Anti-inflammatory drugs

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Questions and Answers

What is the main mechanism by which NSAIDs lower body temperature in patients with fever?

  • Impeding PGE2 synthesis and release (correct)
  • Increasing PGE2 synthesis
  • Enhancing lipoxin production
  • Decreasing leukotriene formation

What is the primary therapeutic effect of NSAIDs?

  • Lowering body temperature
  • Increasing pain perception
  • Reducing inflammation and pain (correct)
  • Promoting inflammatory response

What is the main difference between the effects of NSAIDs on febrile patients and those with normal body temperature?

  • NSAIDs have no effect on normal body temperature (correct)
  • NSAIDs decrease body temperature in normal patients
  • NSAIDs cause sweating only in normal patients
  • NSAIDs increase body temperature in normal patients

What is the key factor that leads to the analgesic activity of salicylates?

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

In what conditions are NSAIDs commonly used for pain relief?

<p>Osteoarthritis and gout (A)</p> Signup and view all the answers

What is the role of lipoxygenases in the arachidonic acid pathway?

<p>Forming leukotrienes and lipoxins depending on the tissue (D)</p> Signup and view all the answers

Which enzyme is responsible for the physiologic production of prostanoids?

<p>Cyclooxygenase-1 (COX-1) (A)</p> Signup and view all the answers

Where is Cyclooxygenase-2 (COX-2) constitutively expressed in the body?

<p>Brain, kidney, and bone (B)</p> Signup and view all the answers

Which pathway forms leukotrienes or lipoxins from arachidonic acid?

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

What are the functions of prostaglandins in the body related to?

<p>Gastrointestinal tract regulation (C)</p> Signup and view all the answers

In what situations is Cyclooxygenase-2 (COX-2) expression increased?

<p>At sites of disease and inflammation (B)</p> Signup and view all the answers

How do small amounts of prostaglandins injected mimic components of inflammation?

<p>By mimicking processes involved in inflammation (B)</p> Signup and view all the answers

What is the recommended way to take NSAIDs to reduce gastrointestinal (GI) upset?

<p>Take with food or fluids (C)</p> Signup and view all the answers

How can NSAID-induced ulcers be prevented in patients at high risk of GI events?

<p>Using proton pump inhibitors or misoprostol (C)</p> Signup and view all the answers

What effect does aspirin have on platelet aggregation?

<p>Reduces platelet aggregation (C)</p> Signup and view all the answers

Why is aspirin often withheld prior to surgery?

<p>To prevent prolongation of bleeding time (C)</p> Signup and view all the answers

What is the main renal effect of NSAIDs?

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

What is the recommendation for patients taking aspirin for cardioprotection regarding concomitant NSAID use?

<p>Avoid concomitant NSAID use if possible or take aspirin at least 30 minutes prior to NSAID (D)</p> Signup and view all the answers

What is the recommended dosage of aspirin for prophylactic use to reduce the risk of cardiovascular events?

<p>75 to 162 mg (D)</p> Signup and view all the answers

Why should aspirin be avoided in patients less than 19 years old with viral infections such as varicella or influenza?

<p>To prevent Reye syndrome (C)</p> Signup and view all the answers

How does aspirin affect platelet aggregation and vasoconstriction?

<p>Reduces platelet aggregation and vasoconstriction (D)</p> Signup and view all the answers

What is the purpose of chronic use of aspirin in terms of platelet inhibition?

<p>To allow for continued inhibition as new platelets are generated (D)</p> Signup and view all the answers

What effects do low doses of aspirin have on transient ischemic attacks (TIAs) and stroke?

<p>Reduce the risk of TIAs and stroke (D)</p> Signup and view all the answers

What is the primary reason for using aspirin acutely in the context of an acute MI?

<p>To reduce the risk of death (B)</p> Signup and view all the answers

What is a consequence of decreased synthesis of prostaglandins?

<p>Retention of sodium and water (C)</p> Signup and view all the answers

Which patients are at a particularly high risk due to the effects of NSAIDs?

