Indomethacin Uses and Contraindications
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Questions and Answers

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?

<p>It has no effect on platelets (C)</p> Signup and view all the answers

What is an advantage of paracetamol over other NSAIDs?

<p>It has no ADR on gastric mucosa (A)</p> Signup and view all the answers

What is the effect of aspirin on labour?

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

Why are NSAIDs avoided in late pregnancy?

<p>Due to their antiplatelet effects (C)</p> Signup and view all the answers

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

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

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

<p>Increased incidence of thrombo-embolism and MI (B)</p> Signup and view all the answers

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

<p>They are safer than non-selective NSAIDs in peptic ulcer diseases (C)</p> Signup and view all the answers

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

<p>They increase the risk of cardiovascular disease (A)</p> Signup and view all the answers

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

<p>Glucuronide and sulfate conjugation (C)</p> Signup and view all the answers

What is the highly reactive intermediate formed during paracetamol metabolism?

<p>N-acetyl-p-benzoquinoneimine (C)</p> Signup and view all the answers

What is the consequence of paracetamol poisoning in the liver?

<p>Centrilobular hepatic necrosis (C)</p> Signup and view all the answers

Why is paracetamol not effective at the site of inflammation?

<p>It does not act in the presence of peroxides formed at the site of inflammation (A)</p> Signup and view all the answers

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

<p>More than 10 gm (C)</p> Signup and view all the answers

What is the consequence of paracetamol poisoning in the kidneys?

<p>Renal tubular necrosis (A)</p> Signup and view all the answers

What is Indomethacin contraindicated in?

<p>Epileptics, psychiatric patients and drivers (D)</p> Signup and view all the answers

What is the route of administration for Indomethacin?

<p>Oral, parenteral, eye drops, and suppository (A)</p> Signup and view all the answers

What is Ketorolac used for?

<p>Short-term pain relief, especially post-operative pain (A)</p> Signup and view all the answers

What is a unique characteristic of Piroxicam and Tenoxicam?

<p>Long-acting due to enterohepatic cycling (D)</p> Signup and view all the answers

What is the mechanism of action of Mefenamic acid?

<p>Non-selective reversible inhibitor of COX (A)</p> Signup and view all the answers

What is Mefenamic acid used to treat in children?

<p>Fever not responding to paracetamol treatment (A)</p> Signup and view all the answers

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

<p>Covalent bonding occurs with hepatic and renal cellular proteins (A)</p> Signup and view all the answers

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

<p>To prevent further absorption of the poison (C)</p> Signup and view all the answers

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

<p>They replenish glutathione stores and conjugate the toxic metabolite (C)</p> Signup and view all the answers

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

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

Who are more susceptible to paracetamol poisoning?

<p>Heavy alcoholics and malnourished individuals (B)</p> Signup and view all the answers

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