Anti-inflammatory Drugs Lecture 2
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Questions and Answers

What is the cardiovascular protective effect associated with agents like aspirin?

  • Decreased PGI2 production
  • Inhibition of leukotriene synthesis
  • Reduction in TXA2 production (correct)
  • Increased risk for cardiovascular events

    • Why are NSAIDs other than aspirin discouraged in patients with established cardiovascular disease?

  • They have a cardiovascular protective effect
  • They increase the production of PGI2
  • They inhibit COX-1 selectivity
  • They are associated with an increased risk for cardiovascular events (correct)

    • Which NSAID is suggested as the least likely to be harmful for patients with cardiovascular disease?

  • Diclofenac
  • Naproxen (correct)
  • Ibuprofen
  • Acetaminophen

    • What is the mechanism of action of NSAIDs in terms of inhibiting cyclooxygenases?

    <p>Inhibition of prostaglandin synthesis (D)</p> Signup and view all the answers

    Why are agents with higher relative COX-2 selectivity associated with an increased risk for cardiovascular events?

    <p>Due to increased TXA2 production (C)</p> Signup and view all the answers

    What is the reason behind the discouraged use of NSAIDs, other than aspirin, in patients with established cardiovascular disease?

    <p>Increased risk for MI and stroke (C)</p> Signup and view all the answers

    Which adverse effect is commonly associated with anti-inflammatory drugs?

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

    What is a benefit associated with the use of celecoxib in comparison to other NSAIDs?

    <p>Reduced incidence of GI bleeding (C)</p> Signup and view all the answers

    Patients at high risk of ulcers and requiring aspirin for cardiovascular prevention should avoid which drug?

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

    What effect does acetaminophen have on platelet function?

    <p>It has no effect on platelet function (A)</p> Signup and view all the answers

    Which drug is not considered an NSAID despite having antipyretic and analgesic effects?

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

    Inhibitors of which enzyme may increase serum levels of celecoxib?

    <p>CYP2C9 (B)</p> Signup and view all the answers

    What is the typical timeframe for the onset of effects after starting methotrexate treatment?

    <p>3 to 6 weeks (A)</p> Signup and view all the answers

    How does taking leucovorin daily after methotrexate help reduce adverse effects?

    <p>It lessens severity of adverse effects (B)</p> Signup and view all the answers

    Which of the following is a common adverse effect of methotrexate treatment?

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

    What is a known adverse effect of hydroxychloroquine related to ocular health?

    <p>Irreversible retinal damage (B)</p> Signup and view all the answers

    In addition to ocular toxicity, what other adverse effect is associated with hydroxychloroquine use?

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

    Why is methotrexate contraindicated in pregnancy?

    <p>Potential for fetal harm (B)</p> Signup and view all the answers

    What is the primary reason acetaminophen is recommended over aspirin for children with viral infections or chickenpox?

    <p>Less risk of developing Reye syndrome (A)</p> Signup and view all the answers

    Which organ primarily conjugates acetaminophen into inactive glucuronidated or sulfated metabolites?

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

    What is the highly reactive metabolite formed when a portion of acetaminophen is hydroxylated in the liver?

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

    At normal therapeutic doses, how does NAPQI react with glutathione, leading to a nontoxic substance formation?

    <p>By binding to sulfhydryl groups (B)</p> Signup and view all the answers

    In patients with hepatic disease, viral hepatitis, or a history of alcoholism, what are they at higher risk of when taking acetaminophen?

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

    What happens when large doses of acetaminophen are consumed, depleting available glutathione in the liver?

    <p>NAPQI reacts with hepatic proteins' sulfhydryl groups, causing hepatotoxicity (D)</p> Signup and view all the answers

    What is the mechanism of action of leflunomide in treating RA?

    <p>Inhibition of dihydroorotate dehydrogenase (DHODH) (A)</p> Signup and view all the answers

    What is a common adverse effect associated with leflunomide use?

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

    Why is leflunomide contraindicated in pregnancy?

    <p>It can lead to fetal harm (C)</p> Signup and view all the answers

    What is a key difference between the use of leflunomide and methotrexate in RA treatment?

    <p>Methotrexate is hepatotoxic while leflunomide is not (D)</p> Signup and view all the answers

    What are the common GI adverse effects associated with sulfasalazine use?

    <p>Nausea, vomiting, anorexia (A)</p> Signup and view all the answers

    Why is monitoring liver enzymes important during leflunomide therapy?

    <p>Due to the potential hepatotoxicity of the drug (B)</p> Signup and view all the answers

    Which enzyme does leflunomide act on to cause cell arrest of autoimmune lymphocytes?

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

    What is the primary enzyme inhibited by leflunomide after biotransformation?

    <p>Dihydroorotate dehydrogenase (DHODH) (C)</p> Signup and view all the answers

    What is the main reason why leflunomide is not recommended for patients with liver disease?

    <p>Potential for hepatotoxicity (B)</p> Signup and view all the answers

    What potential adverse effect is associated with leflunomide use in pregnant patients?

    <p>Neural tube defects in the fetus (D)</p> Signup and view all the answers

    Which parameter should be monitored in patients on leflunomide therapy to detect potential adverse effects?

    <p>Complete blood count (B)</p> Signup and view all the answers

    What is the average onset of activity for sulfasalazine in treating rheumatoid arthritis?

    <p>4 to 6 months (D)</p> Signup and view all the answers

    What is one common gastrointestinal adverse effect associated with sulfasalazine use?

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

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