<p>Patients with a history of heart failure or kidney disease (C)</p> Signup and view all the answers

What renal function can be affected by NSAIDs in susceptible patients?

<p>Acute kidney injury (A)</p> Signup and view all the answers

What is the primary renal cortical action of vasodilatory prostaglandins PGE2 and PGI2?

<p>Renal vasodilatation and maintenance of GFR (D)</p> Signup and view all the answers

What modulatory role do vasodilatory renal prostaglandins play under normal circumstances?

<p>Relatively unimportant role (A)</p> Signup and view all the answers

What conclusion is drawn regarding the role of renal prostaglandins?

<p>They play an important vasoregulatory role (A)</p> Signup and view all the answers

What is the primary role of inflammation in the body?

<p>To destroy invading organisms (C)</p> Signup and view all the answers

Which cells secrete proinflammatory cytokines like tumor necrosis factor (TNF)-α and interleukin (IL)-1 in rheumatoid arthritis?

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

How does inappropriate activation of the immune system contribute to inflammation-related diseases?

<p>By initiating an inflammatory attack (C)</p> Signup and view all the answers

In rheumatoid arthritis, what do B lymphocytes primarily produce to maintain inflammation?

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

Which of the following immune cells are involved in initiating an inflammatory attack in rheumatoid arthritis?

<p>White blood cells (WBCs) (A)</p> Signup and view all the answers

What is the consequence of white blood cell (WBC) activation leading to the secretion of proinflammatory cytokines in rheumatoid arthritis?

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

How do NSAIDs lower body temperature in patients with fever?

<p>By impeding PGE2 synthesis and release (D)</p> Signup and view all the answers

What is the primary therapeutic use of NSAIDs according to the text?

<p>Anti-inflammatory and analgesic purposes (C)</p> Signup and view all the answers

At what doses do salicylates exhibit anti-inflammatory activity?

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

What is the impact of the combination of opioids and NSAIDs in pain management?

<p>Decreased need for opioids (D)</p> Signup and view all the answers

What is the side effect of NSAIDs on normal body temperature?

<p>No effect (D)</p> Signup and view all the answers

How do lipoxygenases contribute to arachidonic acid metabolism?

<p>Producing leukotrienes or lipoxins based on tissue type (C)</p> Signup and view all the answers

Which enzyme is described as a housekeeping enzyme that regulates normal cellular processes?

<p>Cyclooxygenase-1 (COX-1) (C)</p> Signup and view all the answers

In which tissues is Cyclooxygenase-2 (COX-2) constitutively expressed?

<p>Brain, kidney, and bone (A)</p> Signup and view all the answers

What is the primary function of prostaglandins in the gastrointestinal (GI) tract?

<p>Enhance acid secretion (A)</p> Signup and view all the answers

Which enzyme acts on arachidonic acid to form leukotrienes or lipoxins depending on the tissue?

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

What happens when small amounts of prostaglandins are injected intradermally, intravenously, or intra-arterially?

<p>They mimic components of inflammation (A)</p> Signup and view all the answers

Where does the elevated production of prostanoids occur due to Cyclooxygenase-2 (COX-2)?

<p>In sites of disease and inflammation (A)</p> Signup and view all the answers

How do non-steroidal anti-inflammatory drugs (NSAIDs) exert their therapeutic actions?

<p>By inhibiting cyclooxygenase enzymes (D)</p> Signup and view all the answers

What distinguishes aspirin from other NSAIDs in terms of its mechanism of action?

<p>It irreversibly acetylates and inactivates cyclooxygenase (C)</p> Signup and view all the answers

Which statement accurately describes the role of aspirin as a traditional NSAID?

<p>It primarily exhibits anti-inflammatory effects at low doses (B)</p> Signup and view all the answers

What distinguishes the mechanism of action of aspirin from other NSAIDs?

<p>It irreversibly inhibits cyclooxygenase (A)</p> Signup and view all the answers

What therapeutic actions are associated with non-steroidal anti-inflammatory drugs (NSAIDs)?

