Comprehensive Nsaids Quiz MCQs: Get The Answers You Need

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Comprehensive Nsaids Quiz MCQs: Get The Answers You Need - Quiz

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of medications widely used to alleviate pain, reduce inflammation, and manage various conditions, such as arthritis, muscle aches, and headaches. Unlike steroids, NSAIDs work by inhibiting the production of prostaglandins, substances in the body that promote pain and inflammation.
NSAIDs come in both over-the-counter (OTC) and prescription forms and are available in various formulations, including tablets, capsules, creams, and gels. Common OTC NSAIDs include ibuprofen and naproxen, while prescription NSAIDs like diclofenac and celecoxib may offer stronger pain relief.
While NSAIDs can be highly effective in relieving discomfort, they Read moreare not without risks. Prolonged or excessive use can lead to gastrointestinal problems, such as ulcers and bleeding, and may also impact kidney function. Additionally, some individuals may be allergic or intolerant to NSAIDs.
Patients should always consult a healthcare professional before using NSAIDs, especially if they have underlying medical conditions or are taking other medications. Proper usage and adherence to recommended dosages are crucial to maximize the benefits of NSAIDs while minimizing potential side effects.


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

    Correct Answer
    B. Acute = C, Delayed = A, Chronic = B
    Explanation
    The description of acute inflammation includes local vasodilation of small vessels and increased capillary permeability, which is characterized by redness, swelling, and tenderness. This matches with option C. The description of delayed subacute inflammation includes tissue degradation and fibrosis, which matches with option A. The description of chronic proliferative inflammation is not given, but based on the remaining option, it can be inferred that chronic inflammation matches with option B. Therefore, the correct answer is Acute = C, Delayed = A, Chronic = B.

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  • 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

    Correct Answer
    A. Eicosanoids (arachidonic acid metabolites) such as prostaglandins, thromboxanes, and leukotrienes.
    Explanation
    These five are the five groups that inflammatory mediators can be classified into.

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  • 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

    Correct Answer
    C. Histamine, 5-HT, PGE2, bradykinins
    Explanation
    The mediators of pain listed in the answer are histamine, 5-HT (serotonin), PGE2 (prostaglandin E2), and bradykinins. These substances are known to play a role in the transmission and modulation of pain signals in the body. Histamine and 5-HT are neurotransmitters that can sensitize pain receptors, while PGE2 and bradykinins can cause inflammation and increase pain sensitivity.

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  • 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

    Correct Answer
    D. Histamine, 5-HT, bradykinin, PGE2, and leukotrienes
    Explanation
    Histamine, 5-HT, bradykinin, PGE2, and leukotrienes are all mediators that can cause increased permeability or swelling. These substances are released during inflammation and can cause blood vessels to dilate and become more permeable, allowing fluid and immune cells to enter the affected area. This increased permeability is an important part of the immune response and helps to deliver immune cells to the site of injury or infection.

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  • 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

    Correct Answer
    B. IL-1, IL-6, PGE2, IL-1beta, TNFalpha
    Explanation
    The correct answer includes mediators such as IL-1, IL-6, PGE2, IL-1beta, and TNFalpha. These mediators are known for their role in promoting inflammation and fever. IL-1 and TNFalpha are pro-inflammatory cytokines that play a crucial role in initiating the inflammatory response and inducing fever. IL-6 is another pro-inflammatory cytokine that is involved in the immune response. PGE2 is a prostaglandin that is released during inflammation and can contribute to fever. IL-1beta is a pro-inflammatory cytokine that is produced in response to infection or injury and can also induce fever. Overall, these mediators play a significant role in the immunological response to pyrogens.

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  • 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

    Correct Answer
    A. Histamine, 5-HT, bradykinin, LTC4, LTD4, PGE2, C3a, and C5a
    Explanation
    During inflammation, these residents and recruited cells also become a source of a number of mediators that alter smooth muscle function, including IL1-β, nitric oxide (NO), IL-6, and TNF-α

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  • 7. 

    What mediator causes elevation of hypothalmic set-point for temperature control?

    • A.

