MSK I

Question 1

acetaminophen

Answer 1

reversible inhibition COX

no anti-inflammatory

antipyretic, analgesic

Question 2

avoid reye syndrome

Answer 2

tx child with viral infection
-with acetaminophen

not ASA

Question 3

adverse acetaminophen

Answer 3

OD - hepatic necrosis

metabolite - NAPQI - deplete glutathione

toxic byproducts form

Question 4

tx acetaminophen toxicity

Answer 4

N-acetylcysteine - regenerate glutathione

Question 5

LTB4

Answer 5

chemotactic

Question 6

PGI2

Answer 6

prostacyclin

platelet aggregation inhibitor

decreased vascular tone

Question 7

TXA2

Answer 7

thromboxane

increased platelet aggregation and vascular tone

Question 8

PGE1

Answer 8

decreased vascular tone

Question 9

PGE2

Answer 9

increased uterine tone

with PGF2

Question 10

corticosteroids

Answer 10

inhibit PLA2

decreased arachidonic acid synthesis

Question 11

two pathways of arachidonic acid

Answer 11

lipoxygenase - form leukotrienes

COX - form prostacyclin, PGs, thromboxane

Question 12

phospholipase A2

Answer 12

synthesis of AA

inhibited corticoisteroids

Question 13

triamcinolone/methylprednisone

Answer 13

corticosteroid

Question 14

dexamethasone/betamethasone

Answer 14

corticoisteroids

Question 15

zileuton

Answer 15

inhibit lipoxygenase - leukotriene synthesis inhibitor

Question 16

montelukast

Answer 16

inhibit leukotriene receptors

LTC4, D4, E4

Question 17

zafirlukast

Answer 17

inhibit leukotriene receptors

LTC4, D4, E4

Question 18

alprostadil

Answer 18

PGE1 analog

Question 19

dinoprostone

Answer 19

PGE2 analog

Question 20

carboprost

Answer 20

PGF2 analog

Question 21

aspirin

Answer 21

irreversible inhibit COX1 and 2

via acetylation

type of NSAID

Question 22

clinical use aspirin

Answer 22

low dose (300mg) - decreased platelet aggregation

intermediate dose (300-2400mg) - antipyretic and analgesic

high dose (2400-4000mg) - anti-inflammatory

Question 23

adverse aspirin

Answer 23

gastric ulceration

tinnitus - CN VIII

chronic use - acute renal failure - interstitial nephritis

Question 24

reye syndrome

Answer 24

aspirin use in child with viral infection

Question 25

aspirin toxicity

Answer 25

early - respiratory alkalosis

late - mixed metabolic acidosis/resp alkalosis

Question 26

celecoxib

Answer 26

selective COX-2 inhibitor

affect inflammatory and vascular endothelium

spares COX1 - maintain gastric mucosa

also no TXA2 effect - dependent on COX1

Question 27

adverse celecoxib

Answer 27

rheumatoid arthritis
osteoarthritis

sulfa allergy

Question 28

ibuprofen

Answer 28

NSAID

Question 29

naproxen

Answer 29

NSAID

Question 30

indomethacin

Answer 30

NSAID

Question 31

ketorolac

Answer 31

NSAID

Question 32

diclofenac

Answer 32

NSAID

Question 33

NSAID

Answer 33

reversible inhibit COX 1 and 2

block PG synthesis

antipyretic, analgesic, anti-inflammatory

Question 34

tx to close PDA

Answer 34

indomethacin - NSAID

Question 35

adverse NSAID

Answer 35

interstitial nephritis
gastric ulcer (PG protect gastric mucosa)

renal ischemia - PG vasodilate afferent arteriole

Question 36

alendronate

Answer 36

bisphosphonate

Question 37

bisphosphonate

Answer 37

pyrophosphate analog

-bind hydroxyapatite bone - inhibit osteoclast activity

Question 38

clinical use bisphosphonate

Answer 38

osteoporisis
hyperCa
paget disease of bone

inhibit osteoclast actdivity

Question 39

adverse bisphosphonate

Answer 39

corrosive esophagitus

pt should take with water and not lay down after taking it

also - osteonecrosis of jaw