Mod Ii Drug Stuff

Front 1

This selective COX-2 inhibitor probably has fewer GI side effects than
non-selective COX-1/COX-2 inhibitors:

ibuprofen
etodolac
indomethacin
ketorolac
piroxicam

Back 1

b. etodolac

Front 2

Actions of acetaminophen include all EXCEPT:

anti-pyretic
analgesic
anti-inflammatory
inhibition of COX-3 activity
hepatotoxicity

Back 2

c. anti-inflammatory

Front 3

All of the following are true concerning overdose of aspirin EXCEPT:

a. hyperventilation
b. first order elimination kinetics
c. one treatment is alkalinization of urine with bicarbonate
d. coma
e. fever

Back 3

b. first order elimination kinetics

Front 4

You are treating a 65 year old woman who has chronic mild joint and
muscle pain and stiffness but is otherwise healthy. She is living frugally
on a limited income. What drug would you suggest to treat her pain and
inflammation?

celecoxib
acetaminophen
ketorolac
piroxicam
ibuprofen

Back 4

ibuprofen

Front 5

This non-steroidal anti-inflammatory drug is an effective analgesic, but
has little or no anti-inflammatory activity:

aspirin
indomethacin
ibuprofen
acetaminophen

Back 5

acetaminophen

Front 6

Treatment for acetaminophen toxicity includes the use of the antidote:

a. analoxone
b. N-acetylcysteine
c. Buprenorphine
d. Ketoralac

Back 6

b. N-acetylcysteine

Front 7

(T/F) Salicylate poisoning results from a saturation of its major metabolic
pathways leading to an increased production of a toxic metabolite
by cytochrome P-450

Back 7

False

Front 8

Aspirin

produces analgesia mainly by a peripheral action, but it may have a central action as well.
Is more effective for treatment of mild to moderate pain than for treatment of severe pain
Has an analgesic activity that may be related to inhibition of prostaglandin synthesis
May cause GI bleeding when given in therapeutic doses
All of the above are correct

Back 8

d. All of the above are correct

Front 9

(T/F) Alkalinizing the urine is a primary means of protecting against the
toxicity of acetaminophen

Back 9

False

Front 10

Agents which are disease modifying in the treatment of Rheumatoid
arthritis (inflammatory arthritis) include all of the following EXCEPT:

a. Sulfasalazine
b. Methotrexate
c. cyclo-oxygenase inhibitors
d. TNF inhibitors
e. Gold salts

Back 10

c. cyclo-oxygenase inhibitors

Front 11

Your osteoarthritis patients have seen ads on television for two new
NSAIDS, pain-relieving drugs that have few GI side effects and are
asking you to prescribe them. One of these new drugs is metabolized by
cytosolic enzymes, with cytochrome P450 playing only a minor role while
the other drug is metabolized by cytochrome P450 enzymes. Which of
these two drugs will be better to give to a patient who is also taking
cimetidine (Give the name of the drug)

Back 11

vioxx –

Bextra uses P450 mainly, as does celebrex
Vioxx only uses P450 minimally.
Cimetidine uses P450, so you don’t want
to use another drug that also uses P450;
therefore vioxx is the best option

Front 12

Two worried parents bring in a 4 year old to the ER. She is feverish for
the past 2 days and they are giving her adult doses of acetaminophen
every 2 hours. The little girl is now vomiting and seems even more sick.
She was last given the drug about 2 hours before they arrived at the
hospital. What drug Tx should be initiated?