      Bradykinin

    • B.

      5-HT

    • C.

      PGE2

    • D.

      Histamine

    Correct Answer
    C. PGE2
    Explanation
    Stimulus (infection, inflammation, malignancy) causes release of cytokines and pyrogens - PGE2 - increase of cyclic AMP - increase of hypothalamic set point = fever. Treat fever by getting rid of PGE2 - NSAIDs.

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  • 8. 

    What mediator sensitizes the nerves to pain mediators?

    • A.

      Bradykinin

    • B.

      PGE2

    • C.

      Histamine

    • D.

      Serotonin

    Correct Answer
    B. PGE2
    Explanation
    Stimuli such as injury and inflammation triggers the release of cytokines and pain mediators. Cytokines stimulate the synthesis of PGs which not only cause pain but also sensitize the nerves to pain mediators such as bradykinin, histamine, and serotonin.

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  • 9. 

    All of the following chemical mediators released at the site of inflammation cause pain EXCEPT:

    • A.

      Histamine

    • B.

      PGE2

    • C.

      Bradykinin

    • D.

      Glucocorticoids

    Correct Answer
    D. Glucocorticoids
    Explanation
    Glucocorticoids do not cause pain. They reduce it by decreasing inflammation.

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  • 10. 

    Acute transient phase of inflammation is accompanied by tissue degradation and fibrosis.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Fibrosis is a late phase/chronic development of inflammation.

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  • 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.

    Correct Answer
    A. Arrest tissue damaging processes that accompany chronic inflammation.
    Explanation
    NSAIDs (nonsteroidal anti-inflammatory drugs) are commonly used to treat inflammation. They work by reducing pain, swelling, and inflammation in the body. One of the goals of treating inflammation is to arrest tissue damaging processes that accompany chronic inflammation. However, the correct answer states that this goal is NOT met by NSAIDs. This means that while NSAIDs can provide relief of symptoms and help maintain function, they may not be able to completely stop the tissue damaging processes associated with chronic inflammation.

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  • 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

    Correct Answer
    F. A, B
    Explanation
    Pharmacological anti-inflammatory agents antagonize the pharmacological manifestation of inflammation e.g., antihistamines, and immunosuppressants.

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  • 13. 

    NSAIDs can be divided into:

    • A.

      Non-selective COX inhibitors

    • B.

      COX-2 selective inhibitors

    • C.

      CINODs; Nitroaspirins

    • D.

      All of the above.

    Correct Answer
    D. All of the above.
    Explanation
    The correct answer is "All of the above" because NSAIDs can indeed be divided into non-selective COX inhibitors, COX-2 selective inhibitors, and CINODs (cyclooxygenase-inhibiting nitric oxide-donating drugs) such as Nitroaspirins. This categorization helps to differentiate the different types of NSAIDs based on their mechanism of action and selectivity for specific COX enzymes.

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  • 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

    Correct Answer
    C. NSAID, codeine, morphine
    Explanation
    NSAIDs and aspirin are examples of first line drugs for low grade pain (headaches, for example). Codeine is an example of a drug given for moderate pain. Morphine, oxycodone, and fentanyl are examples of drugs given for severe pain.

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  • 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

    Correct Answer
    A. COX-1
    Explanation
    While these drugs are still considered non-selective, they seem to be relatively selective for COX-1.

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  • 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

    Correct Answer
    B. COX-2
    Explanation
    While these drugs are still considered non-selective, they seem to be relatively selective for COX-2.

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  • 17. 

    Which COX enzyme is naproxen more selective for?

    • A.

      COX-1

    • B.

      COX-2

    • C.

      They are equally selective for COX-1 and COX-2.

    Correct Answer
    C. They are equally selective for COX-1 and COX-2.
    Explanation
    Naproxen is a nonsteroidal anti-inflammatory drug (NSAIDs) that inhibits the activity of both COX-1 and COX-2 enzymes. This means that they are equally selective for both COX-1 and COX-2. COX-1 is involved in protecting the stomach lining and promoting platelet aggregation, while COX-2 is associated with inflammation and pain. By inhibiting both enzymes, naproxen and diclofenac effectively reduce inflammation and pain, but they may also cause side effects such as gastrointestinal irritation and increased bleeding risk.

