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 are 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.
Non-selective COX inhibitors
COX-2 selective inhibitors
CINODs; Nitroaspirins
All of the above.
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True
False
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True
False
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Histamine
PGE2
Bradykinin
Glucocorticoids
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By binding already formed platelets and preventing aggregation.
By vasodilating the vessels.
By inhibiting platelet thromboxane A2 production.
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True
False
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Ibuprofen
Aspirin
Celebrex
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True
False
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True
False
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True
False
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NSAID, morphine, codeine
Codeine, NSAID, morphine
NSAID, codeine, morphine
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Decreased PG generation means less sensitization of nociceptive nerve endings to inflammatory mediators
Decreased PG-mediated vasodilation (in headache relief)
All of the above.
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Ketoprofen
Acetaminophen
Aspirin
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True
False
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Bradykinin
5-HT
PGE2
Histamine
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A decrease in renal blood flow and glomerular filtration rate due to unopposed vascoconstriction.
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)
Promote hypokalemia via: increased reabsorption of K+ and suppression of PG-induced secretion of renin.
All of the above.
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Acute = A, Delayed = B, Chronic = C
Acute = C, Delayed = A, Chronic = B
Acute = B, Delayed = C, Chronic = A
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Etodolac
Indomethacin
Sulindac
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Probenecid
Allopurinol
Sulfinpyrazone
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1 = Allopurinol, 2 = Colchicine and Aspirin, 3 = Febuxostat, 4 = NSAIDs and corticosteroids, 5 = uricosuric agents.
1 = colchicine, 2 = colchicine and NSAIDs and corticosteroids, 3 = allopurinol, 4 = Febuxostat, 5 = Uricosuric agents, and aspirin.
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False
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Frequent urination
Increased retention of fluids
Hypokalemia
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Decrease in vasodilator prostaglandins (PGE2, PGI2) means less vasodilation and, indirectly, less edema.
Inhibit the migration of polymorphonuclear leukocytes and macrophages into the site of inflammation.
Stabilize lysosomal membranes, thereby preventing release of inflammatory mediators.
All of the above.
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False
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Histamine, 5-HT, bradykinin, LTC4, LTD4, PGE2, C3a, and C5a
IL-1, IL-6, PGE2, IL-1beta, TNFalpha
Histamine, 5-HT, PGE2, bradykinins
Histamine, 5-HT, bradykinin, PGE2, and leukotrienes
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Co-administration of NSAID with PPI.
Enteric coated tablets.
Prescribe CINODs instead.
All of the above.
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Alkaline urine
Acidic urine
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Do not possess anti-inflammatory actions.
Do not possess analgesic actions.
Do not possess antipyretic actions.
Have less GI side effects.
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More.
Less.
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True
False
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Histamine, 5-HT, bradykinin, LTC4, LTD4, PGE2, C3a, and C5a
IL-1, IL-6, PGE2, IL-1beta, TNFalpha
Histamine, 5-HT, PGE2, bradykinins
Histamine, 5-HT, bradykinin, PGE2, and leukotrienes
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They are COX-2 inhibitors.
They are COX-1 inhibitors.
They can release NO.
They are extremely potent NSAIDs.
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Snake venom
Protamine
Diclofenac
There is no antidote
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Direct
Indirect
Both direct and indirect
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Block prostaglandin receptors
Block histamine receptors
Block serotonin receptors
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True
False
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Probenacid
Allopurinol
Sulfinpyrazone
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Inhibiting uric acid synthesis
Increasing uric acid secretion
Inhibiting leukocyte migration into the joint
General anti-inflammatory and analgesic effects
All of the above are ways to treat gout
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COX-1
COX-2
They are equally selective for COX-1 and COX-2.
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It causes spina bifida in the fetus.
It causes excess bleeding during delivery.
It causes prolongation of gestation or delayed spontaneous labor.
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Indomethacin
Celecoxib
Acetaminophen
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Acetaminophen
Ibuprofen
Motrin
Aspirin
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Bradykinin
PGE2
Histamine
Serotonin
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Concurrent aspirin usage.
Intake of large amounts of water.
Food in the stomach.
An empty stomach.
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COX-1
COX-2
They are equally selective for COX-1 and COX-2
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5-8 hours
3-4 weeks
4-7 days
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COX-1
COX-2
They are equally selective for COX-1 and COX-2
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Protamine
Warfarin
N-acetylcysteine
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