50 Questions
Which of the following is a characteristic of non-steroidal anti-inflammatory drugs (NSAIDs)?
They provide weaker anti-inflammatory effects compared to glucocorticoids.
What is the main purpose of using narcotics over NSAIDs?
To manage severe pain such as colic, fracture, and infarction.
What distinguishes the analgesic effects of NSAIDs from narcotics?
NSAIDs induce analgesia without causing numbness and loss of consciousness.
Which of the following is not a characteristic of inflammation?
Numbness and loss of consciousness
Which NSAID selectively inhibits COX-1 and irreversibly inhibits both COXs at analgesic doses?
Acetylsalicylic acid
Which NSAID is absorbed from the stomach and metabolized in the liver, showing dose-dependent kinetics?
Aspirin
Which NSAID is used in intestine-coated tablets and has delayed absorption?
Sodium salicylate
Which NSAID is a difluorophenyl derivative of salicylic acid with equal activity to aspirin?
Diflunisal
Which gastrointestinal side effects can NSAIDs cause?
Irritation, bleeding, and ulcers
Which medications can help mitigate gastrointestinal side effects of NSAIDs?
Proton pump inhibitors and H2 receptor antagonists
Which NSAID can prolong bleeding time and cause liver and kidney effects?
Aspirin
Which condition can NSAIDs exacerbate?
Hypertension and congestive heart failure
Which type of cells do NSAIDs easily enter and concentrate in?
Acidic cells
Which NSAID is the most widely used and inexpensive analgesic?
Acetylsalicylic acid
Which NSAID is classified as a COX-2 inhibitor?
Celecoxib
Which NSAID is not a salicylate?
Ibuprofen
What is the primary mechanism of the analgesic effect of NSAIDs?
Inhibition of prostaglandin synthesis
What is the purpose of pain treatment?
To produce the strongest analgesic effect with the fewest side effects
Which type of COX enzyme is responsible for pro-inflammatory prostaglandins?
COX-2
What are the prerequisites for the use of analgesics?
Understanding the drug's mechanism of action, side effects, drug interactions, and detailed knowledge of doses
What should an ideal analgesic not be?
Tolerant or addictive
What do antipyretics reduce fever due to?
Reduction in the synthesis of prostaglandins
In which situations does fever need to be reduced?
Elderly people with coronary insufficiency
What can cause fever?
Phenothiazine
What are the mechanisms of anti-inflammatory action of NSAIDs?
Cyclooxygenase inhibition, reduction in the synthesis of cytokines and active oxygen radicals
What physicochemical properties increase anti-inflammatory activity?
Weak acidity of both analgesics and their metabolites
Which drug from the profens group is known for causing cystitis as a side effect?
Tiaprofenic acid
What is the primary reason for the prohibition of Ketorolac tromethamine?
Acute kidney failure
Which drug is known to have little interaction with antihypertensive medications?
Sulindac
Which drug is most selective for COX-2 at low doses, potentially reducing upper GI adverse events?
Etodolac
Which medication from the profens group is most commonly used and has antipyretic, analgesic, and anti-inflammatory properties?
Ibuprofen
For which conditions is Indomethacin primarily used?
Ankylosing spondylitis, osteoarthritis, and rheumatoid arthritis
What distinguishes Naproxen within the profens group?
Longest duration of action
Which drug is administered via the intramuscular route and is effective against rheumatoid arthritis and osteoarthritis?
Diclofenac sodium
Which of the following oxicams is known for being long-acting?
All of the above
Which side effects are rare but possible with the use of Flurbiprofen?
Rigidity, ataxia, tremor, and myoclonus
Which drug inhibits cyclooxygenase and has effects similar to those of indomethacin?
Ketoprofen
Which drug from the profens group is not recommended for use due to serious side effects?
Ketorolac tromethamine
Which drug from the profens group is known for causing cystitis as a side effect?
Tiaprofenic acid
What is the primary reason for the prohibition of Ketorolac tromethamine?
Acute kidney failure
Which drug is known to have little interaction with antihypertensive medications?
Sulindac
Which drug is most selective for COX-2 at low doses, potentially reducing upper GI adverse events?
Etodolac
Which medication from the profens group is most commonly used and has antipyretic, analgesic, and anti-inflammatory properties?
Ibuprofen
For which conditions is Indomethacin primarily used?
