Table 3: Drugs Used for Pain Management in Small Animals Drug Indication/s
Common Examples
Mode of Action Side Effects
Important Notes
• Contraindications : kidney, liver, blood clotting, or stomach problems • Use cautiously in cats because of felines’ required to metabolize NSAIDs • Precaution : should never be used with corticosteroids or aspirin • Precaution : should not be used at the same time as NSAIDs limited ability for the hepatic glucuronidation
Nonsteroidal Anti- Inflammatory Drugs (NSAIDs)
• Carprofen • Firocoxib • Meloxicam • Robenacoxib • Ketoprofen
• Gastric
Act by inhibiting cyclooxygenase enzymes; these enzymes synthesize prostaglandins, which in turn precipitate the inflammatory process
• Analgesic, anti- inflammatory and anti-pyretic properties • Distinct antihyperalgesic properties
ulceration and renal papillary necrosis • Nephrotoxicity
Corticosteroids Reduce
• Prednisone • Cortisol
• Can
• Suppress the production of inflammatory mediators like prostaglandins, leukotrienes, and cytokines which are produced by the body pain pathways in the central nervous system by reducing the excitability of pain-transmitting neurons • Work to reduce pain through their interaction with alpha-2 adrenergic receptors in the nervous system • Some alpha-2 agonists may also have a local anesthetic effect by blocking potassium and calcium channels in pain- transmitting neurons in response to injury or pain • May influence
temporarily weaken the immune system appetite and thirst, and increased need to urinate
inflammation and provide pain relief
• Increased
Alpha-2 Agonists
• Xylazine • Medetomidine • Detomidine • Romifidine
• Often paired with opioids because pain relief and sedation are greater than the effects of either drug alone • Xylazine has been identified as a contributor to perioperative mortality in cats and is no longer recommended as a pre-medication for cats
• Can cause
Offer both pre- emptive and postoperative analgesic benefits Preoperative • Reduce anxiety and stress • Enhance the analgesic effects
deep sedation, which restricts their use in pain management protocols intravenously or in debilitated
• When used
of opioids, allowing for lower opioid doses and potentially reducing their side effects
patients, judicious dosing is crucial • Dose related
cardiovascular depression can be marked
Postoperative • Provide short-term to
• Have
sympatholytic effects which can indirectly contribute to pain relief by reducing factors like muscle tension and anxiety that can worsen pain perception
moderate pain relief following surgery
• Often used as part of a
multimodal pain management approach
• Neuropathic pain • Chronic pain
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