Analgesic Drug Questions Flashcards
Which 2 of the following drugs are part of stage 1 of the analgesic ladder?
1 - codeine
2 - tramadol
3 - paracetamol
4 - NSAIDs
3 - paracetamol
4 - NSAIDs
Which 2 of the following drugs are part of stage 2 of the analgesic ladder?
1 - codeine
2 - tramadol
3 - paracetamol
4 - NSAIDs
1 - codeine
2 - tramadol
Which of the following is on stage 3 of the analgesic ladder?
1 - codeine
2 - morphine
3 - paracetamol
4 - NSAIDs
2 - morphine
NSAIDS have 3 properties: analgesic (pain-killing), anti-inflammatory and antipyretic (fever-reducing) properties. Which of the following is NOT classed as a NSAIDs?
1 - aspirin
2 - paracetamol
3 - ibuprofen
4 - diclofenac
2 - paracetamol
- analgesic and antipyretic only
- NOT anti-inflammatory
A 22-year-old man presents with complaints of ankle pain and swelling from a sports injury oneday prior. X-rays are negative for a fracture and he is directed to rest the joint and allow it to heal. Which drug will provide LESS benefit in alleviating pain and inflammation of the swollen joint?
A. Celecoxib
B. Naproxen
C. Diclofenac
D. Acetaminophen
D. Acetaminophen
- more commonly known as paracetamol
- other 3 drugs are NSAIDS
A patient with which of the following conditions is the most appropriate candidate for use of acetaminophen to manage chronic pain associated with osteoarthritis?
A. Chronic malnutrition
B. Obesity
C. Alcoholism
D. Viral hepatitis
B. Obesity
- other conditions increase risk of acetaminophen (paracetamol) related hepatotoxicity.
- acetaminophen depletes glutathione concentrations in the liver and NAPQI builds up.
- low levels of glutathione are common in malnutrition, again increasing levels of NAPQI
- alcoholism depletes endogenous glutathione
- viral hepatitis damages the liver, and could reduce levels of glutathione
Among NSAIDs, aspirin is unique because it:
(A) Irreversibly inhibits its target enzyme
(B) Prevents episodes of gouty arthritis with long-term use
(C) Reduces fever
(D) Reduces the risk of colon cancer
(E) Selectively inhibits the COX-2 enzyme
(A) Irreversibly inhibits its target enzyme
- non-selective irreversibly inhibition of cyclooxygenase 1 and 2
Which of the following is an analgesic and antipyretic drug that lacks an anti-inflammatory action?
(A) Acetaminophen
(B) Celecoxib
(C) Colchicine
(D) Indomethacin
(E) Probenecid
(A) Acetaminophen
An 18-month-old boy dies from an accidental overdose of acetaminophen. Which of the following is the most likely cause of this patient’s death?
(A) Arrhythmia
(B) Haemorrhagic stroke
(C) Liver failure
(D) Noncardiogenic pulmonary edema
(E) Ventilatory failure
(C) Liver failure
- liver failure as a result of its conversion by hepatic cytochrome P450 enzymes to a highly reactive metabolite NAPQI
A 54-year-old woman presented with signs and symptoms consistent with an early stage of rheumatoid arthritis. The decision was made to initiate NSAID therapy. Which of the following patient characteristics is the most compelling reason for avoiding celecoxib in the treatment of her arthritis?
(A) History of alcohol abuse
(B) History of gout
(C) History of myocardial infarction
(D) History of osteoporosis
(E) History of peptic ulcer disease
(C) History of myocardial infarction
- COX-2-selective inhibitor
- increased risk of arterial thrombotic events.
- history of MI would be a compelling reason to avoid a COX-2 inhibitor
Which of the following statements is correct regarding morphine?
1 - Morphine is the most lipophilic opioid.
2 - Morphine is metabolised through CYP2D6 and CYP3A4 and has numerous drug interactions.
3 - Morphine has active metabolites that can accumulate in renal impairment, leading to clinically relevant effects.
4 - Morphine can cause opioid-induced constipation upon initiation of opioid therapy, but tolerance occurs after 1 to 2weeks of opioid exposure.
3 - Morphine has active metabolites that can accumulate in renal impairment, leading to clinically relevant effects.
- Morphine has two active metabolites M3G and M6G, which are renally eliminated.