Back 12

NAC for overdose

Front 13

Acetaminophen may induce liver disease characterized as:

a. allergic reaction inducing cholestasis at a therapeutic dose
b. hepatitis when a therapeutic dose is ingested with beer
c. hypersensitivity reaction in asthmatic patients due to a normal
dose
d. necrosis due to ingestion of a large dose

Back 13

d. necrosis due to ingestion of a large dose

Front 14

NSAIDS have the following characteristics EXCEPT:

a. all NSAIDS relieve mild to moderate pain
b. all NSAIDS reduce inflammation
c. all NSAIDS reduce fever
d. all NSAIDS show cross-sensitivity

Back 14

b. all NSAIDS reduce inflammation

Front 15

Which NSAID prevents production of thromboxane by platelets?

a. Indomethacin
b. Aspirin
c. Acetaminophen
d. Methyl salicylate

Back 15

b. Aspirin

Front 16

Indomethacin is the drug of choice for:

a. closing the ductus arteriosus
b. suppressing polyp formation
c. suppressing uterine contractions in premature labor
d. inducing apoptosis in colorectal cancer
e. a and b
f. a and c
g. a, b and d

Back 16

f. a and c

Front 17

All of the following are true EXCEPT:

GI damage by NSAIDS is not prevented by antacids or H2 antagonists
Misoprostol may prevent GI damage when given along with NSAIDS
NSAIDS can precipitate acute renal failure
NSAIDS can produce mild, reversible, and dose dependent liver disorders except for aspirin
NSAIDS are not associated with teratogenicity

Back 17

d. NSAIDS can produce mild, reversible, and dose dependent
liver disorders except for aspirin

Front 18

Which one is NOT characteristic of aspirin

reversibly inhibits cyclooxygenase via acetylation of the enzyme
has a plasma half life of 15 minutes
is widely used as an analgesic, antipyretic and anti-inflammatory agent
used in the treatment of coronary heart disease
should be avoided during pregnancy

Back 18

a. reversibly inhibits cyclooxygenase via acetylation of the enzyme

Front 19

Which of the following are characteristic of diflunisal?

a. not converted to salicylic acid in vivo
b. more anti-inflammatory activity than aspirin
c. anti-pyretic exhibiting good CNS penetration
d. less GI irritation than aspirin
e. more antiplatelet effects than aspirin
f. effective analgesic agent
g. a, b, d, f are true

Back 19

g. a, b, d, f are true

Front 20

Aspirin have all of the following adverse reactions EXCEPT:

a. gastritis
b. a shortening of bleeding time
c. microvesicular fatty change in the liver
d. dizziness, nausea, and vomiting
e. metabolic derangements

Back 20

b. a shortening of bleeding time

Front 21

Osteoporosis is most reliably detected by:

serum calcium levels
serum phosphorus levels
alkaline phosphatase levels
plain radiographs
none of the above

Back 21

none of the above

Front 22

Aspirin causes decreased platelet aggregation by

inhibition of platelet cyclooxygenase
inhibition of formation of prostacyclin
increasing levels of thromboxane A2 in platelets
inhibiting the formation of cAMP in platelets
stimulation of adenlyl cyclase

Back 22

inhibition of platelet cyclooxygenase

Front 23

In platelets, aspirin

a. irreversibly inhibits cyclooxygenase
b. requires high doses to be effective
c. has duration of action of days compared to hours in other tissues
d. A and C
e. All of the above

Back 23

d. A and C

Front 24

Which drug should be used for short term treatment

Ketorolac
Piroxicam
Phenylbutazone
Mefenamate
Apazone

Back 24

a. Ketarolac

Front 25

(T/F) Aspirin is safe to use to treat children with chicken-pox and
influenza

Back 25

False

Front 26

(T/F) The use of aspirin should be avoided in patients with gout

Back 26

True

Front 27

(T/F) The rate limiting step of oral aspirin use is disintegration and
dissolution of the tablet

Back 27

true

Front 28

(T/F) Buffered preparations of aspirin increase gastric pH and increase
rate of tablet dissolution

Back 28

true

Front 29

(T/F) Low doses of aspirin follow first order elimination kinetics with a
salicylate half life of 2.5 hours

Back 29

true

Front 30

(T/F) Enteric coated preparation of aspirin do not effect absorption

Back 30

false