<p>Reducing inflammation, pain, and fever (C)</p> Signup and view all the answers

What is the primary difference between aspirin and other NSAIDs?

<p>Other NSAIDs are irreversible inhibitors of cyclooxygenase (B)</p> Signup and view all the answers

What is the reason behind recommending the concomitant use of proton pump inhibitors or misoprostol with NSAIDs in patients at high risk for GI events?

<p>To prevent NSAID-induced ulcers (D)</p> Signup and view all the answers

What is the impact of aspirin on platelet aggregation, according to the text?

<p>It decreases platelet aggregation (A)</p> Signup and view all the answers

What is the main mechanism by which aspirin affects bleeding time?

<p>Inhibiting platelet aggregation by blocking COX-1 (C)</p> Signup and view all the answers

Why are NSAIDs other than aspirin not typically used for their antiplatelet effect?

<p>They can prolong bleeding time (C)</p> Signup and view all the answers

How do NSAIDs affect renal blood flow according to the text?

<p>They enhance vasoconstriction in the kidneys (A)</p> Signup and view all the answers

What is the significance of concomitant use of NSAIDs and aspirin in relation to cyclooxygenase binding?

<p>It prevents aspirin from binding to cyclooxygenase (C)</p> Signup and view all the answers

Which enzyme is responsible for the synthesis of thromboxanes and prostacyclins from arachidonic acid?

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

What is the primary function of prostaglandins in the context of rheumatoid arthritis?

<p>Reduction of inflammation and pain (D)</p> Signup and view all the answers

Which lipid compound is synthesized from the same precursor as prostaglandins?

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

What is the primary goal of pharmacotherapy in rheumatoid arthritis?

<p>Reduce inflammation and pain (C)</p> Signup and view all the answers

Which fatty acid derivative contains a cyclic ring structure in its chemical composition?

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

What immune cells secrete proinflammatory cytokines like tumor necrosis factor (TNF)-α and interleukin (IL)-1 in rheumatoid arthritis?

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

What is the primary role of white blood cells (WBCs) in initiating an inflammatory attack in rheumatoid arthritis?

<p>Activating T lymphocytes (C)</p> Signup and view all the answers

Which enzyme acts on arachidonic acid to form leukotrienes or lipoxins depending on the tissue?

<p>Cyclooxygenase-1 (COX-1) (A)</p> Signup and view all the answers

What is the impact of aspirin on platelet aggregation and vasoconstriction?

<p>Reduces both platelet aggregation and vasoconstriction (A)</p> Signup and view all the answers

Why are B lymphocytes involved in rheumatoid arthritis?

<p>To maintain inflammation by producing autoantibodies (B)</p> Signup and view all the answers

Which enzyme is responsible for the elevated production of prostanoids in sites of disease and inflammation?

<p>Cyclooxygenase-2 (COX-2) (D)</p> Signup and view all the answers

In which tissues is Cyclooxygenase-2 (COX-2) constitutively expressed?

<p>Brain, kidney, and bone (C)</p> Signup and view all the answers

What physiological functions are controlled by prostaglandins and their metabolites in the gastrointestinal (GI) tract?

<p>Acid secretion and mucus production (C)</p> Signup and view all the answers

What happens when small amounts of prostaglandins are injected intradermally, intravenously, or intra-arterially?

<p>They mimic components of inflammation (D)</p> Signup and view all the answers

What is the role of Cyclooxygenase-1 (COX-1) in normal cellular processes?

<p>Regulating gastric cytoprotection (E)</p> Signup and view all the answers

What is the primary mechanism by which NSAIDs lower body temperature in febrile patients?

<p>Impeding PGE2 synthesis (C)</p> Signup and view all the answers

What is the primary difference between leukotrienes and lipoxins produced by lipoxygenases from arachidonic acid?

<p>Their tissue distribution (D)</p> Signup and view all the answers

What distinguishes the analgesic activity of salicylates from their anti-inflammatory activity?

