NSAID

Question 1

What is the definition of pain?

Answer 1

An unpleasant sensation due to actual or potential tissue damage. Pain is both sensory and emotional, influenced by physiological and psychological factors.

Question 2

What are the four main effects of NSAIDs?

Answer 2

Anti-inflammatory, antipyretic, analgesic, and anti-platelet effects.

Question 3

How are NSAIDs classified based on their chemical structure?

Answer 3

Salicylates (e.g., aspirin), acetic acid derivatives (e.g., diclofenac), propionic acid derivatives (e.g., ibuprofen), enolic acids (e.g., piroxicam), and others (e.g., celecoxib).

Question 4

What is the mechanism of action of NSAIDs?

Answer 4

NSAIDs inhibit cyclo-oxygenase (COX) enzymes, blocking prostaglandin synthesis.

Question 5

What are the two isoforms of COX enzymes?

Answer 5

COX-1 (housekeeping enzyme) and COX-2 (inducible in inflammation).

Question 6

What are the housekeeping roles of prostaglandins?

Answer 6

Protect gastric mucosa, maintain renal blood flow, and inhibit gastric acid synthesis.

Question 7

What are the pharmacokinetics of NSAIDs?

Answer 7

Absorbed in the GI tract, metabolized in the liver, and excreted by the kidneys.

Question 8

What factors should be considered when choosing an NSAID?

Answer 8

Age, safety, efficacy, tolerance, formulation, convenience, and cost.

Question 9

What are common side effects of NSAIDs?

Answer 9

GI issues (e.g., dyspepsia, ulcers), renal toxicity, cardiovascular risks, and hepatotoxicity.

Question 10

What are risk factors for NSAID-induced GI toxicity?

Answer 10

Age >60 years, alcohol use, smoking, H. pylori infection, multiple NSAIDs, prednisolone use, and history of GI issues.

Question 11

What are risk factors for NSAID-induced renal toxicity?

Answer 11

Advanced age, hypertension, diabetes, dehydration, and pre-existing renal disease.

Question 12

What are analgesics derived from para-aminophenol?

Answer 12

Phenacetin and acetaminophen (paracetamol).

Question 13

What are the effects of acetaminophen?

Answer 13

Analgesic and antipyretic effects. It lacks anti-inflammatory and anti-platelet functions.

Question 14

What are the pharmacokinetics of acetaminophen?

Answer 14

Rapid GI absorption, liver metabolism, and renal excretion.

Question 15

What is the recommended dose of acetaminophen?

Answer 15

500–1000 mg orally daily (maximum 2 g daily); parenteral dose: 300 mg intramuscularly or intravenously.

Question 16

What are common uses of acetaminophen?

Answer 16

Antipyretic, musculoskeletal pain, general aches, and mild osteoarthritis.

Question 17

What is the maximum safe dose of acetaminophen per day?

Answer 17

4 grams; exceeding this can cause fulminant hepatic failure.

Question 18

What are common drug interactions of acetaminophen?

Answer 18

Increased liver toxicity with alcohol or drugs like phenytoin; reduced effects of diuretics and zidovudine.

Question 19

What are complications of NSAID use in the cardiovascular system?

Answer 19

Hypertension, fluid retention, exacerbation of heart failure, and increased stroke risk.

Question 20

What is the importance of NSAID classification?

Answer 20

NSAIDs within the same class have similar actions, efficacy, and side effect profiles.