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  • 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.

    Correct Answer
    C. They can release NO.
    Explanation
    CINODs are indevelopment - NO releasing NSAID - gets rid of some of the adverse effects of getting rid of prostaglandins.

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  • 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.

    Correct Answer
    D. All of the above.
    Explanation
    NSAIDs have anti-inflammatory actions by decreasing the levels of vasodilator prostaglandins, which results in less vasodilation and edema. They also inhibit the migration of certain immune cells, such as polymorphonuclear leukocytes and macrophages, to the site of inflammation. Additionally, NSAIDs stabilize lysosomal membranes, preventing the release of inflammatory mediators. Therefore, all of the given options describe the anti-inflammatory actions of NSAIDs.

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  • 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.

    Correct Answer
    C. All of the above.
    Explanation
    The analgesic actions of NSAIDs include decreased PG generation, which reduces the sensitization of nociceptive nerve endings to inflammatory mediators. Additionally, NSAIDs also decrease PG-mediated vasodilation, which can provide relief from headaches. Therefore, the correct answer is that all of the above actions contribute to the analgesic effects of NSAIDs.

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  • 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.

    Correct Answer
    C. By inhibiting platelet thromboxane A2 production.
    Explanation
    NSAIDs (Nonsteroidal anti-inflammatory drugs) cause an anticoagulation effect by inhibiting platelet thromboxane A2 production. Thromboxane A2 is a substance that promotes platelet aggregation and vasoconstriction. By inhibiting its production, NSAIDs prevent platelet aggregation and reduce the risk of blood clot formation. This anticoagulation effect can be beneficial in conditions such as cardiovascular diseases or after surgical procedures to prevent excessive blood clotting.

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  • 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.

    Correct Answer
    D. All of the above.
    Explanation
    CINODs - NO provides cytoprotection to gastric mucosa.

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  • 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.

    Correct Answer
    C. It causes prolongation of gestation or delayed spontaneous labor.
    Explanation
    Due to inhibition of contractile PGs in the uterus wall, thereby delaying the onset of labor and prolonging the gestation period. (Morning after pill)

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  • 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.

    Correct Answer
    D. All of the above.
    Explanation
    Exception: CINODs - NO antagonizes intrarenal effects of vasoconstrictors in absence of PGs, therefore CINODs are protective to the intra-renal system.

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  • 25. 

    Which drugs require a "black box warning"?

    • A.

      All NSAIDs

    • B.

      Aspirins

    • C.

      Coxibs

    • D.

      B and C

    Correct Answer
    C. Coxibs
    Explanation
    Coxibs increase risk of cardiovascular events due to: suppression of vascular PGI2 (an inhibitor of platelet aggregation) and lack of inhibitory effect on thromboxane A2. CINODs and aspirin-like NSAIDs do not require this warning.

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  • 26. 

    Antipyretic effect of NSAIDs is due to the inhibitory effect of NSAIDs on biosynthesis of thromboxane A2.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The antipyretic effect of NSAIDs is not due to their inhibitory effect on the biosynthesis of thromboxane A2. Instead, NSAIDs reduce fever by inhibiting the synthesis of prostaglandins, which are involved in the regulation of body temperature. While NSAIDs do inhibit the production of thromboxane A2, this is not the mechanism responsible for their antipyretic effect.

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  • 27. 

    NSAIDs decrease renal blood flow and glomerular filtration rate in patients with normal kidney function.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    NSAIDs actually decrease renal blood flow and glomerular filtration rate in patients with impaired kidney function, not in those with normal kidney function. In patients with normal kidney function, NSAIDs do not have a significant impact on renal blood flow and glomerular filtration rate. Therefore, the statement is false.

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  • 28. 

