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Discussion on Dex combined with bute
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Member:
frances
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Posted on Thursday, May 14, 2009 - 7:55 am:
Does anyone know why it is that dexamethasone is sometimes given concurrently with bute? I would have thought one type of anti-inflammatory would be enough, but maybe one potentiates the other? Just curious....
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Moderator:
DrO
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Posted on Friday, May 15, 2009 - 8:08 am:
Hello LL,
Though both are antiinflammatory they have significantly different mechanisms of action at a number of points of the antiinflammatory cascade. You have to remember that inflammation is not a single event but hundreds of different events. While glucocorticoids have a much broader effect on inflammation, NSAIDs have fever reducing properties and some pain relief properties that glucocorticoids don't have.
There is significant overlap of the two class of drugs at the point of suppressing cyclooxygenase (COX-1, COX-2, COX-3?) activity and prostaglandin production. And while you are right they potentiate each other at this point this is also a problem. This is the same system that when suppressed leads to gastro-intestinal ulcers. And this is the reason they should only be used together with great care.
DrO
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Member:
frances
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Posted on Saturday, May 16, 2009 - 8:54 am:
Many thanks, DrO, for the clear and detailed reply. Really interesting. I suppose for a 3-day period in a horse with no history of GI problems, it should normally be ok?
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Moderator:
DrO
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Posted on Sunday, May 17, 2009 - 9:20 am:
What were the dosage rates? If low to moderate I would not expect problems in all but the rare case of a horse with increased sensitivity.
DrO
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Member:
frances
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Posted on Sunday, May 17, 2009 - 12:33 pm:
The injectible bute was 10 ml daily for the 3 days. The dexamethasone was 10 ml for day 1, and 5ml for days 2 & 3.
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Moderator:
DrO
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Posted on Monday, May 18, 2009 - 6:32 am:
Assuming usual concentrations this would be moderate dosages.
DrO
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Member:
frances
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Posted on Monday, May 18, 2009 - 9:35 am:
Thank you DrO.
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