fludiazepam, ethyl loflazepate, etizolam, clotiazepam, tofisopam, flurazepam, flunitrazepam, estazolam, triazolam, lormetazepam, temazepam, brotizolam, quazepam, loprazolam, zopiclone, zolpidem) Fentanyl, alfentanil, sufentanil, remifentanil, morphine, Opioid analgesics hydromorphone, nicomorphine, oxycodone, tramadol, (10 drugs) pethidine Acetaminophen, Non-steroidal anti-inflammatory drugs (36) (celecoxib, polmacoxib, etoricoxib, nimesulide, aceclofenac, acemetacin, amfenac, cinnoxicam, dexibuprofen, diclofenac, emorfazone, Non-opioid analgesics etodolac, fenoprofen, flufenamic acid, flurbiprofen, ibuprofen, (44 drugs) ketoprofen, ketorolac, lornoxicam, loxoprofen, mefenamiate, meloxicam, nabumetone, naproxen, oxaprozin, piroxicam, pranoprofen, proglumetacin, sulindac, talniflumate, tenoxicam, tiaprofenic acid, zaltoprofen, morniflumate, pelubiprofen, indomethacin), Anticonvulsants (7) (gabapentin, pregabalin, lamotrigine, levetiracetam, carbamazepine, valproic acid, lacosamide) Vecuronium, rocuronium bromide, cisatracurium, atracurium, Neuromuscular hexafluronium, pipecuronium bromide, doxacurium chloride, blocking agents fazadinium bromide, mivacurium chloride, (12 drugs) pancuronium, gallamine, succinylcholine
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Drug and Medication Classification Schedule
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Dog Owner Information About ® Chewable Tablets (Carprofen)
Dog Owner Information about ® Chewable Tablets (carprofen) ® Caplets (carprofen, USP) Rimadyl® (pronounced “Rim-a-dill”) for Osteoarthritis and Post-Surgical Pain Generic name: carprofen (“car-pro-fen”) This summary contains important information about Rimadyl. You should read this What are the possible side effects that may occur in my dog during information before you start giving your dog Rimadyl and review it each time the Rimadyl therapy? prescription is refilled. This sheet is provided only as a summary and does not take Rimadyl, like other drugs, may cause some side effects. Serious but rare side effects the place of instructions from your veterinarian. Talk to your veterinarian if you do not have been reported in dogs taking NSAIDs, including Rimadyl. Serious side effects can understand any of this information or if you want to know more about Rimadyl. occur with or without warning and in rare situations result in death. What is Rimadyl? The most common NSAID-related side effects generally involve the stomach (such as Rimadyl is a nonsteroidal anti-inflammatory drug (NSAID) that is used to reduce pain bleeding ulcers), and liver or kidney problems. Look for the following side effects that and inflammation (soreness) due to osteoarthritis and pain following surgery in dogs. can indicate your dog may be having a problem with Rimadyl or may have another Rimadyl is a prescription drug for dogs. It is available as a caplet and chewable tablet medical problem: and is given to dogs by mouth. • Decrease or increase in appetite Osteoarthritis
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