<p>Timing of onset of action (A)</p> Signup and view all the answers

In what context are combinations of opioids and NSAIDs used for pain treatment?

<p>Malignancy-related pain (A)</p> Signup and view all the answers

What is the primary therapeutic use of NSAIDs in the context of osteoarthritis and rheumatoid arthritis?

<p>Providing anti-inflammatory and analgesic effects (D)</p> Signup and view all the answers

What is the impact of salicylic acid on corns, calluses, and warts?

<p>It is used topically to treat them (A)</p> Signup and view all the answers

Which drug is available in topical formulations for the treatment of osteoarthritis in specific joints?

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

How are salicylates (except diflunisal) primarily eliminated from the body?

<p>Via skin absorption (D)</p> Signup and view all the answers

At what point do anti-inflammatory dosages of aspirin exhibit zero-order kinetics?

<p>Above 4 g/day (D)</p> Signup and view all the answers

Which anti-inflammatory drug is approved for management of seasonal allergic conjunctivitis and pain related to ocular surgery?

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

Flashcards

How do NSAIDs lower body temperature?

NSAIDs decrease body temperature by inhibiting the synthesis and release of PGE2, a prostaglandin involved in fever production.

What is the primary therapeutic effect of NSAIDs?

NSAIDs primarily reduce inflammation and pain by inhibiting cyclooxygenase (COX) enzymes, which are essential for prostaglandin production.

What's the difference between NSAIDs' effect on fever and normal temperature?

NSAIDs have no effect on normal body temperature. Their effect is specific to febrile states due to their action on prostaglandins involved in fever.

What causes the analgesic activity of salicylates?

Salicylates, like aspirin, exhibit analgesic effects at lower doses by reducing prostaglandin production, which mediates pain signaling.

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Where are NSAIDs used for pain relief?

NSAIDs are commonly used to relieve pain in osteoarthritis and gout, conditions characterized by inflammation and joint pain.

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What's the role of lipoxygenases?

Lipoxygenases are enzymes in the arachidonic acid pathway responsible for producing leukotrienes, involved in inflammation, and lipoxins, with anti-inflammatory effects, depending on the tissue.

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Which enzyme produces prostanoids?

Cyclooxygenase-1 (COX-1) is the enzyme responsible for the physiologic production of prostanoids, which regulate various bodily functions.

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Where is COX-2 found in the body?

Cyclooxygenase-2 (COX-2) is constitutively expressed in the brain, kidney, and bone, indicating its involvement in normal functions in these tissues.

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What pathway produces leukotrienes or lipoxins?

The lipoxygenase pathway converts arachidonic acid into leukotrienes or lipoxins, depending on the tissue. Leukotrienes are pro-inflammatory, while lipoxins are anti-inflammatory.

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What are the functions of prostaglandins?

Prostaglandins play a key role in regulating various functions, including gastrointestinal tract regulation, inflammation, and pain perception.

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When is COX-2 expression increased?

Cyclooxygenase-2 (COX-2) expression is increased in sites of disease and inflammation, indicating its involvement in inflammatory responses.

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How do injected prostaglandins mimic inflammation?

Small amounts of prostaglandins, when injected into the body, can mimic components of inflammation, highlighting their role in inflammatory processes.

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How to reduce GI upset from NSAIDs?

To minimize gastrointestinal upset, it's recommended to take NSAIDs with food or fluids, which helps buffer the drug and reduce irritation.

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How to prevent NSAID-induced ulcers?

Proton pump inhibitors (PPIs) or misoprostol are commonly used to prevent NSAID-induced ulcers, particularly in patients at high risk of gastrointestinal complications.

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What's the effect of aspirin on platelets?

Aspirin has a unique effect on platelet aggregation, irreversibly inhibiting it and prolonging bleeding time, which is crucial for its anti-thrombotic action.

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Why is aspirin withheld before surgery?

Aspirin is often withheld prior to surgery to prevent prolongation of bleeding time and potential complications during or following surgery.

