1- Choosing analgesic

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Questions and Answers

What is a significant reason why many people avoid seeking dental care?

  • Lack of awareness about dental hygiene
  • Fear of pain (correct)
  • Fear of needles
  • Lack of insurance

Which type of pain usually has identifiable tissue damage and a predictable endpoint?

  • Acute pain (correct)
  • Neuropathic pain
  • Somatic pain
  • Chronic pain

How long must pain be present in order to be classified as chronic pain?

  • Greater than 3 months duration (correct)
  • Greater than 2 years duration
  • Greater than 6 months duration
  • Greater than 1 year duration

What physiological arousal is not usually seen in chronic pain compared to acute pain?

<p>Increased pulse and respiratory rate (A)</p> Signup and view all the answers

According to the text, what is the most accurate and reliable indicator of the existence and intensity of pain?

<p>Patient's report (A)</p> Signup and view all the answers

What is one misconception mentioned in the text?

<p>Wait as long as possible before taking medication (B)</p> Signup and view all the answers

Which nociceptive process can pharmacologic control of pain be directed at, according to the text?

<p>Initiation of impulses (C)</p> Signup and view all the answers

Which of the following is considered one of the most important and useful nonopioid analgesics in dentistry?

<p>Acetaminophen (B)</p> Signup and view all the answers

Where do NSAIDs primarily act to prevent the synthesis and release of inflammatory mediators?

<p>At the peripheral nervous system (A)</p> Signup and view all the answers

What substance do aspirin-like drugs prevent platelet production of?

<p>Thromboxanes and Prostaglandins (B)</p> Signup and view all the answers

Which opioid analgesic is commonly used in dentistry?

<p>all of the above (D)</p> Signup and view all the answers

What is a potential indication for aspirin-like drugs?

<p>Reducing fever (D)</p> Signup and view all the answers

Which condition would be a contraindication for aspirin-like drugs?

<p>Gastric ulcers (C)</p> Signup and view all the answers

What is a potential side effect of aspirin-like drugs mentioned in the text?

<p>Nausea and vomiting (D)</p> Signup and view all the answers

For which medical condition might aspirin-like drugs be prescribed?

<p>Thromboembolic disorders (D)</p> Signup and view all the answers

What is the most significant association with Reye’s syndrome as mentioned in the text?

<p>Aspirin therapy (C)</p> Signup and view all the answers

When does Reye’s syndrome usually occur in infants and young children as per the text?

<p>During a respiratory viral infection (A)</p> Signup and view all the answers

What has consistently demonstrated to be more effective than placebo or codeine for post-extraction pain as per the text?

<p>650mg of aspirin (D)</p> Signup and view all the answers

What is the usual cause of acute encephalopathic symptoms and liver issues in infants and young children?

<p>Reye’s Syndrome (C)</p> Signup and view all the answers

What is the maximum daily dosage of ibuprofen for adults?

<p>3.2g (D)</p> Signup and view all the answers

What is the recommended dosage of ibuprofen for children aged 2-11 years?

<p>7.5mg/kg qid (D)</p> Signup and view all the answers

Which medication is most frequently recommended for treating acute pain after 3rd molar surgery?

<p>Ibuprofen (B)</p> Signup and view all the answers

What is the maximum daily dosage of Naproxen Sodium for adults as per the text?

<p>1375mg (B)</p> Signup and view all the answers

How often should an adult take Naproxen Sodium after the loading dose according to the text?

<p>q 6-8 h (A)</p> Signup and view all the answers

What is the half-life of Naproxen as mentioned in the text?

<p>3-3.5 hours (D)</p> Signup and view all the answers

In what way is Naproxen Sodium similar to ibuprofen in providing relief of acute clinical pain?

<p>Slower onset time (B)</p> Signup and view all the answers

What is the primary mechanism responsible for the gastrointestinal side effects of NSAIDs?

<p>Inhibition of prostaglandin responsible for protecting the gastric lining (D)</p> Signup and view all the answers

Which NSAID has an irreversible effect on platelet cyclooxygenases?

<p>Aspirin (C)</p> Signup and view all the answers

What is the most common side effect of NSAIDs according to the text?

<p>Dyspepsia (C)</p> Signup and view all the answers

Which prostaglandin-related effect is unique to aspirin among NSAIDs?

<p>Significantly prolongs bleeding (B)</p> Signup and view all the answers

What is the potential advantage of selective COX-2 inhibitors over other NSAIDs?

<p>Selective inhibition of COX-2 enzymes, sparing COX-1 constitutive enzymes associated with maintaining gastrointestinal health (B)</p> Signup and view all the answers

What is the result of the selective inhibition of COX-2 enzymes by selective COX-2 inhibitors?

<p>Limitation of gastrointestinal erosions, ulcers, and bleeding (A)</p> Signup and view all the answers

What adverse effect has been associated with rofecoxib and valdecoxib among selective COX-2 inhibitors?

<p>Increase in myocardial infarctions and strokes (B)</p> Signup and view all the answers

What is the recommended choice for managing acute pain during late pregnancy?

<p>APAP (D)</p> Signup and view all the answers

What potential risk is associated with the use of aspirin and NSAIDs in the third trimester of pregnancy?

<p>Pulmonary hypertension of the newborn (B)</p> Signup and view all the answers

What is a potential complication of using non-opioid analgesics late in pregnancy?

<p>Postpartum hemorrhage (A)</p> Signup and view all the answers

What is the mechanism through which aspirin and NSAIDs can affect labor?

<p>Inhibiting contractions (D)</p> Signup and view all the answers

Which medication is generally thought to be equipotent to aspirin but with fewer side effects, and has an unclear mechanism of action?

