Pharmacology- Musculoskeletal Issues & Non-opioid Analgesia (Nsaid's)
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Questions and Answers
- 1.
__________________ is the original NSAID
Explanation
Aspirin is considered the original NSAID (nonsteroidal anti-inflammatory drug) because it was the first NSAID to be discovered and widely used. It was first synthesized in 1897 and has been used for its analgesic, anti-inflammatory, and antipyretic properties ever since. Aspirin works by inhibiting the production of prostaglandins, which are responsible for pain, inflammation, and fever. Its effectiveness and widespread use have made it a cornerstone in the treatment of various conditions, including headaches, fever, and mild to moderate pain.Rate this question:
- 2.
True or false: NSAIDs ↓ sensitivity of vessels to bradykinin and histamine, affect T lymphocytes, & reverse vasodilation of inflammation
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
NSAIDs, or nonsteroidal anti-inflammatory drugs, can decrease the sensitivity of blood vessels to bradykinin and histamine, which are substances involved in inflammation. They can also affect T lymphocytes, which are a type of white blood cell involved in the immune response. Additionally, NSAIDs can reverse vasodilation, which is the widening of blood vessels that occurs during inflammation. Therefore, the statement that NSAIDs decrease sensitivity to bradykinin and histamine, affect T lymphocytes, and reverse vasodilation of inflammation is true.Rate this question:
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- 3.
___________ inhibitors were developed to inhibit prostaglandin synthesis at sites of inflammation, and higher incidence of CV thrombotic events.
- A.
COX-2
- B.
COX -1
Correct Answer
A. COX-2Explanation
COX-2 inhibitors were developed to inhibit prostaglandin synthesis at sites of inflammation, and they have a higher incidence of cardiovascular (CV) thrombotic events. This suggests that COX-2 inhibitors specifically target the COX-2 enzyme, which is responsible for inflammation, while sparing the COX-1 enzyme, which is involved in protecting the stomach lining and promoting platelet aggregation. As a result, the inhibition of COX-2 without affecting COX-1 can lead to an increased risk of CV thrombotic events.Rate this question:
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- 4.
Antiplatelet effect of NSAIDs comes from blocking the ___________ enzyme and producing thromboxane
- A.
COX-1
- B.
Cox-2
Correct Answer
A. COX-1Explanation
NSAIDs (non-steroidal anti-inflammatory drugs) exert their antiplatelet effect by blocking the COX-1 enzyme. COX-1 is responsible for the synthesis of thromboxane, a molecule that promotes platelet aggregation and blood clot formation. By inhibiting COX-1, NSAIDs reduce the production of thromboxane, leading to decreased platelet aggregation and a decreased risk of blood clots. COX-2, on the other hand, is involved in the production of prostaglandins that mediate inflammation and pain.Rate this question:
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- 5.
Select all: General ADE in NSAIDs
- A.
Headaches, tinnitus
- B.
Contispation, anorexia
- C.
Confusion, irritability
- D.
Fluid retention, hypertension
- E.
Nausea, vomiting
Correct Answer(s)
A. Headaches, tinnitus
D. Fluid retention, hypertension
E. Nausea, vomitingExplanation
This question is asking for the general adverse drug effects (ADE) associated with NSAIDs. The correct answer includes headaches, tinnitus, fluid retention, hypertension, nausea, and vomiting. These are common side effects that can occur when taking NSAIDs.Rate this question:
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- 6.
What is the First-line Treatment of MSK Pain?
- A.
acetaminophen
- B.
Aspirin
- C.
Ibuprofen
- D.
Aleve
Correct Answer
A. acetaminophenExplanation
Acetaminophen is the first-line treatment for musculoskeletal (MSK) pain. It is a commonly used over-the-counter pain reliever that helps reduce pain and fever. Acetaminophen works by inhibiting the production of certain chemicals in the body that cause pain and inflammation. It is considered a safe and effective option for managing MSK pain, especially for individuals who cannot take nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, or Aleve due to allergies or other medical conditions.Rate this question:
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- 7.
In the nonpharmacologic treatment of MK pain, what does the acronym R.I.C.E stand for?
- A.
Relax, Intervene, Compression, elevation
- B.
Rest, Ice, Compression, Elevation
- C.
Relax, Ice, Compression, Elevation
- D.