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What's the main renal effect of NSAIDs?

NSAIDs primarily affect the renal system by antagonizing vasoconstrictors, which are substances that constrict blood vessels, potentially affecting renal blood flow.

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What about NSAID use with aspirin for cardioprotection?

Patients taking aspirin for cardioprotection should avoid concomitant NSAID use if possible or take aspirin at least 30 minutes before NSAID to minimize potential interference with aspirin's effects.

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What's the dosage of aspirin for cardioprotection?

The recommended dosage of aspirin for prophylactic use to reduce the risk of cardiovascular events is typically between 75 to 162 mg daily.

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Why avoid aspirin in kids with viral infections?

Aspirin should be avoided in patients under 19 years old with viral infections like varicella or influenza to prevent the development of Reye syndrome, a rare but serious condition.

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How does aspirin affect aggregation and vasoconstriction?

Aspirin reduces platelet aggregation, preventing blood clots, and also reduces vasoconstriction, promoting blood vessel relaxation and improved blood flow.

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What's the purpose of chronic aspirin use?

Chronic use of aspirin leads to continued inhibition of platelet aggregation as new platelets are generated, effectively preventing blood clots over time.

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What are the effects of low-dose aspirin on TIAs and stroke?

Low doses of aspirin have been shown to reduce the risk of transient ischemic attacks (TIAs) and stroke, both conditions related to blood clots in the brain.

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Why is aspirin used acutely in MI?

Aspirin is used acutely in the context of an acute myocardial infarction (MI) (heart attack) to reduce the risk of death by preventing blood clots from forming and blocking blood flow to the heart.

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What's the consequence of decreased prostaglandin synthesis?

Decreased synthesis of prostaglandins, due to NSAID use, can lead to sodium and water retention, potentially affecting blood pressure and overall fluid balance.

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Who are at high risk from NSAIDs?

Patients with a history of heart failure or kidney disease are at particularly high risk for complications from NSAIDs due to their effects on fluid balance and kidney function.

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What renal function can be affected by NSAIDs?

NSAIDs can lead to acute kidney injury in susceptible patients, especially those with pre-existing renal problems or who are taking other drugs that affect the kidneys.

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What's the renal action of vasodilatory prostaglandins?

Vasodilatory prostaglandins like PGE2 and PGI2 play a crucial role in maintaining renal blood flow and glomerular filtration rate (GFR) by dilating blood vessels in the kidneys.

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What's their role under normal circumstances?

Under normal circumstances, vasodilatory renal prostaglandins play a relatively unimportant role in regulating renal blood flow.

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What's the conclusion on the role of renal prostaglandins?

Renal prostaglandins play an important vasoregulatory role, particularly when blood flow to the kidneys is compromised or in certain disease states.

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What is the primary role of inflammation?

Inflammation is a protective response to injury or infection, aimed at destroying invading organisms and initiating tissue repair.

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Which cells secrete proinflammatory cytokines in rheumatoid arthritis?

In rheumatoid arthritis, monocytes and macrophages, types of white blood cells, secrete proinflammatory cytokines like TNF-α and IL-1, contributing to chronic inflammation.

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How does the immune system contribute to inflammation?

Inappropriate activation of the immune system can lead to an inflammatory attack on the body's own tissues, contributing to autoimmune diseases like rheumatoid arthritis.

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What do B lymphocytes produce in rheumatoid arthritis?

In rheumatoid arthritis, B lymphocytes produce autoantibodies that sustain inflammation by targeting the body's own tissues.

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Which cells initiate inflammation in rheumatoid arthritis?

White blood cells (WBCs) are central to initiating an inflammatory attack in rheumatoid arthritis by activating and releasing proinflammatory cytokines, perpetuating the disease.

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What’s the consequence of WBC activation in rheumatoid arthritis?

Activation of white blood cells (WBCs) leads to the secretion of proinflammatory cytokines, which then stimulate the destruction of joint tissues, characteristic of rheumatoid arthritis.

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