anti-inflammatory drugs

Question 1

Calecoxib

Answer 1

Selective COX-2 inhibitor

Question 2

Valdecoxib

Answer 2

Selective COX-2 inhibitor

Question 3

Etoricoxib

Answer 3

Selective COX-2 inhibitor

Question 4

Nabumetone

Answer 4

Selective COX-2 inhibitor in lower dosage

Question 5

Meloxicam

Answer 5

Selective COX-2 inhibitor in lower dosage, rheumatoid arthritis, gout, osteorthritis

Question 6

Etodilac

Answer 6

Selective COX-2 inhibitor in lower dosage

Question 7

Asprin

Answer 7

(irreversibly binds to COX1) higher dosage non selective

Question 8

Ibuprofen

Answer 8

higher dosage non selective to COX1 or COX2

Question 9

Indomethacin

Answer 9

higher dosage non selective to COX1 or COX2

Question 10

Naproxen

Answer 10

higher dosage non selective to COX1 or COX2

Question 11

Diclofenac

Answer 11

higher dosage non selective to COX1 or COX2

Question 12

NSAIDs CNS effect

Answer 12

Headache and tinnitus

Question 13

NSAIDs Cardiovascular effect

Answer 13

Fluid rentention, hypertension

Question 14

NSAIDs Hematologic effect

Answer 14

Rare thrombocytopenia

Question 15

NSAIDs Hepatic effect

Answer 15

Abnormal liver function test

Question 16

NSAIDs Rashes

Answer 16

all types

Question 17

NSAIDs Renal effect

Answer 17

chronic analgesic nephropathy

Question 18

Asprin overdose Sx

Answer 18

Hyperventilation, CNS depression of respiration, bleeding time increase

Question 19

In Kids due to Asprin usage due to viral infection

Answer 19

Reye’s syndrome

Question 20

Sx: Acute encephalophathy and fatty liver failure, seen in children after viral infection, nausea, vomiting, change in mental status

Answer 20

Reye’s syndrome

Question 21

When can you use Aspirin in children ?

Answer 21

Kawasaki Diseases

Question 22

Low dosage of Asprin (<300 mg)

Answer 22

Decrease platelet aggregation

Question 23

Medium dosage of Aspirin (300- 2400 mg)

Answer 23

antipyretic and analgesic

Question 24

(2400 -4000 mg) Asprin (large)

Answer 24

anti-inflammatory

Question 25

COX2 inhibitors are used for:

Answer 25

rheumatoid artheritis and other inflammation disease

Question 26

When is COX2 inhibitors preferred to be used?

Answer 26

Patients with history of gastritis or ulcers as COX1 inhibition is less.

Question 27

COX-2 inibits production of PGI2 so:

Answer 27

unopposed effect of TxA2, increased risk of cardiovascular and cerebrovascular events, so edema and hypertension

Question 28

Rofecoxib

Answer 28

most prescribed selective cox2 inhibitor, Vioxx, ceoxx, ceeoxx,

Question 29

Adverse effect of celecoxib

Answer 29

increased risk of thrombosis, sulfa-allergy

Question 30

Acetaminophen

Answer 30

analgesic, antipyretic, used for mild and moderate pain

Question 31

What is preferred for children with viral infection?

Answer 31

Acetaminophen

Question 32

Adverse reaction of acetaminophen?

Answer 32

increase of hepatic enzymes (hepatotoxicity with centrilobular necrosis),

Question 33

Adverse dose of Acetaminophen

Answer 33

15 g

Question 34

Antidote for Acetaminophen toxicity

Answer 34

N-acetylcysteine--regenerates glutathione-start within 8-10 hrs, liver transplant may be required.

Question 35

What happens to APAP?

Answer 35

Oxidized to N-acetyl-p-benzoquinoneimine (highly electrophilic), accumulates and adducts with macromolecular systems and cell function

Question 36

How does APAP work?

Answer 36

weak COX1 and 2 inactivated peripherally tissues

Question 37

What does APAP toxicity work?

Answer 37

hepatic necorsis, APAP metabolites depletes glutathione and form toxic tissues

Question 38

What is glucocorticoids?

Answer 38

anti-inflammatory drugs used for Addison's disease and asthma, have powerful immunosuppresent actions as well

Question 39

Prednisone

Answer 39

glucocorticoids

Question 40

Cortisone

Answer 40

glucocorticoids

Question 41

Hydrocortisone

Answer 41

glucocorticoids

Question 42

How does glucocorticoids work?

Answer 42

inhibits PLA2, which suppresses cox-2 syn, so decrease leukotrines and prostaglandin, and upregulates anit-inflamm protein in gene and protein level

Question 43

Toxicity of glucocorticoids?

Answer 43

adrenal insufficiency and Cushing's syndrome (osteoporesis due to demineralization)

Question 44

Sx: buffalo hump, moon facies, truncal obesity, muscle wasting, thin, osteoporsis, adrenocortical atrophy, peptic ulcer, diabetes

Answer 44

Latrogenic Cushing's syndrome

Question 45

What happens when you stop glucocorticoids after using a long time?

Answer 45

Adrenal insufficiency

Question 46

What is the first choice to treat rheumatoid arthritis?

Answer 46

DMARDS: Methotrexate (MTX)

Question 47

MTX toxicity

Answer 47

myelosuppression (reversible with leucovorin), fatty liver, mucositis, teratogenic (bad pregnancy)

Question 48

When is MTX used?

Answer 48

Cancers (leukemias, lymphomas, choriocarcinoma, sarcomas), nonneoplastic (abortion, ectopic preg, rheumatoid arthritis)