Analgesics 5

Question 1

Enumerate the uses of indomethacin?

Answer 1

1. Articular inflammatory conditions: as rheumatoid arthritis, osteoarthritis, ankylosing
   spondylitis and acute gouty arthritis.
2. Anti-pyretic in refractory cases of fever (Hodgkin’s fever).
3. To induce closure of Patent ductus arterious in early infancy.
4. Batter’s syndrome (syndrome in children with juxtaglomerular hyperplasia, high renin, Ald., normotension)
5. Delay premature labor (Tocolytic, suppress uterine contraction).

Question 2

Mention the prodrug that changed to active sulfide in the body => less GIT toxicity?

Answer 2

Sulindac

Question 3

Drug associated with hepatic abnormalities (elevation of transaminase)?

Answer 3

Diclofenac

Question 4

Drug used as short term analgesic for post -operative pain and Its analgesic effect is equivalent to morphine?

Answer 4

Ketorolac

Question 5

Drug Long t ½ (50 h.), so can be used once /day (due to enterohepatic circulation)?

Answer 5

Piroxicam

Question 6

Oxicam undergo complete absorption after oral administration?

Answer 6

Piroxicam

Question 7

Oxicam show some cox-II selectivity and cause Less gastric ulceration/ less adverse effect on the kidney

Answer 7

Meloxicam

Question 8

Prodrug Its half-life of more than 24 hours and used once-daily and its the only nonacid NSAID?

Answer 8

Nabumetone

Question 9

All the following true about Selective Cox-2 inhibitors (Coxibs) except?

A. Has no antiplatelet or cardio-protective effect
B. Enhance the effect of ADH
C. Vasoconstriction occurs reducing the glomerular filtration rate (GFR) which may result in acute renal failure
D. Associated with high gastric ulceration

Answer 9

D / Associated with little or no gastric ulceration

Question 10

T OR F/ Selective Cox-2 inhibitors, inhibit COX-2-mediated prostacyclin synthesis in the vascular endothelium result in the risk of cardiovascular adverse effects as heart attacks, thrombosis and stroke

Answer 10

T

Question 11

Two drugs have CVS side effects which are removed from the market?

Answer 11

Rofecoxib and valdecoxib

Question 12

Selective Cox-2 inhibitors has a sulfur atom and may cause problem in patients with allergies to sulfonamides?

Answer 12

Celcoxib

Question 13

All the following are true about Paracetamol except?

A. Well and complete absorption after oral administration
B. Cross placental barrier and cause teratogenic effect during pregnancy
C. Inactivated in the liver by conjugation with glucuronic acid and sulfuric acid
D. Inhibit PGs synthesis centrally only

Answer 13

B / Cross placental barrier and safe during pregnancy (non-teratogenic)

Question 14

Mention the pharmacological actions of Paracetamol?

Answer 14

analgesic, anti-pyretic action only

Question 15

Enumerate the adverse effect of Paracetamol?

Answer 15

1. Allergic reactions such as skin rash
2. Acute paracetamol toxicity lead to fatal hepatic necrosis
3. Chronic use of paracetamol may lead to nephrotoxicity in susceptible individuals

Question 16

The treatment of acute paracetamol toxicity that cause fatal hepatic necrosis is?

Answer 16

N-acetyl cysteine