Relieve, Intervene, Compression, elevation
Correct Answer
B. Rest, Ice, Compression, ElevationExplanation
R.I.C.E stands for Rest, Ice, Compression, Elevation. This acronym is used in the nonpharmacologic treatment of MK pain. Rest refers to avoiding activities that worsen the pain and allowing the injured area to heal. Ice involves applying cold packs or ice to reduce inflammation and numb the area. Compression is the application of pressure to reduce swelling and support the injured area. Elevation refers to raising the injured area above the level of the heart to reduce swelling and promote blood flow.Rate this question:
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- 8.
Treatment of MSK Pain: If a patient has moderate pain, consider starting ____________ at the same time as nonpharmacologic treatment
- A.
Salicylates
- B.
NSAIDs
- C.
Acetaminophen
Correct Answer
B. NSAIDsExplanation
If a patient has moderate pain, it is recommended to consider starting NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) at the same time as nonpharmacologic treatment. NSAIDs are commonly used to relieve pain and reduce inflammation. They work by inhibiting the production of certain chemicals in the body that cause pain and inflammation. Therefore, using NSAIDs alongside nonpharmacologic treatments can provide effective relief for moderate MSK (Musculoskeletal) pain.Rate this question:
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- 9.
Avoid aspirin in children/adolescents because it can cause ___________ syndrome
- A.
Turner
- B.
Reye's
- C.
Guillain-Barré
- D.
Sjogren's
Correct Answer
B. Reye'sExplanation
Reye syndrome is a rare but serious disease that most often affects children ages 6 to 12 years old. It can cause brain swelling and liver damage. It may be related to using aspirin to treat viral infections. Reye syndrome can lead to brain damage, liver damage, and death.Rate this question:
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- 10.
Select all: Agents used in pharmacologic Treatment of OA
- A.
Acetaminophen
- B.
NSAIDs
- C.
COX-2 inhibitors
- D.
Cox-1 inhibitors
- E.
Intraarticular injection of steroids
Correct Answer(s)
A. Acetaminophen
B. NSAIDs
C. COX-2 inhibitors
E. Intraarticular injection of steroidsExplanation
The correct answer includes acetaminophen, NSAIDs, COX-2 inhibitors, and intraarticular injection of steroids. These agents are commonly used in the pharmacologic treatment of osteoarthritis (OA). Acetaminophen is a non-opioid analgesic that helps relieve pain. NSAIDs (nonsteroidal anti-inflammatory drugs) reduce inflammation and alleviate pain. COX-2 inhibitors specifically target the COX-2 enzyme, which is responsible for inflammation and pain. Intraarticular injection of steroids involves injecting corticosteroids directly into the affected joint to reduce inflammation and provide pain relief. These agents are commonly prescribed to manage the symptoms of OA and improve the patient's quality of life.Rate this question:
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- 11.
True or false: Gout Aims of treatment includes: decreasing symptoms of an acute attack, decreasing the risk of recurrent attacks and increasing serum urate levels
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Treatment Mechanisms of Gout
Aims of treatment:
• decrease symptoms of an acute attack
• decrease risk of recurrent attacks
• lower serum urate levelsRate this question:
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- 12.
What is the first-line treatment for Gout in a patient with acute symptoms?
- A.
Colchicine
- B.
NSAIDs
- C.
Corticosteroids
- D.
Uricosuric drugs
Correct Answer
B. NSAIDsExplanation
NSAIDs (Nonsteroidal anti-inflammatory drugs) are the first-line treatment for gout in patients with acute symptoms. Gout is a form of arthritis caused by the buildup of uric acid crystals in the joints, leading to severe pain and inflammation. NSAIDs help reduce pain, inflammation, and swelling by inhibiting the production of prostaglandins, which are responsible for these symptoms. They are effective in providing relief and are commonly prescribed to manage acute gout attacks. Other options like colchicine, corticosteroids, and uricosuric drugs may be used in certain cases, but NSAIDs are the preferred initial treatment.Rate this question:
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- 13.
What is the first-line treatment for Gout in Preventative therapy?
- A.
Colchicine
- B.
keterolac
- C.
Allopurinol
- D.
Methylprednisolone
Correct Answer
A. ColchicineExplanation
Colchicine works by inhibiting microtubules involved in the chemotaxis of neutrophils. It is a good drug of 2nd choice for treating gout, especially when NSAIDs are contraindicated.