Ankylosing spondylitis, osteoarthritis, and rheumatoid arthritis
What distinguishes Naproxen within the profens group?
Longest duration of action
Which drug is administered via the intramuscular route and is effective against rheumatoid arthritis and osteoarthritis?
Diclofenac sodium
Which of the following oxicams is known for being long-acting?
All of the above
Which side effects are rare but possible with the use of Flurbiprofen?
Rigidity, ataxia, tremor, and myoclonus
Which drug inhibits cyclooxygenase and has effects similar to those of indomethacin?
Ketoprofen
Which drug from the profens group is not recommended for use due to serious side effects?
Ketorolac tromethamine
Study Notes
Analgesics and Antipyretics Summary
- NSAIDs are preferred in minor musculoskeletal trauma, soft tissue inflammation, superficial surgical intervention, minor gynecological procedures, acute pain of mild to moderate severity, ureteral colic, and dysmenorrhea.
- There are two types of pain mediators: algesic mediators and hyperalgesic pain mediators, which increase the sensitivity of nerve endings to algesic agents.
- The analgesic effect of NSAIDs is largely due to their peripheral effects, reducing the synthesis of prostaglandins and preventing pain through anti-inflammatory action.
- COX enzyme types include COX-1, which has a protective function, COX-2, responsible for pro-inflammatory prostaglandins, and COX-3 present in the central nervous system.
- Prerequisites for the use of analgesics include understanding the drug's mechanism of action, side effects, drug interactions, and detailed knowledge of doses.
- The purpose of pain treatment is to produce the strongest analgesic effect with the fewest side effects, optimal dose, and easiest application.
- An ideal analgesic should be effective when used orally, have a sufficient analgesic effect, not be tolerant or addictive, have a specific effect in the central nervous system, and have an antidote.
- Antipyretics reduce fever due to infection and inflammation by reducing the synthesis of prostaglandins and increasing heat loss by vasodilation.
- Situations in which fever needs to be reduced include elderly people with coronary insufficiency, pregnant women, young children with convulsions, and hyperthermia.
- Medicines that can cause fever include phenothiazine, anticholinergic drugs, and cocaine use, while malignant hyperthermia is characterized by hypermetabolism and muscle rigidity.
- The mechanisms of anti-inflammatory action of NSAIDs include cyclooxygenase inhibition, reduction in the synthesis of cytokines and active oxygen radicals, and stabilization of lysosome membrane.
- Physicochemical properties that increase anti-inflammatory activity include weak acidity of both analgesics and their metabolites.
Summary of Analgesic Drug Groups
- Profens (phenylpropionic acid derivatives) are a commonly used analgesic drug group after aspirin and paracetamol.
- Ibuprofen is the most used drug in the profens group, with antipyretic, analgesic, and anti-inflammatory properties.
- Naproxen, with the longest duration of action, is used for rheumatoid arthritis, osteoarthritis, and mild to moderate pain.
- Ketoprofen inhibits cyclooxygenase and has analgesic, antipyretic, and anti-inflammatory effects, similar to indomethacin.
- Flurbiprofen, a profen drug, may cause rigidity, ataxia, tremor, and myoclonus as rare side effects.
- Tiaprofenic acid is used for osteoarthritis, rheumatoid arthritis, and soft tissue inflammation, but can cause cystitis.
- Diclofenac sodium is administered via the intramuscular route and has been found effective against rheumatoid arthritis and osteoarthritis.
- Indomethacin is used for its anti-inflammatory effect and in conditions like ankylosing spondylitis, osteoarthritis, and rheumatoid arthritis.
- Ketorolac tromethamine is now prohibited due to causing GI bleeding, acute kidney failure, and anaphylactic shock.
- Sulindac, a prodrug, converts to a sulfur derivative in the liver and has little interaction with antihypertensive drugs.
- Etodolac is selective for COX-2 at low doses and causes fewer upper GI adverse events in clinical trials.
- Oxicams and others like piroxicam, tenoxicam, and meloxicam are long-acting analgesics with specific uses and characteristics.
Test your knowledge of analgesics and antipyretics with this summary quiz. Explore the mechanisms of action, drug groups, and specific uses of various analgesic medications, including NSAIDs and profens. Assess your understanding of pain treatment and fever reduction, as well as the physiological and chemical properties that influence anti-inflammatory activity.
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