Misc Analgesic and Anti-inflammatory agents

Question 1

Allopurinol Brand Name

Answer 1

Zyloprim

Question 2

Allopurinol Indications/Dosages

Answer 2

Treatment of Gout and uric acid nephropathy w/ or w/o symptoms: 200-300mg/day for mild gout, 400-600mg/day in divided doses for mod-severe tophaceous gout
Prevention of gout flair-up: 100mg daily initially, increased by 100mg weekly until serum UA level is 6mg/100ml or less

Question 3

Allopurinol Mechanism

Answer 3

competitively inhibits xanthine oxidase (converts hypoxanthine to xanthine to UA)
Also metabolized to alloxanthine which inhibits xanthine oxidase

Question 4

Allopurinol drug interactions

Answer 4

may increase ampicillin-induced skin rash

increases pharmacological and toxic effects of oral thiopurines (mercaptopurine and axathioprine) and chlorpropamide

Question 5

Allopurinol CI/Precautions

Answer 5

impaired renal or hepatic function
use with colchicine or NSAIDs prophylactically at first due to increase in gout attacks during initiation of therapy
adequate fluid intake should yield urine output of 2L/day to prevent xanthine calculi and prevent urate precipitation
decrease dose interval to 1-2x/week in severe renal insufficiency

Question 6

Allopurinol Pregnancy Category

Answer 6

C

Question 7

Allopurinol ADR’s

Answer 7

Drowsiness, diarrhea, nausea, vomiting, abdominal pain,

RASH (including SJS)

Question 8

Allopurinol Patient Education

Answer 8

May take 1+ weeks to reach max effectiveness, compliance is essential
May take with food
Use caution when operating machinery or when mental alertness is required
Avoid alcohol
High fluid intake is beneficial

Question 9

Butalbital, APAP, Caffeine brand name

Answer 9

Fioricet

Question 10

Butalbital, APAP, Caffeine indications/dosage

Answer 10

relief of symptom complex of tension headache: 1-2t q5h PRN
DO NOT EXCEED 6 tabs/day
Not recommended for children

Question 11

Butalbital, APAP, Caffeine mechanism

Answer 11

APAP: inhibits prostaglandin synthesis in CNS and peripheral pain impulse blockade
Butalbital: produces sensory cortex depression through inhibition of conduction in reticular formation in thalamus
Caffeine: CNS stimulation through PDE inhibition, thus increasing accumulation of cAMP

Question 12

Butalbital, APAP, Caffeine drug interactions

Answer 12

may decrease pharm effects of oral anticoagulants, CS, estrogens, griseofulvin, doxy, theophyllines, quinidine, and B-blockers
May increase toxic effects of methoxyflurane
hepatotoxicity potential increases when use with hydantoins or sulfinpyrazone
alcohol and other CNS depressants increase toxic effects

Question 13

Butalbital, APAP, Caffeine CI/precautions

Answer 13

CI: hypersensitivity or porphyria
caution: increased ICP, head injury, severe hepatic/renal impairment, Addison’s disease, hypothyroidism, prostatic hypertrophy or urethral stricture

Question 14

Butalbital, APAP, Caffeine pregnancy category

Answer 14

C

Question 15

Butalbital, APAP, Caffeine ADRs

Answer 15

drowsiness, dizziness, lightheadedness

Question 16

Butalbital, APAP, Caffeine patient education

Answer 16

may cause drowsiness, caution when alertness required
avoid alcohol
may take with food
do not exceed prescribed dose
may be habit forming