    NSAIDs are capable of delaying progression of bone and cartilage deformation that is characteristic of chronic inflammatory conditions such as arthritis.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    NSAIDs, or nonsteroidal anti-inflammatory drugs, are commonly used to relieve pain and reduce inflammation in conditions like arthritis. However, they do not have the ability to delay the progression of bone and cartilage deformation that occurs in chronic inflammatory conditions. While NSAIDs can provide symptomatic relief, they do not target the underlying disease process. Therefore, the statement that NSAIDs are capable of delaying progression of bone and cartilage deformation is false.

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  • 29. 

    Mr. X has been suffering from congestive heart failure. A few weeks ago, he started experiencing pain in his finger joints. His wife who has a long history of arthritis gave him several doses of the NSAID tablets she has been taking. Mr. X is likely to experience:

    • A.

      Frequent urination

    • B.

      Increased retention of fluids

    • C.

      Hypokalemia

    Correct Answer
    B. Increased retention of fluids
    Explanation
    Mr. X is likely to experience increased retention of fluids. Congestive heart failure is a condition where the heart is unable to pump blood effectively, leading to fluid buildup in the body. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) are known to cause fluid retention as a side effect. Therefore, when Mr. X took the NSAID tablets, it is probable that his fluid retention increased, exacerbating his congestive heart failure symptoms.

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  • 30. 

    Which NSAID binds irreversibly to COX?

    • A.

      Ibuprofen

    • B.

      Aspirin

    • C.

      Celebrex

    Correct Answer
    B. Aspirin
    Explanation
    Aspirin is the correct answer because it binds irreversibly to COX (cyclooxygenase), an enzyme involved in the production of prostaglandins, which are responsible for inflammation, pain, and fever. Unlike other NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen and celebrex, aspirin irreversibly acetylates COX, inhibiting its activity permanently. This irreversible binding makes aspirin unique among NSAIDs and gives it its long-lasting effects.

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  • 31. 

    A single dose of aspirin can prolong the bleeding time of normal persons for how long?

    • A.

      5-8 hours

    • B.

      3-4 weeks

    • C.

      4-7 days

    Correct Answer
    C. 4-7 days
    Explanation
    Acetylation (irreversible) of the active site of COX in platelets leads to a reduction in the biosynthesis of thromboxane A2 - I  takes days to replace the platelets.

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  • 32. 

    Salicylates have the following effects on respiration:

    • A.

      Direct

    • B.

      Indirect

    • C.

      Both direct and indirect

    Correct Answer
    C. Both direct and indirect
    Explanation
    direct - stimulation of the respiratory center in the medulla in medium to large doses = hyperventilation
    indirect - salicylate-induced uncoupling of oxidative phosphorylation - O2 coming in, but instead of ATP, have heat coming out - profus sweating and hyperventilation

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  • 33. 

    Aspirin can be used in the treatment of gout.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The salicylates have uricosuric effects - low doses (1-2 g per day) decrease urate excretion (uric acid is retained - large doses (>5g per day) uricosuria and low plasma urate levels - excreted from kidneys.

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  • 34. 

    Salicylates are contraindicated in pregnancy.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    They readily cross the placental barrier.

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  • 35. 

    Rate of urinary excretion of salicylates is higher in:

    • A.

      Alkaline urine

    • B.

      Acidic urine

    Correct Answer
    A. Alkaline urine
    Explanation
    base binds the acid for excretion

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  • 36. 

    At low and high toxic salicylate levels, repiratory alkalosis may occur as a result of increased ventilation and the body is able to compensate.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    At low toxic salicylate levels, respiratory alkalosis may occur as a result of increased ventilation. Compensation is achieved by: increased renal excretion of bicarb - plasma bicarb is lowered and blood pH returns to normal.
    At high toxic salicylate lvels, there is uncompensated respiratory acidosis plus metabolic acidosis, with the latter seen particularly in children - characterized by: decrease in blood pH and low plasma bicarb levels.

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  • 37. 

    Drug Interactions: Salicylates can displace all of the following drugs EXCEPT:

    • A.

      Tolbutamide

    • B.

      Methotrexate

    • C.

      Penicillins

    • D.

      Phenytoin

    • E.

      Warfarin

    • F.

      Ibuprofen

    Correct Answer
    F. Ibuprofen
    Explanation
    Displacement leads to the potentiation of the effects caused by these drugs.

