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?

Anti-inflammatory, analgesic, antipyretic, and antiplatelet (D) Signup and view all the answers

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

1915 (C) Signup and view all the answers

What is the consequence of chronic intoxication of salicylates?

Acidosis and altered mental status (A) Signup and view all the answers

What is the level of salicylates considered very dangerous?

600 mg/L (A) Signup and view all the answers

What is the effect of hyperventilation caused by salicylate toxicity?

Respiratory alkalosis (D) Signup and view all the answers

What is the consequence of salicylate overdose?

Accidental death in children (A) Signup and view all the answers

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

Systemic acidemia (A) 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?

Dialysis (A) 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?

To guide the selection of the most effective treatment modality (A) Signup and view all the answers

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

Respiratory alkalosis and metabolic acidosis (A) Signup and view all the answers

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

Severe respiratory distress (B) Signup and view all the answers

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

Ibuprofen (B) 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?

Dehydration and electrolyte disturbances (D) Signup and view all the answers

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

It is effective in removing salicylates but does not address fluid disturbances. (D) Signup and view all the answers

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

To assess the need for dialysis (B) Signup and view all the answers

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

Ketorolac (B) Signup and view all the answers

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

To enhance clotting in patients with hypoprothrombinemia (D) Signup and view all the answers

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

Inhibition of cyclooxygenase (B) Signup and view all the answers

In which situation would activated charcoal be administered?

For NSAID overdose if available (B) Signup and view all the answers

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

Omeprazole (D) Signup and view all the answers

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

Hepatic dysfunction (B) Signup and view all the answers

Which NSAID is classified under the fenamates?

Mefenamic acid (B) Signup and view all the answers

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

To replace fluid losses (A) Signup and view all the answers

Which of the following statements about NSAID antidotes is true?

There is no specific antidote for most NSAID overdoses (A) Signup and view all the answers

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

Dehydration due to metabolic acidosis (D) Signup and view all the answers

Which laboratory test is critical for evaluating metabolic acidosis?

Arterial blood gases (D) Signup and view all the answers

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

Intravenous sodium bicarbonate (B) Signup and view all the answers

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

Cerebral edema (A) Signup and view all the answers

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

Decrease blood glucose levels (A) Signup and view all the answers

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

Provide supplemental oxygen (C) Signup and view all the answers

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

325-650 mg (C) Signup and view all the answers

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

Prolonged prothrombin time (B) Signup and view all the answers

What condition can be caused by prolonged acidosis and hypoventilation?

Cerebral hypoxia (C) Signup and view all the answers

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

Activated charcoal with a cathartic (D) Signup and view all the answers

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

Hematochezia (B) Signup and view all the answers

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

High protein binding and large volume of distribution (B) Signup and view all the answers

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

5-10 times the therapeutic dose (B) Signup and view all the answers

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

Decreased gastric blood flow (C) Signup and view all the answers

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

Vomiting of blood (A) Signup and view all the answers

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

Phenylbutazone (D) Signup and view all the answers

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

Asymptomatic or mild gastrointestinal upset (D) Signup and view all the answers

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

To adsorb the toxins present (B) 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.