Aspirin Pharmacology Quiz
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Questions and Answers

What was one of the leading causes of accidental death in children before the introduction of child-resistant containers?

  • Fatal heart attacks
  • Chronic intoxication
  • Respiratory alkalosis
  • Salicylate overdose (correct)
  • What is the primary mechanism of toxicity of salicylates?

  • Hyperventilation leading to respiratory alkalosis (correct)
  • Analgesic effects
  • Anti-inflammatory effects
  • Inhibition of platelet aggregation
  • What is the blood concentration of salicylates in arthritis patients?

  • 600 mg/L
  • 100-300 mg/L (correct)
  • 10-30 mg/dL
  • 60 mg/dL
  • What is a indication of aspirin?

    <p>Anti-inflammatory, analgesic, antipyretic, and antiplatelet</p> Signup and view all the answers

    What year was aspirin distributed to doctors and became the number one drug worldwide?

    <p>1915</p> Signup and view all the answers

    What is the consequence of chronic intoxication of salicylates?

    <p>Acidosis and altered mental status</p> Signup and view all the answers

    What is the level of salicylates considered very dangerous?

    <p>600 mg/L</p> Signup and view all the answers

    What is the effect of hyperventilation caused by salicylate toxicity?

    <p>Respiratory alkalosis</p> Signup and view all the answers

    What is the consequence of salicylate overdose?

    <p>Accidental death in children</p> Signup and view all the answers

    In a patient with salicylate overdose, which of the following factors contributes to worsening toxicity?

    <p>Systemic acidemia</p> Signup and view all the answers

    Which of the following interventions is considered the most effective in rapidly reducing serum salicylate levels in a patient with salicylate overdose?

    <p>Dialysis</p> Signup and view all the answers

    A patient presents with a history of acute salicylate ingestion. The clinician decides to utilize a nomogram to estimate toxicity. What is the primary reason for this decision?

    <p>To guide the selection of the most effective treatment modality</p> Signup and view all the answers

    What characteristic arterial blood gas findings are typically observed in a patient with salicylate overdose?

    <p>Respiratory alkalosis and metabolic acidosis</p> Signup and view all the answers

    Which of the following is NOT a common symptom associated with overdose of most NSAIDs?

    <p>Severe respiratory distress</p> Signup and view all the answers

    Which of the following NSAIDs is NOT mentioned as causing seizures and coma in overdose?

    <p>Ibuprofen</p> Signup and view all the answers

    Which of the following is a potential complication of repeat-dose activated charcoal therapy in a patient with salicylate overdose?

    <p>Dehydration and electrolyte disturbances</p> Signup and view all the answers

    Which of the following statements accurately describes hemoperfusion in the context of salicylate overdose?

    <p>It is effective in removing salicylates but does not address fluid disturbances.</p> Signup and view all the answers

    Why is it important to obtain serial serum salicylate concentrations in a patient with salicylate overdose?

    <p>To assess the need for dialysis</p> Signup and view all the answers

    Which of the following NSAIDs is an alternative to morphine for nonsurgical procedures?

    <p>Ketorolac</p> Signup and view all the answers

    What is a potential use of vitamin K in relation to NSAID toxicity?

    <p>To enhance clotting in patients with hypoprothrombinemia</p> Signup and view all the answers

    What mechanism of action is primarily linked to the toxicity effects of NSAIDs?

    <p>Inhibition of cyclooxygenase</p> Signup and view all the answers

    In which situation would activated charcoal be administered?

    <p>For NSAID overdose if available</p> Signup and view all the answers

    Which of the following is NOT mentioned as a specific antacid used for gastrointestinal upset?

    <p>Omeprazole</p> Signup and view all the answers

    What is a common toxicity effect of NSAIDs on the body?

    <p>Hepatic dysfunction</p> Signup and view all the answers

    Which NSAID is classified under the fenamates?

    <p>Mefenamic acid</p> Signup and view all the answers

    What is the role of intravenous crystalloid solutions in the management of NSAID toxicity?

    <p>To replace fluid losses</p> Signup and view all the answers

    Which of the following statements about NSAID antidotes is true?

    <p>There is no specific antidote for most NSAID overdoses</p> Signup and view all the answers

    What is a significant effect of increased acid buildup in the body?

    <p>Dehydration due to metabolic acidosis</p> Signup and view all the answers

    Which laboratory test is critical for evaluating metabolic acidosis?

    <p>Arterial blood gases</p> Signup and view all the answers

    What treatment should be avoided if the serum pH falls below 7.4?

    <p>Intravenous sodium bicarbonate</p> Signup and view all the answers

    What condition is related to the alteration in capillary integrity during metabolic acidosis?

    <p>Cerebral edema</p> Signup and view all the answers

    Which of the following is NOT part of the emergency measures for treating metabolic acidosis?

