NSAIDs, Acetaminophen And Drugs For Gout

Question 0

Aspirin dose <300mg/d is for?

Answer 0

Low: For platelet aggregation

Question 1

Antiplatelet drug
Contraindicated in pxs with Gout because it prevents uric acid excretion
Nonselective IRREVERSIBLE COX1/2 inhibitor
Drug for prevention of ARTERIAL thrombosis and for inflammatory disorders
Uncoupler of Oxidative Phosphorylation

Answer 1

Aspirin

Question 2

Aspirin dose 300-2400mg/d is for?

Answer 2

Intermediate: Antipyretic and analgesic effects

Question 3

Aspirin dose (2400-4000mg/d) is for?

Answer 3

High: Anti-inflammatory effects

Follows Zero Order Elimination (constant amount)

Question 4

Toxic and Lethal dose of ASA

Answer 4

Toxic: 150mg/kg
Lethal: 500mg/kg

Question 5

Tx for ASA Overdose (Weak acid)

Answer 5

Alkalinize Urine with HCO3
Supportive mgmt
Activated charcoal/gastric lavage

Question 6

Non-selective REVERSIBLE COX1/2 inhibitor
Inhibits Prostaglandin synthesis
Drug for analgesia
SE: GI bleeding (less than ASA)
Long term use reduces risk for Colon CA

Drug, Class

Answer 6

Ibuprofen, NSAID nonselective

Marami pang iba

Question 7

Non-selective REVERSIBLE COX1/2 inhibitor
Inhibits Prostaglandin synthesis
Drug for POST-SURGICAL analgesia
SE: high risk for GI toxicity and nephrotoxicity
Only IV NSAID

Drug

Answer 7

Ketorolac, NSAID nonselective

Restrict use to 72 hours only

Question 8

Non-selective REVERSIBLE COX1/2 inhibitor
Inhibits Prostaglandin synthesis
Drug for closure of PDA
SE: serious hematologic reactions

Drug, Class

Answer 8

Indomethacin, NSAID nonselective

Question 9

Selective COX2 inhibitor, inhibits prostaglandin synthesis
Drug for analgesia, anti-inflammatory
SE: reduced risk for GI bleeding

Drug

Answer 9

Celecoxib

Etoricoxib, Parecoxib, Rofecoxib, Valdecoxib

Question 10

COX3 inhibitor, weak COX1 and COX2 inhibitor
Drug for analgesia, antipyretic
SE: hepatotoxicity (inc with alcohol overdose)
Preferred antipyretic in children, does not cause Reye Syndrome

Drug

Answer 10

Paracetamol

Acetaminophen, Phenacetin

Question 11

Antidote for Paracetamol toxicity

Answer 11

N-acetylcysteine (sulfhydryl donor)

May do supportive management with gastric decontamination

Question 12

Identify the Stage of Paracetamol Overdose:

Nausea/vomiting

Answer 12

Stage I: up to 24 hours

Question 13

Identify the Stage of Paracetamol Overdose:

Hepatotoxicity

Answer 13

Stage II: 24-72 hours

Question 14

Identify the Stage of Paracetamol Overdose:

ATN, HAGMA

Answer 14

Stage III: 72-96 hours

Question 15

Identify the Stage of Paracetamol Overdose:

Recovery

Answer 15

Stage IV: 4 days to 2 weeks

Question 16

Paracetamol:
Toxic Dose:________
Lethal Dose:________

Answer 16

Toxic: 150mg/kg (same as ASA)
Lethal: 15g

Question 17

Inhibits AICAR transformylase
DMARD of choice for RA, chemotherapy
SE: mucosal ulcers, pseudolymphomatous reaction

Drug

Answer 17

Methotrexate

Question 18

Rescue agent for MTX toxicity

Answer 18

Leucovorin (Folinic acid)

Question 19

Binds to TNF-alpha to prevent binding
DMARD for Crohn’s disease
SE: bacterial infections, reactivation of latent TB, lymphoma
Synergistic with MTX

Drug

Answer 19

Infliximab

Adalimumab, Etanercept

Question 20

Forms 6-thioguanine
DMARD for RA
SE: bone marrow suppression, increased incidence of lymphoma
Cannot give with Allopurinol

Drug

Answer 20

Azarhioprine

Question 21

Suppresses T-lymphocyte response to mitogens
DMARD for RA and malaria
SE: ocular toxicity

Drug

Answer 21

Chloroquine
(Hydroxychloroquine)

Safe in pregnant

Question 22

Forms Phosphoramide mustard, crosslinking DNA to prevent replication
DMARD for RA, chemotherapy
SE: hemorrhagic cystitis

Drug

Answer 22

Cyclophosphamide

Question 23

Inhibits IL1 and IL2 receptor production
DMARD for RA, tissue transplantation
SE: nephrotoxicity, gingival hyperplasia, hirsutism

Drug

Answer 23

Cyclosporine

Question 24

Inhibits Inosine monophosphate dehydrogenase (impt in guanine nucleotide synthesis) Inhibits T lymphocyte proliferation Drug for SLE nephritis, RA SE: reversible myelosuppression (neutropenia) Drug

Answer 24

Mycophenolate Mofetil

Question 25

Inhibits inflammatory cytokines DMARD for RA, inflammatory bowel disease SE: hemolytic anemia, methemoglobinemia, reversible infertility in men Drug

Answer 25

Sulfasalazine

Question 26

Inhibits microtubule assembly Drug for gout, Familial Mediterranean Fever SE: diarrhea, hepatic necrosis, ARF, agranulocytosis Drug

Answer 26

Colchicine

Question 27

NSAID used as initial treatment of gout as Colchicine replacement

Answer 27

Indomethacin

Question 28

Competes with Uric Acid for reabsorption in the proximal tubules Drug for gout SI: GI irritation, aplastic anemia May precipitate acute gout during early phase and inhibits secretion of other weak acids Drug?

Answer 28

Probenecid | Sulfinpyrazone

Question 29

Irreversible Xanthine Oxidase inhibitor First line tx for Gout, tumor lysis syndrome SI: cataracts Witheld 1-2 wks after acute gouty arthritis Inh metabolism of mercaptopurine and azathioprine Drug?

Answer 29

Allopurinol

Question 30

Reversible xanthine oxidase inhibitor More selective Drug for chronic gout, tumor lysis syndrome Witheld for 1-2 weeks after acute gouty arthritis Drug?

Answer 30

Febuxostat