Indomethacin Uses and Contraindications

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What is the primary mechanism of analgesia of paracetamol?

Activation of descending serotonergic pathways (correct)

Stimulation of cannabinoid receptors

Inhibition of COX-2 in peripheral tissues

Inhibition of COX-1 in the CNS

What is a common side effect of paracetamol?

Bleeding disorders

Reye's syndrome

Skin rash (correct)

Gastric ulcer

What is the maximum daily dose of paracetamol?

3g

5g

4g (correct)

2g

Why is paracetamol safe in patients with bleeding disorders?

It has no effect on platelets Signup and view all the answers

What is an advantage of paracetamol over other NSAIDs?

It has no ADR on gastric mucosa Signup and view all the answers

What is the effect of aspirin on labour?

Delayed labour Signup and view all the answers

Why are NSAIDs avoided in late pregnancy?

Due to their antiplatelet effects Signup and view all the answers

What is the analgesic action of selective COX-2 inhibitors?

Weak Signup and view all the answers

What is a side effect of selective COX-2 inhibitors?

Increased incidence of thrombo-embolism and MI Signup and view all the answers

Why are selective COX-2 inhibitors preferred for elderly patients with osteoarthritis?

They are safer than non-selective NSAIDs in peptic ulcer diseases Signup and view all the answers

Why are selective COX-2 inhibitors contraindicated in patients with cardiovascular disease?

They increase the risk of cardiovascular disease Signup and view all the answers

What is the primary mechanism by which paracetamol is metabolized in the liver?

Glucuronide and sulfate conjugation Signup and view all the answers

What is the highly reactive intermediate formed during paracetamol metabolism?

N-acetyl-p-benzoquinoneimine Signup and view all the answers

What is the consequence of paracetamol poisoning in the liver?

Centrilobular hepatic necrosis Signup and view all the answers

Why is paracetamol not effective at the site of inflammation?

It does not act in the presence of peroxides formed at the site of inflammation Signup and view all the answers

What is the typical dose of paracetamol that can lead to poisoning?

More than 10 gm Signup and view all the answers

What is the consequence of paracetamol poisoning in the kidneys?

Renal tubular necrosis Signup and view all the answers

What is Indomethacin contraindicated in?

Epileptics, psychiatric patients and drivers Signup and view all the answers

What is the route of administration for Indomethacin?

Oral, parenteral, eye drops, and suppository Signup and view all the answers

What is Ketorolac used for?

Short-term pain relief, especially post-operative pain Signup and view all the answers

What is a unique characteristic of Piroxicam and Tenoxicam?

Long-acting due to enterohepatic cycling Signup and view all the answers

What is the mechanism of action of Mefenamic acid?

Non-selective reversible inhibitor of COX Signup and view all the answers

What is Mefenamic acid used to treat in children?

Fever not responding to paracetamol treatment Signup and view all the answers

What happens when the amount of paracetamol metabolite exceeds the available glutathione?

Covalent bonding occurs with hepatic and renal cellular proteins Signup and view all the answers

Why is it important to start treatment of paracetamol poisoning early?

To prevent further absorption of the poison Signup and view all the answers

What is the role of N-acetyl cysteine and oral methionine in treating paracetamol poisoning?

They replenish glutathione stores and conjugate the toxic metabolite Signup and view all the answers

What group is present in glutathione, N-acetyl cysteine, and oral methionine?

SH group Signup and view all the answers

Who are more susceptible to paracetamol poisoning?

Heavy alcoholics and malnourished individuals Signup and view all the answers