Colchicine works best when taken very early in an attack of gout (e.g. at the first sign of joint discomfort), as it will reduce the activation & chemotaxis of neutrophils to the site of inflammation. It can also be combined with NSAIDs (when NSAIDs are not contraindicated).Rate this question:
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- 14.
What medication is used for ACUTE Gout attacks and causes significant Gi distress (diarrhea, N/V, abd. pain)?
- A.
Febuxostat
- B.
Allopurinol
- C.
Colchicine
- D.
Probenecid
Correct Answer
C. ColchicineExplanation
Colchicine is the correct answer because it is a medication used specifically for acute gout attacks. It is known to cause significant gastrointestinal distress, including symptoms such as diarrhea, nausea, vomiting, and abdominal pain. Febuxostat, allopurinol, and probenecid are also used in the management of gout, but they do not typically cause significant gastrointestinal side effects.Rate this question:
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- 15.
Which Gout medications reduce production of uric acid by inhibition of xanthine oxidase (an enzyme that converts hypoxanthine to xanthine and xanthine to uric acid)
- A.
Allopurinol
- B.
Febuxostat
- C.
Probenecid
- D.
Colchicine
Correct Answer(s)
A. Allopurinol
B. FebuxostatExplanation
Allopurinol and Febuxostat are both medications that reduce the production of uric acid by inhibiting xanthine oxidase, the enzyme responsible for converting hypoxanthine to xanthine and xanthine to uric acid. These medications work by blocking the activity of xanthine oxidase, thereby reducing the amount of uric acid produced in the body. Probenecid, on the other hand, works by increasing the excretion of uric acid from the body, while colchicine is used to treat gout symptoms but does not directly affect uric acid production. Therefore, the correct answer is Allopurinol and Febuxostat.Rate this question:
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- 16.
Gout is caused by the buildup of what substance in the body?
- A.
Calcium
- B.
Uric acid
- C.
Pyruvic acid
- D.
Oxalate
Correct Answer
B. Uric acidExplanation
Gout is caused by the buildup of uric acid in the body. Uric acid is a waste product that is normally excreted through the kidneys. However, in people with gout, there is an overproduction or underexcretion of uric acid, leading to its accumulation in the joints. This can result in the formation of urate crystals, causing inflammation, pain, and swelling characteristic of gout.Rate this question:
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- 17.
Acute attacks of gouty arthritis may occur early in treatment with allopurinol (Zyloprim, Purinol) because:
- A.
Allopurinol (Zyloprim, Purinol) increases urate synthesis
- B.
Urate crystals move from tissue to plasma
- C.
Allopurinol (Zyloprim, Purinol) increases release of chemotactic factors
- D.
A & B
- E.
A, B & C
Correct Answer
B. Urate crystals move from tissue to plasmaExplanation
Acute attacks of gouty arthritis occur early in treatment with allopurinol because allopurinol inhibits the enzyme xanthine oxidase, which leads to a decrease in uric acid production. As a result, urate crystals that have accumulated in the tissues start to dissolve and move from the tissue into the plasma, causing an acute gouty attack. Therefore, the correct answer is "urate crystals move from tissue to plasma."Rate this question:
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- 18.
Rational indication(s) for allopurinol (Zyloprim, Purinol) administration:
- A.
Chronic tophaceous gout;when tophi reabsorption more rapid with uricosuric agents
- B.
When probenecid or sulfinpyrazone cannot be used
- C.
presence of renal functional impairment
- D.
in a patient with recurrent renal stones
- E.
All of the above
Correct Answer
E. All of the aboveExplanation
The rational indications for allopurinol administration include chronic tophaceous gout, when tophi reabsorption is more rapid with uricosuric agents, when probenecid or sulfinpyrazone cannot be used, presence of renal functional impairment, and in a patient with recurrent renal stones. Allopurinol is used to reduce the production of uric acid in the body, which helps prevent the formation of uric acid crystals and the development of gout and kidney stones. Therefore, all of the above indications are valid reasons for allopurinol administration.Rate this question:
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- 19.
Previously most popular drug for treating inflammation of acute gouty arthritis -- NSAIDs now more commonly used because of diarrhea associated with earlier medication:
- A.
Allopurinol (Zyloprim, Purinol)
- B.
colchicine
- C.
Acetaminophen (Tylenol, Panadol)
- D.
probenecid (Benemid)
Correct Answer
B. colchicineExplanation
Colchicine is the correct answer because it is a drug commonly used for treating inflammation of acute gouty arthritis. It is preferred over the previously popular drug, allopurinol, because allopurinol can cause diarrhea as a side effect. Therefore, colchicine is now more commonly used due to its effectiveness and lower risk of causing diarrhea.Rate this question:
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- 20.