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  • 38. 

    What is the first sign/symptom of salicylate intoxication?

    • A.

      Headache

    • B.

      Dizziness

    • C.

      Ringing in the ears

    • D.

      Hyperventilation

    Correct Answer
    C. Ringing in the ears
    Explanation
    The first sign/symptom of salicylate intoxication is ringing in the ears. This can be a common symptom of salicylate toxicity, also known as aspirin poisoning. Salicylates can affect the auditory system and cause a sensation of ringing or buzzing in the ears, known as tinnitus. It is important to recognize this symptom as it can indicate the presence of salicylate intoxication and prompt appropriate medical intervention.

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  • 39. 

    What is the antidote for aspirin overdose?

    • A.

      Snake venom

    • B.

      Protamine

    • C.

      Diclofenac

    • D.

      There is no antidote

    Correct Answer
    D. There is no antidote
    Explanation
    No antidote for aspirin overdose - alkalyze the urine and perform gastric lavage. Activated charcoal can also be given - universal antidote - binds almost anything.

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  • 40. 

    The acetic acid derivatives (indomethacin, sulindac, and etodolac) are more or less potent than aspirin?

    • A.

      More.

    • B.

      Less.

    Correct Answer
    A. More.
    Explanation
    The acetic acid derivatives, including indomethacin, sulindac, and etodolac, are more potent than aspirin. These drugs belong to the class of nonsteroidal anti-inflammatory drugs (NSAIDs) and are known for their strong anti-inflammatory and analgesic effects. Compared to aspirin, they have a higher potency in inhibiting the production of prostaglandins, which are responsible for pain and inflammation. Therefore, these acetic acid derivatives are considered to be more effective in relieving pain and reducing inflammation than aspirin.

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  • 41. 

    Indomethacin can cause CNS disturbances such as depression, psychosis and hallucinations and is therefore contraindicated in psychiatric disorders.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Indomethacin, a medication commonly used for pain and inflammation, has been known to cause central nervous system (CNS) disturbances. These disturbances can manifest as depression, psychosis, and hallucinations. Due to this potential side effect, indomethacin is contraindicated in individuals with psychiatric disorders. Therefore, the given statement is true.

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  • 42. 

    Which acetic acid derivative is used to accelerate the closure of patent ductus arteriosus (hole in the heart)?

    • A.

      Etodolac

    • B.

      Indomethacin

    • C.

      Sulindac

    Correct Answer
    B. Indomethacin
    Explanation
    Indomethacin is not routinely used as an analgesic-antipyretic agent because of its side-effects. However, it is useful in special conditions: acute gouty arthritis, ankylosing spondylitis, Bartters's syndrome, osteoarthritis, and used to accelerate the closure of patent ductus arteriosus.

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  • 43. 

    Propionic acid derivatives (ibuprofen, naproxen, ketoprofen, fenoprofen, oxaprozin, and flurbiprofen) are better tolerated by patients than phenylbutazone or indomethacin.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Propionic acid derivatives such as ibuprofen, naproxen, ketoprofen, fenoprofen, oxaprozin, and flurbiprofen are indeed better tolerated by patients compared to phenylbutazone, or indomethacin. This means that patients experience fewer side effects or adverse reactions when taking propionic acid derivatives.

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  • 44. 

    Which propionic acid derivative accumulates in synovial fluids and is therefore useful in the treatment of arthritis?

    • A.

      Ketoprofen

    • B.

      Naproxen

    • C.

      Flurbiprofen

    • D.

      Ibuprofen

    Correct Answer
    C. Flurbiprofen
    Explanation
    Flurbiprofen is a propionic acid derivative that accumulates in synovial fluids, making it useful in the treatment of arthritis. It is a nonsteroidal anti-inflammatory drug (NSAID) that helps to reduce inflammation and relieve pain in the joints. By accumulating in the synovial fluid, flurbiprofen can directly target the affected areas, providing localized relief for arthritis symptoms.

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  • 45. 

    Absorption of propionic acid derivatives is retarded by what?

