Anti-inflamatórios inibidores da COX-2 em equinos no Nordeste Brasileiro: abordagem prescricional e efeitos adversos do uso prolongado de meloxicam.

Abstract

COX-2 inhibitor anti-inflammatory drugs in horses in Northeast Brazil: prescription approach and adverse effects of long-term meloxicam use. Non­steroidal anti­inflammatory drugs (NSAIDs) are widely used in human and veterinary medicine for their anti­inflammatory, analgesic and antipyretic effects. The main adverse effects of the use of anti­inflammatory drugs are related to kidney and gastric disorders. COX­2 inhibitors have a good action profile and greater safety, without the toxicity of traditional NSAIDs, which led to the search for new drugs, however, it is suspected that their prolonged use can also lead to the same adverse effects of non­selective inhibitors. This thesis was divided into three chapters. The first is a literature review that addresses the central theme of the thesis and aimed to raise information about the adverse effects of prolonged use of COX­2 inhibitory NSAIDs in equine species. For this, a bibliographic review of articles was performed (time cut, 2000 to 2020). In the second article, the prescription of NSAIDs in northeastern Brazil was evaluated. A survey was conducted with veterinarians and salespeople/counters of agricultural stores in the Northeast region of Brazil, all working in the equine area. One hundred questionnaires (50 per group) were applied in order to identify the main NSAIDs recommended by them for affections of the locomotor and digestive system of the equine species. For disorders of the locomotor system: as a first option, phenylbutazone was described as the main NSAID in both groups (G1: 58% and G2: 28%). As a second option, flunixin meglumine was the most recommended (G1: 32% and G2: 24%). As a third option, meloxicam was also the most recommended by both (G1:26% and G2: 16%). For digestive system disorders: as a first option, flunixin meglumine was the most recommended drug (G1: 54% and G2: 40%). As a second option, for G1, flunixin meglumine (36%) and for G2, dipyrone (30%). As a third option, for G1, meloxicam and DMSO were the most mentioned (18% each) and for G2, phenylbutazone (18%). Non­selective NSAIDs are the most recommended by veterinarians and sellers of agricultural stores in Northeast Brazil for the treatment of locomotor and digestive disorders in horses, while selective inhibitors for COX­2 are still little recommended, with meloxicam being the most mentioned by interviewees, which guided us to the development of the third chapter of the thesis. For the third chapter, a study was carried out to assess the adverse effects of prolonged use of meloxicam in healthy horses. A paired test was carried out using 7 horses, which received a dose of 0.6 mg/kg of meloxicam paste, orally, once a day, for 28 days, and evaluated the clinical, hematological, biochemical, time test parameters. bleeding, gastroscopy (assessed at five times: M0, M7, M14, M21 and M28) and electrocardiogram (at three times: M0, M14 and M28). No relevant adverse effects were observed in animals under the circumstances of the study. Although COX­2 inhibitory NSAIDs are proposed as safe, they have relevant adverse effects, especially if used in overdoses and for a long time. The traditional NSAIDs phenylbutazone, flunixin meglumine and dipyrone are the most prescribed anti­inflammatory drugs by veterinarians and agricultural store vendors in northeastern Brazil, while meloxicam is the most recommended COX­2 inhibitor. Control measures in the sale of NSAIDs, as well as guidance to horse professionals are necessary. The use of meloxicam for 28 days did not cause adverse effects of clinical importance on the evaluated parameters.