Pharm - Non- Narcotics

Question 1

What is the MOA of NSAID’s?

Answer 1

Inhibition of cyclo-oxygenase (COX) → inhibition of prostaglandin synthesis

Question 2

Which enzyme is inducible enzyme; induced by cytokines & endotoxins in inflammation?

Answer 2

Cycolo-oxygenase 2 ( COX-2)

Question 3

Where can COX -2 enzymes be found?

Answer 3

In macrophages, endothelial cells, fibroblasts, Leukocytes

Question 4

Where can COX-1 enzymes be found?

Answer 4

Intestines
Stomach
Platelets
Kidneys

Question 5

What are the classification of NSAIDS?

Answer 5

• Non-selective COX Inhibitors
• Selective COX-2 Inhibitors

Question 6

What are examples of Selective COX-2 inhibitors?

Answer 6

Celecoxib (Celebrex)
Etoricoxib (Arcoxia)

Question 7

What are examples of the Non - Selective COX inhibitors?

Answer 7

SALICYLATES: Aspirin (acetylsalicylic acid), sodium salicylate, diflunisal

ACETIC ACID DERIVATIVES: Indomethacin, diclofenac, aceclofenac

FENAMATES: Mefenamic acid, meclofenamate

PROPIONIC ACID DERIVATIVES: Ibuprofen, dexketoprofen, ketoprofen, fIurbiprofen, naproxen, oxaprozin

OXICAMS: Piroxicam, tenoxicam, meloxicam, lornoxicam

Question 8

What are the examples of Acetic acid derivatives?

Answer 8

Indomethacin
Diclofenac
Aceclofenac

Question 9

What are examples of Salicylic acid derivatives?

Answer 9

• Aspirin (acetylsalicylic acid), *Sodium salicylate
  *Diflunisal

Question 10

Fill in the blanks. “Mefenamic acid & meclofenamate are examples of _________.”

Answer 10

Fenamates

Question 11

What are examples of Propionic acid derivatives?

Answer 11

• Ibuprofen
  *Dexketoprofen
• Ketoprofen
• FIurbiprofen
  *Naproxen
  *Oxaprozin

Question 12

What are examples of Oxicams?

Answer 12

• Piroxicam
• Tenoxicam
• Meloxicam
• Lornoxicam

Question 13

What are the Main pharmacological actions of NSAIDS?

Answer 13

• Analgesic effects
• Anti-inflammatory effects
• Antipyretic effects
• Anti-platelet activity

Question 14

Fill in the blanks.” ____ & _______ mediate Vasodilation leading to oedema.”

Answer 14

PGE2 & PGI2

Question 15

True or False? NSAIDs also inhibit migration of leukocytes & macrophages to site of inflammation.

Answer 15

TRUE!!

Question 16

Which compound is responsible for platelet aggregation?

Answer 16

Thromboxane A2 ( TXA2)

Question 17

Which drug irreversible inhibits platelet aggregation?

Answer 17

Aspirin

Question 18

True or False? COX-2 inhibitors also have anti-platelet activity.

Answer 18

FALSE!! COX 2 inhibitors DO NOT have any antiplatelet activity

Question 19

What is the lifespan of Aspirin anti-platelet activity?

Answer 19

7-10 days

Question 20

Which drug can be used to ↑ ionization & elimination of salicylic acid in aspirin overdose?

Answer 20

Sodium bicarbonate

Question 21

What are the adverse effects of Aspirin?

Answer 21

• GI effects: N,V, gastric bleeding, ulceration
• Hypersensitivity reactions (bronchospasm, rash, rhinitis)
• Prolonged bleeding time
• Reye’s Syndrome (↑ risk in children with viral infection leading to severe hepatic injury & encephalopathy)

Question 22

Which drug is an additional mechanism of antagonizing PG receptors (especially in uterus) &
May reduce blood loss in menorrhagia?

Answer 22

Fenamates- Mefenamic acid

Question 23

Which NSAID can cause closure of ductus arteriosus in premature infants ?

Answer 23

Indomethacin

Question 24

What is the MOA for Selective COX-2 inhibitors?

Answer 24

Selective reversible inhibitor of COX 2, blocking arachidonic acid → PGG 2 & subsequent production of prostaglandins & thromboxanes

Question 25

True or False? COX 2 inhibitors lack any antiplatelet activity .

Answer 25

TRUE!!

Question 26

Which NSAID should be avoided in patients with a sulpha allergy?

Answer 26

Celecoxib

Question 27

True or False? Acetaminophen should not be classified as an NSAID as it is not an anti-inflammatory agent.

Answer 27

TRUE!!!

Question 28

How does Acetaminophen differ from NSAIDS?

Answer 28

Acetaminophen differs from NSAIDs in that it does not possess significant anti-platelet activity.

Question 29

What is the Antidote for Acetaminophen toxicity?

Answer 29

Acetylcysteine (provides sulfhydryl group to inactivate toxic metabolite)