    • A.

      Concurrent aspirin usage.

    • B.

      Intake of large amounts of water.

    • C.

      Food in the stomach.

    • D.

      An empty stomach.

    Correct Answer
    C. Food in the stomach.
    Explanation
    The absorption of propionic acid derivatives is slowed down by the presence of food in the stomach. When food is present, it delays the emptying of the stomach and slows down the passage of the propionic acid derivatives into the small intestine, where absorption takes place. This can affect the effectiveness and onset of action of the propionic acid derivatives.

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  • 46. 

    The oxicams (piroxicam, tenoxicam, and meloxicam) are similar to the salicylates EXCEPT they:

    • A.

      Do not possess anti-inflammatory actions.

    • B.

      Do not possess analgesic actions.

    • C.

      Do not possess antipyretic actions.

    • D.

      Have less GI side effects.

    Correct Answer
    D. Have less GI side effects.
    Explanation
    The correct answer is "have less GI side effects." This means that the oxicams (piroxicam, tenoxicam, and meloxicam) are similar to the salicylates in terms of anti-inflammatory actions, analgesic actions, and antipyretic actions. However, they differ in that they have less gastrointestinal (GI) side effects. This suggests that the oxicams may be a preferred choice over salicylates for individuals who are prone to GI issues or have a higher risk of developing GI side effects.

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  • 47. 

    In addition to inhibition of COX, fenamates (mefenamic acid and meclofenamate) can also:

    • A.

      Block prostaglandin receptors

    • B.

      Block histamine receptors

    • C.

      Block serotonin receptors

    Correct Answer
    A. Block prostaglandin receptors
    Explanation
    Fenamates, such as mefenamic acid and meclofenamate, are known to inhibit the enzyme COX. In addition to this, they can also block prostaglandin receptors. Prostaglandins are lipid compounds that play a role in inflammation and pain. By blocking their receptors, fenamates can further reduce inflammation and alleviate pain. This additional mechanism of action makes fenamates effective in managing conditions associated with inflammation and pain.

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  • 48. 

    Fenamates are used as first-line therapy.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Although used in rheumatoid arthritis and osteoarthritis, they are not recommended as initial therapy.

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  • 49. 

    Which NSAID is a prodrug?

    • A.

      Ibuprofen

    • B.

      Aspirin

    • C.

      Acetaminophen

    • D.

      Nabumetone

    • E.

      Meclofenamate

    Correct Answer
    D. Nabumetone
    Explanation
    Active orally; converted in the liver to an active metabolite - it is a PRODRUG.

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  • 50. 

    Which drug listed below is the only non-acid NSAID?

    • A.

      Celecoxib

    • B.

      Ketoprofen

    • C.

      Nabumetone

    • D.

      Indomethacin

    Correct Answer
    C. Nabumetone
    Explanation
    Nabumetone is the only non-acid NSAID among the given options. NSAIDs (non-steroidal anti-inflammatory drugs) are a class of medications commonly used to relieve pain, reduce inflammation, and lower fever. Most NSAIDs are acidic and can cause gastrointestinal side effects such as stomach ulcers. However, nabumetone is a prodrug that is metabolized in the body to an active form, which is non-acidic. This makes nabumetone less likely to cause stomach irritation and ulcers compared to other NSAIDs.

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Amanda Nwachukwu |Pharm(D) |
Medical Expert
Amanda, holding a Doctorate in Pharmacy from Texas Tech University Health Sciences Center, adeptly simplifies complex medical concepts into accessible content. With clinical proficiency, she ensures optimal patient care, while her adept medical writing skills facilitate comprehension and accessibility of healthcare information. Utilizing her education and expertise, Amanda meticulously reviews medical science quizzes, ensuring accuracy and clarity. Her commitment to excellence in healthcare education drives her passion for delivering quality content, ultimately benefiting both healthcare professionals and patients alike.

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Sep 26, 2023
    Quiz Edited by
    ProProfs Editorial Team

    Expert Reviewed by
    Amanda Nwachukwu
  • Nov 08, 2010
    Quiz Created by
    Krys2001
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