Pharm - Exam 3 - Nsaids

68 Questions | By Krys2001 | Last updated: Mar 22, 2022 | Total Attempts: 3314

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This just covers the points that were emphasized in the lecture (according to my notes) - take it or leave it - but I hope it helps! :)

Questions and Answers

1.

Match the description with the stage of inflammation: Acute transient phase, delayed subacute phase, and chronic proliferative phase.A. Infiltration of leukocytes and phagocytic cells to the site of inflammation; immunologicalB. tissue degradation and fibrocis; immunologicalC. local vasodilation of small vessels and increased capillary permeability; mediated by autacoids; characterized by redness (erythema), swelling (edema), and tenderness (hyperalgesia)
- A.
  
  Acute = A, Delayed = B, Chronic = C
- B.
  
  Acute = C, Delayed = A, Chronic = B
- C.
  
  Acute = B, Delayed = C, Chronic = A
2.

Which mediators of inflammation are acted on by NSAIDs?
- A.
  
  Eicosanoids (arachidonic acid metabolites) such as prostaglandins, thromboxanes, and leukotrienes.
- B.
  
  Degradative enzymes such as proteases, hyaluronidases
- C.
  
  Vasoactive amines such as histamine and serotonin
- D.
  
  Biologically derived oxidants such as hydrogen peroxide and superoxide anion
- E.
  
  Plasma proteins and peptides such products of the complement and kinin
3.

What are some mediators of pain?
- A.
  
  Histamine, 5-HT, bradykinin, LTC4, LTD4, PGE2, C3a, and C5a
- B.
  
  IL-1, IL-6, PGE2, IL-1beta, TNFalpha
- C.
  
  Histamine, 5-HT, PGE2, bradykinins
- D.
  
  Histamine, 5-HT, bradykinin, PGE2, and leukotrienes
4.

What are some mediators for increased permeability (swelling)?
- A.
  
  Histamine, 5-HT, bradykinin, LTC4, LTD4, PGE2, C3a, and C5a
- B.
  
  IL-1, IL-6, PGE2, IL-1beta, TNFalpha
- C.
  
  Histamine, 5-HT, PGE2, bradykinins
- D.
  
  Histamine, 5-HT, bradykinin, PGE2, and leukotrienes
5.

What are some mediators for pyrogens (immunologically)?
- A.
  
  Histamine, 5-HT, bradykinin, LTC4, LTD4, PGE2, C3a, and C5a
- B.
  
  IL-1, IL-6, PGE2, IL-1beta, TNFalpha
- C.
  
  Histamine, 5-HT, PGE2, bradykinins
- D.
  
  Histamine, 5-HT, bradykinin, PGE2, and leukotrienes
6.

What are some mediators for smooth muscle contraction?
- A.
  
  Histamine, 5-HT, bradykinin, LTC4, LTD4, PGE2, C3a, and C5a
- B.
  
  IL-1, IL-6, PGE2, IL-1beta, TNFalpha
- C.
  
  Histamine, 5-HT, PGE2, bradykinins
- D.
  
  Histamine, 5-HT, bradykinin, PGE2, and leukotrienes
7.

What mediator causes elevation of hypothalmic set-point for temperature control?
- A.
  
  Bradykinin
- B.
  
  5-HT
- C.
  
  PGE2
- D.
  
  Histamine
8.

What mediator sensitizes the nerves to pain mediators?
- A.
  
  Bradykinin
- B.
  
  PGE2
- C.
  
  Histamine
- D.
  
  Serotonin
9.

All of the following chemical mediators released at the sit of inflammation cause pain EXCEPT:
- A.
  
  Histamine
- B.
  
  PGE2
- C.
  
  Bradykinin
- D.
  
  Glucocorticoids
10.

Acute transient phase of inflammation is accompanied by tissue degradation and fibrosis.
- A.
  
  True
- B.
  
  False
11.

Which goal of treatment of inflammation is NOT met by NSAIDs?
- A.
  
  Arrest tissue damaging processes that accompany chronic inflammation.
- B.
  
