Musculoskeletal

Question 1

Aspirin MOA

Answer 1

Irreversibly binds cyclooxygenase (COX1+2)decreases thromboxane A2 and prostoglandin synthesis

Question 2

Aspirin - clinical use

Answer 2

low dose: decreased platelet aggregationintermediate dose: antipyretic/analgesichigh dose - anti-inflammatory

Question 3

Aspirin - AEs

Answer 3

GI bleeding, tinnitus, acute renal failureRisk of Reye’s syndrome in kids treated for viral infection (strep vs mono)

Question 4

NSAIDs - 5 common

Answer 4

Ibuprofen, naproxen, indomethacin, ketorolac, diclofenac

Question 5

NSAIDs - MOA

Answer 5

Reversibly bind cyclooxygenase (COX 1+2)-> blocks prostaglandin synthesis

Question 6

NSAIDs - clinical use

Answer 6

antipyretic, analgesic, anti-inflammatory

Question 7

Specific NSAID used to close PDAs

Answer 7

Indomethacin

Question 8

NSAIDs - AEs

Answer 8

interstitial nephritis, GI ulceration/bleeding, renal ischemia

Question 9

COX-2 inhibitors - common one

Answer 9

celecoxib

Question 10

COX-2 inhibitors - MOA

Answer 10

reversibly inhibits COX-2

Question 11

COX-2 inhibitors - clinical use

Answer 11

Rheumatoid and osteoarthritisshould spare gastric mucosa and platelet function (COX-1 dependent)

Question 12

COX-2 inhibitors - AEs

Answer 12

increased thrombosis risk

Question 13

Acetaminophen - MOA

Answer 13

reversibly binds COX, mostly in CNS

Question 14

Acetaminophen - clinical use

Answer 14

antipyretic and analgesic (NOT anti-inflammatory)use to avoid Reye’s in kids w/ viral infection

Question 15

Acetaminophen - AEs

Answer 15

hepatic necrosis (glutathione depletion in liver)

Question 16

Bisphosphonates - common one

Answer 16

Alendronate and other -dronates

Question 17

Bisphosphonates - MOA

Answer 17

binds hydroxyapatite in bone ->inhibits osteoclast activity

Question 18

Bisphosphonates - clinical use

Answer 18

osteoporosis, hypercalcemia, Paget’s disease

Question 19

Bisphosphonates - AEs

Answer 19

corrosive esophagitis, osteonecrosis of jaw

Question 20

Chronic gout treatment

Answer 20

allopurinol, febuxostat

Question 21

Acute gout- best NSAIDS

Answer 21

naproxen, indomethacin

Question 22

TNF-alpha inhibitors - common ones

Answer 22

EtanerceptInfliximab, adalimumab

Question 23

TNF-alpha - AEs

Answer 23

increased risk of infectionreactivation of TB, especially (prevents macrophage activation)

Question 24

Etanercept - MOA

Answer 24

fusion protein (decoy receptor)

Question 25

Etanercept - clinical use

Answer 25

RA, psoriasis, ankylosing spondylitis

Question 26

Infliximab/adalimumab - MOA

Answer 26

anti-TNF-alpha monoclonal antibody

Question 27

Infliximab/adalimumab - clincal use

Answer 27

Crohn’s, RA, ankylosing spondylitis, psoriasis

Question 28

Other chronic gout drug and MOA

Answer 28

Probenecid - inhibits uric acid reabsorption at PCT