Quiz for Pharmacology, Fall 2009Ch 24 Drugs treating Mild to Moderate Pain, Fever, Inflammation, and Migraine Headache
Mary with hypertensions
Judy with migraine headaches
Constance with peptic ulcer disease
Clair with chronic constipation
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325 mg q 8 h
650 mg q 4 to 6 h
325 mg q 4 h
650 mg q 12 h
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5 - 8 g
10 - 30 g
50 - 100 g
40 - 60 g
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Headache, tinnitus, and GI distress
Resp stimulation, constipation, GI distress
GI distress, diarrhea, and resp depression
Headache, hypervigilance, and confusion
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CNS
Respiratory
GI
Cardiovascular
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30 min
24 h
2 to 4 h
12 h
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If one medication does not work, none will
A benefit of NSAIDs therapy is a longer duration of action than that provided by salicyclates
There is a cross-sensitivity among all NSAIDs
Unlike salicyclates, NSAIDs do not have antiplatelet actvitiy
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Ketoprofen
Mefenamic acid
Naproxen
Ketorolac
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Naproxen
Diclofenac sodium
Celecoxib
Mefenamic acid
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It does not have antiplatelet activity
It has increased antiplatelet activity
It has an increased risk for CNS depression
It has a decreased risk of CNS depression
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Analgestic and anti-inflammatory
Antipyretic and antiplatelet
Antiplatelet and anti-inflammatory
Analgestic and antipyretic
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Pulmonary edema
Urinary retention
Hepatoxicity
Ototoxicity
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Kelly, age 30, who is pregnant
Helen, age 16, who has history of seizure disorder
Mark, age 55, with history of hepatitis
John, age 40, who is an alcoholic
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Inhibiting prostaglandin synthesis
Vasoconstriction and inhibiting the release of proinflammatory neuropeptides
Enhancing the release of proinflammatory neuropeptides
Stimulating prostaglandin synthesis
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Hematologic
Intergumentary
Cardiovascular
Respiratory
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Cardiovascular
Integumentary
Respiratory
Immune
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"Be sure to increase the intake of your fluids"
"Do not take sumatriptan for ordinary headaches"
"You can take as many as 3 tablets in an hour for a really bad headache"
"Drink a caffeine product if your headache is not relieved in an hour"
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"Take the aspirin at least 4 times a day. If there is no relief, take another dose"
"Because of your age, you should limit your aspirin intake to only 6 per day"
"You have three predisposing factors for an increased risk to develop an ulcer with aspirin therapy. Let's start with trying to quit smoking"
"You just can't take these pills because of your lifestyle. Get used to the discomfort"
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Daily PT/INR
Urine output
Resp rate
CBC every other day
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Need to be increased
Need to be decreased
Remain unchanged
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Ototoxicity
CHF
GI bleeding
Bronchospasm
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Monitor renal output
Monitor for CHF
Monitor for lost of hypertension control
Monitor for constipation
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"Taking these drugs together is not a problem"
"We will monitor your lithium level closely and make any adjustments necessary"
"Call us if you have any adverse reactions. You should be OK"
"I'm not sure why your provider prescribed this. It's pretty dangerous"
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"It may take up to 2 weeks to feel the benefit of this medication"
"I guess you should make an appt and get something else"
"Your burstis is obviously resistant to NSAIDs"
"It might work better if you double the dose for a few days"
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Increase the amt of fluids taken with the celecoxib
Take an additional 81 mg of aspirin a day
Monitor her BP closely
At green leafy vegetables to her diet
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Take only the recommended dose
Read the labels of all OTC meds to avoid overdose
Seek medical care immediately in case of overdose
All of the above
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CBC
Liver function tests
Kidney function tests
All of the above
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Depression
Benign prostatic hypertrophy
Diabetes mellitus
Hypothyroidism
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"Have you tried doubling the dose?"
"Are you taking the drug at the first sign of the headache?"
"Are you still smoking?"
"Do you take it with a glass of water?"
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Take aspirin on an empty stomach
Store aspirin in a bathroom medicine chest
Return for lab tests every 6 mo
Crush the ER tablets for easier swallowing
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Unusual brusing
Slow heartbeat
Upset stomach
Slight dizziness
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Draw blood for a platelet count
Administer acetylcysteine
Administer acetylsalicylic acid
Send the patient for an abdominal CT scan
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Either aspirin or ibuprofen can be substituted if the patient prefers
Aspirin and ibuprofen don't relieve arthritis pain
Celeoxib does not cause GI upset as frequently as aspirin or ibuprofen
Celeoxib is prescription strength aspirin
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Take the med at the first sign of a migraine headache
Take the med with a full glass of water
The med can be crushed if the patient has difficulty swallowing
The med may cause dizziness, weakness, or light headedness
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