  Relief of symptoms and maintenance of function.
- C.
  
  Both are met by NSAIDs.
12.

What is an example of a pharmacological anti-inflammatory agent?
- A.
  
  Antihistamines
- B.
  
  Immunosuppressants
- C.
  
  Antibiotics
- D.
  
  Analgesics
- E.
  
  All of the above
- F.
  
  A, B, C
13.

NSAIDs can be divided into:
- A.
  
  Non-selective COX inhibitors
- B.
  
  COX-2 selective inhibitors
- C.
  
  CINODs; Nitroaspirins
- D.
  
  All of the above.
14.

Put these drugs in the order they would be given based on the amount of pain felt by the patients - from lowest amount of pain to highest.
- A.
  
  NSAID, morphine, codeine
- B.
  
  Codeine, NSAID, morphine
- C.
  
  NSAID, codeine, morphine
15.

Which COX enzyme are aspirin, indomethacin, and sulindac more selective for?
- A.
  
  COX-1
- B.
  
  COX-2
- C.
  
  They are equally selective for COX-1 and COX-2
16.

Which COX enzyme are piroxicam, ibuprofen, flurbiprofen and mefenamic acid more selective for?
- A.
  
  COX-1
- B.
  
  COX-2
- C.
  
  They are equally selective for COX-1 and COX-2
17.

Which COX enzyme is naproxen and diclofenac more selective for?
- A.
  
  COX-1
- B.
  
  COX-2
- C.
  
  They are equally selective for COX-1 and COX-2.
18.

What is special about CINODs?
- A.
  
  They are COX-2 inhibitors.
- B.
  
  They are COX-1 inhibitors.
- C.
  
  They can release NO.
- D.
  
  They are extremely potent NSAIDs.
19.

What are the anti-inflammatory actions of NSAIDs?
- A.
  
  Decrease in vasodilator prostaglandins (PGE2, PGI2) means less vasodilation and, indirectly, less edema.
- B.
  
  Inhibit the migration of polymorphonuclear leukocytes and macrophages into the site of inflammation.
- C.
  
  Stabilize lysosomal membranes, thereby preventing release of inflammatory mediators.
- D.
  
  All of the above.
20.

What are the analgesic actions of NSAIDs?
- A.
  
  Decreased PG generation means less sensitization of nociceptive nerve endings to inflammatory mediators
- B.
  
  Decreased PG-mediated vasodilation (in headache relief)
- C.
  
  All of the above.
21.

How do NSAIDs cause an anticoagulation effect?
- A.
  
  By binding already formed platelets and preventing aggregation.
- B.
  
  By vasodilating the vessels.
- C.
  
  By inhibiting platelet thromboxane A2 production.
22.

What can be done to prevent the GI side effects of NSAIDs?
- A.
  
  Co-administration of NSAID with PPI.
- B.
  
  Enteric coated tablets.
- C.
  
  Prescribe CINODs instead.
- D.
  
  All of the above.
23.

Why don't you want to give NSAIDs to pregnant women, especially in the third trimester?
- A.
  
  It causes spina bifida in the fetus.
- B.
  
  It causes excess bleeding during delivery.
- C.
  
  It causes prolongation of gestation or delayed spontaneous labor.
24.

The changes in renal failure of congestive heart failure patients, hepatic cirrhosis patients, chornic renal disease patients and hypovolemic patients given NSAIDs include:
- A.
  
  A decrease in renal blood flow and glomerular filtration rate due to unopposed vascoconstriction.
- B.
  
  Promote retention of salt and water by inhibiting PG-induced inhibition of the reabsorption of Cl- and the action of ADH. (may cause drug-induced edema)
- C.
  
  Promote hypokalemia via: increased reabsorption of K+ and suppression of PG-induced secretion of renin.
- D.
  
  All of the above.
25.

Which drugs require a "black box warning"?
- A.
  
  All NSAIDs
- B.
  
  Aspirins
- C.
  
  Coxibs
- D.
  
  NANSAIDs
- E.
  
  B and C
- F.
  
  C and D