___________________reduces uric acid synthesis: for management of gout
- A.
Colchicine
- B.
Probenecid (Benemid)
- C.
Allopurinol (Zyloprim, Purinol)
- D.
Oxaprozin (Daypro)
Correct Answer
C. Allopurinol (Zyloprim, Purinol)Explanation
Allopurinol is the correct answer because it is a medication used for the management of gout. It works by reducing the synthesis of uric acid, which is the main cause of gout. By inhibiting the production of uric acid, allopurinol helps to prevent the formation of urate crystals in the joints, which can cause inflammation and pain. This medication is commonly prescribed for individuals with gout to help control symptoms and prevent future gout attacks.Rate this question:
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- 21.
This drug inhibits the secretion of many weak acids (penicillin, methotrexate) in addition to inhibiting reabsorption of uric acid and is used orally to treat chronic gout:
- A.
Allopurinol
- B.
Probenecid
- C.
Febuxostat
- D.
Colchicine
Correct Answer
B. ProbenecidExplanation
Probenecid is the correct answer because it inhibits the secretion of weak acids, including penicillin and methotrexate, and also inhibits the reabsorption of uric acid. This makes it an effective treatment for chronic gout when taken orally. Allopurinol is also used to treat gout, but it works by reducing the production of uric acid rather than inhibiting its secretion or reabsorption. Febuxostat and colchicine are other medications used to treat gout, but they do not have the same mechanism of action as probenecid.Rate this question:
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- 22.
Which medication for Gout should a patient NOT use if they are allergic to Sulfonamides?
- A.
Probenecid
- B.
Colchicine
- C.
Allopurinol
- D.
Febuxostat
Correct Answer
A. ProbenecidExplanation
Probenecid is a medication used to treat gout by reducing the levels of uric acid in the body. However, it is a sulfa drug, meaning it contains a sulfonamide group. Therefore, if a patient is allergic to sulfonamides, they should not use Probenecid as it may trigger an allergic reaction.Rate this question:
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- 23.
What class of Gout medications should a patient not use concurrently with Uricosuric Agents because it can antagonize its effect?
- A.
NSAIDs
- B.
Salicylates
- C.
Xanthine Oxidase Inhibitors
Correct Answer
B. SalicylatesExplanation
Salicylates should not be used concurrently with Uricosuric Agents because they can antagonize its effect. Salicylates, such as aspirin, have been shown to decrease the excretion of uric acid, which is the opposite effect of Uricosuric Agents. This can lead to increased levels of uric acid in the body and potentially worsen the symptoms of gout. Therefore, it is important for patients to avoid using salicylates while taking Uricosuric Agents to ensure the effectiveness of the medication.Rate this question:
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- 24.
Gout medication that enhances the effects of CNS depressants and sympathomimetic agents, may interfere w/ vitamin B12 absorption and have Increased toxicity w/ concurrent use of clarithromycin, erythromycin, and grapefruit juice
- A.
Allopurinol
- B.
Febuxostat
- C.
Colchicine
- D.
Probenecid
Correct Answer
C. ColchicineExplanation
Colchicine is the correct answer because it is a gout medication that can enhance the effects of CNS depressants and sympathomimetic agents. It can also interfere with vitamin B12 absorption and have increased toxicity when used concurrently with clarithromycin, erythromycin, and grapefruit juice. This suggests that colchicine has potential interactions and side effects that should be considered when prescribing or taking it.Rate this question:
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- 25.
Both of these Gout medications decrease concentrations of less soluble uric acid- ↓ precipitation of uric acid crystals in joints and tissues
- A.
Colchicine
- B.
Allopurinol
- C.
Febuxostat
- D.
Probenecid
Correct Answer(s)
B. Allopurinol
C. FebuxostatExplanation
Allopurinol and Febuxostat are both gout medications that decrease the concentrations of less soluble uric acid. By doing so, they help to prevent the precipitation of uric acid crystals in joints and tissues. This is important because the accumulation of uric acid crystals is what causes the painful symptoms associated with gout. Therefore, Allopurinol and Febuxostat are effective in reducing the frequency and severity of gout attacks by lowering uric acid levels in the body.Rate this question:
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Mar 20, 2023Quiz Edited by
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