    <p>Decrease blood glucose levels</p> Signup and view all the answers

    What acute intervention is necessary for patients exhibiting signs of pulmonary edema?

    <p>Provide supplemental oxygen</p> Signup and view all the answers

    What is the average therapeutic single dose of aspirin for adults?

    <p>325-650 mg</p> Signup and view all the answers

    What symptom is associated with altered platelet function during metabolic acidosis?

    <p>Prolonged prothrombin time</p> Signup and view all the answers

    What condition can be caused by prolonged acidosis and hypoventilation?

    <p>Cerebral hypoxia</p> Signup and view all the answers

    What is the primary treatment recommended for NSAID overdose in a hospital setting?

    <p>Activated charcoal with a cathartic</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly associated with NSAID overdose?

    <p>Hematochezia</p> Signup and view all the answers

    What is a significant limitation of hemodialysis in the treatment of NSAID overdose?

    <p>High protein binding and large volume of distribution</p> Signup and view all the answers

    What range of ingestion is considered a toxic dose of NSAIDs?

    <p>5-10 times the therapeutic dose</p> Signup and view all the answers

    What effect does chronic intoxication of NSAIDs have on the gastric mucosa?

    <p>Decreased gastric blood flow</p> Signup and view all the answers

    Which one of the following is a potential side effect of NSAID overdose?

    <p>Vomiting of blood</p> Signup and view all the answers

    Charcoal hemoperfusion is indicated specifically in the overdose of which NSAID?

    <p>Phenylbutazone</p> Signup and view all the answers

    Which of the following is generally the result of NSAID overdose?

    <p>Asymptomatic or mild gastrointestinal upset</p> Signup and view all the answers

    In the context of NSAID overdose treatment, what is the role of activated charcoal?

    <p>To adsorb the toxins present</p> Signup and view all the answers

    Study Notes

    Aspirin and Salicylates

    • Aspirin (acetylsalicylic acid) was developed in 1897 and became the most widely used drug by 1915.
    • Four main indications for aspirin: anti-inflammatory, analgesic, antipyretic, and antiplatelet (inhibits platelet aggregation).
    • Salicylate overdose was a leading cause of accidental death in children before child-resistant containers were introduced.

    Mechanism of Toxicity

    • Salicylates can cause multiple toxic effects:
      • Hyperventilation leads to respiratory alkalosis (increased blood pH) due to carbon dioxide loss.
      • Metabolic acidosis occurs with higher blood salicylate levels (>600 mg/L) and can alter mental status.
      • Chronic therapeutic concentrations in arthritis patients range from 100 to 300 mg/L.
      • Uncoupling of oxidative phosphorylation disrupts glucose and fatty acid metabolism.
      • Cerebral and pulmonary edema can develop due to capillary integrity alterations.

    Treatment Protocols

    • Emergency measures include maintaining airway and ventilation, administering supplemental oxygen, and monitoring arterial blood gases and chest x-rays for pulmonary edema.
    • Treat coma, seizures, pulmonary edema, and hyperthermia; administer intravenous sodium bicarbonate for metabolic acidosis.
    • Replace fluids and electrolytes lost to vomiting and hyperventilation with intravenous crystalloid solutions.
    • For acute ingestion, salicylate levels are plotted on a nomogram to estimate toxicity and treatment efficacy.
    • Repeat-dose activated charcoal therapy can reduce serum salicylate half-life.

    NSAIDs Overview

    • Nonsteroidal anti-inflammatory drugs (NSAIDs) include various agents for pain and inflammation control.
    • Common examples: ibuprofen, naproxen, ketorolac, mefenamic acid, and piroxicam.
    • Typical overdose effects are mild gastrointestinal upset, but serious outcomes like seizures and coma can occur.

    Mechanism of NSAID Toxicity

    • Toxicity commonly results from cyclooxygenase inhibition, affecting the CNS, hemodynamic, pulmonary, and hepatic systems.
    • Acute or chronic NSAID use can harm gastric mucosa and renal blood flow due to decreased prostaglandin synthesis.

    Clinical Signs of NSAID Overdose

    • Generally asymptomatic or present with mild gastrointestinal symptoms (nausea, vomiting, abdominal pain).
    • Severe cases may exhibit drowsiness, lethargy, ataxia, tinnitus, and disorientation.

    Treatment of NSAID Overdose

    • There is no specific antidote for NSAID overdoses; treatment focuses on symptom management.
    • Activated charcoal administration may be effective in both prehospital and hospital settings.
    • Enhanced elimination methods like hemodialysis are generally ineffective due to high protein binding and large volume distribution of NSAIDs.

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    Description

    Test your knowledge on the indications and history of aspirin, including its anti-inflammatory, analgesic, and antipyretic properties. Learn about its role in preventing fatal heart attacks and more.

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