<p>Acetaminophen (Tylenol) (C)</p> Signup and view all the answers

What did the USFDA alert practitioners and consumers about regarding a specific medication?

<p>Acetaminophen (Tylenol) (A)</p> Signup and view all the answers

What has resulted in the voluntary reduction of the maximum daily dose recommendation of a specific medication from 4000 mg to 3000 mg?

<p>Acetaminophen (Tylenol) (B)</p> Signup and view all the answers

What is a known contraindication for APAP?

<p>Hypersensitivity (B)</p> Signup and view all the answers

What is the primary risk associated with the combination of NSAIDs and Alcohol?

<p>Gastrointestinal bleeding (D)</p> Signup and view all the answers

What is the maximum daily dosage of acetaminophen for adults according to the text?

<p>3 gm/day (A)</p> Signup and view all the answers

What is the recommended dosage of acetaminophen for children over 12 years old?

<p>325-650mg q4h (D)</p> Signup and view all the answers

What is a common side effect of centrally-acting analgesics mentioned in the text?

<p>Nausea and vomiting (C)</p> Signup and view all the answers

How do centrally-acting analgesics relieve pain, according to the text?

<p>By reducing the perception of pain in the CNS (A)</p> Signup and view all the answers

What is the first-pass effect of centrally-acting analgesics as mentioned in the text?

<p>Only a small fraction of the absorbed drug reaches the analgesic receptors in the brain (B)</p> Signup and view all the answers

What is a significant contraindication for the use of centrally-acting analgesics?

<p>Head injuries (A)</p> Signup and view all the answers

What physiological response is associated with increasing doses of centrally-acting analgesics?

<p>Increased noxious side effects (A)</p> Signup and view all the answers

What area in the central nervous system is considered important to the perception of pain?

<p>Medulla oblongata (D)</p> Signup and view all the answers

What is the primary difference between complete agonist and partial agonist-antagonist centrally-acting analgesics?

<p>The mechanism of action (B)</p> Signup and view all the answers

Which is a Partial Agonist-Antagonist opioid

<p>Pentazocine (Talwin) (B)</p> Signup and view all the answers

What is a significant difference between nonopioid analgesics and opioid analgesics?

<p>Non Opioid analgesics have a ceiling effect on their analgesic response (D)</p> Signup and view all the answers

What is the potential risk associated with taking more than the prescribed dose of an acetaminophen-containing product in a 24 hr period?

<p>Severe liver injury (D)</p> Signup and view all the answers

What is a common characteristic of combination analgesics with opioid and nonopioid components?

<p>The nonopioid component limits the dose of the opioid (A)</p> Signup and view all the answers

What is the primary rationale for selecting a full agonist with minimal first-pass metabolism in managing acute pain in dentistry?

<p>To improve the analgesic response (C)</p> Signup and view all the answers

What is a characteristic of long-acting local anesthetics used in perioperative pain management?

<p>They can delay the onset of post procedural pain (D)</p> Signup and view all the answers

What distinguishes Opioid Analgesics from Nonopioid Analgesics?

<p>Non Opioids have a ceiling effect on their analgesic response (C)</p> Signup and view all the answers

What is the FDA's recommendation regarding acetaminophen prescription combination drug products with more than 325 mg?

<p>To discontinue prescribing and dispensing them (A)</p> Signup and view all the answers

In which scenario have cases of severe liver injury with acetaminophen occurred, according to the FDA statement?

<p>When taken with alcohol (A)</p> Signup and view all the answers

What action does the FDA recommend for pharmacists who receive a prescription for a combination product with more than 325 mg of acetaminophen per dosage unit?

<p>Contact the prescriber to discuss a lower dose of acetaminophen (D)</p> Signup and view all the answers

What is the consequence of taking more than 325 mg of acetaminophen per dosage unit, according to the FDA statement?

<p>Added risk of severe liver injury from inadvertent overdose (A)</p> Signup and view all the answers

What is the recommended dosage of Ibuprofen for mild postoperative dental pain?

<p>200-400mg every 4-6 hours as needed (B)</p> Signup and view all the answers

What is the maximum daily dosage of Advil Dual Action for individuals aged 12 years and older?

<p>6 caplets in 24 hours (D)</p> Signup and view all the answers

Which combination of medications is recommended for severe postoperative dental pain after the initial fixed interval period?

<p>Ibuprofen (400-600mg) with Acetaminophen (650mg) with hydrocodone (10 mg) q 6hrs: Fixed interval for 24-48 hrs, then ibuprofen (400-600mg) with Acetaminophen (500 mg) q 6 hrs prn pain (C)</p> Signup and view all the answers

What is the primary action of Codeine in the CNS?

<p>Alters perception and emotional response to pain (C)</p> Signup and view all the answers

What drug interaction should be considered when prescribing Codeine?

<p>CNS depressants (B)</p> Signup and view all the answers

How often should acetaminophen be taken for mild pain or fever?

<p>Every 4 to 6 hours (B)</p> Signup and view all the answers

What is the maximum daily dose of acetaminophen recommended for adults?

<p>3 grams (B)</p> Signup and view all the answers

How does acetaminophen relieve fever?

<p>By central action in the hypothalamic heat regulating center (D)</p> Signup and view all the answers

What is the maximum daily dose of Motrin for adults?

<p>3.2 grams (D)</p> Signup and view all the answers

Which adverse reaction is associated with the respiratory system when taking Motrin?

<p>Bronchospasm (D)</p> Signup and view all the answers

Which medication interaction may decrease the effectiveness of antihypertensives?

<p>Motrin (D)</p> Signup and view all the answers

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