Anti-inflammatory drugs 2

RadiantHyena avatar
RadiantHyena
·
·
Download

Start Quiz

Study Flashcards

Questions and Answers

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

Nausea

What is a notable benefit of celecoxib compared to other NSAIDs?

Less gastrointestinal bleeding and dyspepsia

Why should patients at high risk of ulcers and requiring aspirin for cardiovascular prevention avoid using celecoxib?

It elevates the risk of ulcers

What effect does acetaminophen have on platelet function and bleeding time?

<p>No effect on platelet function or bleeding time</p> Signup and view all the answers

Why is acetaminophen not considered an NSAID?

<p>Due to its strong anti-inflammatory activity on peripheral tissues</p> Signup and view all the answers

Which population would benefit from using acetaminophen over NSAIDs?

<p>Patients with gastric complaints/risks with NSAIDs</p> Signup and view all the answers

How soon can a response to methotrexate be observed after starting treatment?

<p>Within 3 to 6 weeks</p> Signup and view all the answers

What is a common adverse effect of methotrexate treatment?

<p>Mucosal ulceration and nausea</p> Signup and view all the answers

How does supplementation with folic acid impact the tolerability of methotrexate?

<p>Improves tolerability and reduces GI and hepatic adverse effects</p> Signup and view all the answers

What is a potential severe adverse effect of hydroxychloroquine mentioned in the text?

<p>Ocular toxicity, including irreversible retinal damage</p> Signup and view all the answers

Which organ system is particularly affected by the adverse effects of methotrexate?

<p>Liver</p> Signup and view all the answers

What is the recommended frequency for taking methotrexate in the treatment mentioned?

<p>Once a week</p> Signup and view all the answers

What is the role of N-acetylcysteine in cases of overdose?

<p>An antidote</p> Signup and view all the answers

Which traditional DMARD is generally preferred for mono-therapy in the treatment of RA?

<p>Methotrexate</p> Signup and view all the answers

What is the mechanism of action of methotrexate in the treatment of RA?

<p>Inhibits purine nucleotide biosynthesis</p> Signup and view all the answers

In patients with inadequate response to monotherapy, what treatment approach may be needed?

<p>Addition of a TNF inhibitor or non-TNF biologic agent</p> Signup and view all the answers

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

<p>To prevent the risk of Reye syndrome associated with aspirin</p> Signup and view all the answers

What is the mainstay of treatment in patients with rheumatoid or psoriatic arthritis?

<p>Methotrexate combined with other traditional DMARDs</p> Signup and view all the answers

How is acetaminophen metabolized in the liver?

<p>It is hydroxylated to form N-acetyl-p-benzoquinoneimine (NAPQI)</p> Signup and view all the answers

Why should traditional DMARDs be started as soon as possible following the diagnosis of RA?

<p>To prevent progression of the disease</p> Signup and view all the answers

What happens when there are large doses of acetaminophen consumed?

<p>Hepatic necrosis can occur due to NAPQI reacting with hepatic proteins</p> Signup and view all the answers

Why should acetaminophen be avoided in patients with severe hepatic impairment?

<p>It can deplete glutathione and lead to hepatotoxicity</p> Signup and view all the answers

How are acetaminophen and its metabolites eliminated from the body?

<p>Excreted in urine</p> Signup and view all the answers

What is the mechanism by which NAPQI causes liver damage?

<p>By reacting with sulfhydryl groups and causing hepatotoxicity</p> Signup and view all the answers

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

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

Which adverse effect is NOT commonly associated with leflunomide use?

<p>Hypertension</p> Signup and view all the answers

What is a contraindication for the use of leflunomide?

<p>Liver disease</p> Signup and view all the answers

Which drug can leflunomide be used in combination with for patients with suboptimal response to monotherapy?

<p>Methotrexate</p> Signup and view all the answers

What is the onset of activity for sulfasalazine in treating RA?

<p>1-3 months</p> Signup and view all the answers

Which adverse effect is commonly associated with sulfasalazine use?

<p>Leukopenia</p> Signup and view all the answers

What adverse effect can occur due to the inhibition of prostaglandin synthesis by NSAIDs in patients with asthma?

<p>Shift toward leukotriene production</p> Signup and view all the answers

Which symptom is characteristic of mild salicylate toxicity, also known as salicylism?

<p>Marked hyperventilation</p> Signup and view all the answers

What is a common symptom of hypersensitivity reactions experienced by approximately 15% of patients taking aspirin?

<p>Urticaria</p> Signup and view all the answers

In patients with severe hypersensitivity to aspirin, what is the recommended action regarding NSAIDs?

<p>Avoid using NSAIDs</p> Signup and view all the answers

Which phenomenon can occur when aspirin displaces highly protein-bound drugs like warfarin or phenytoin?

<p>Increased concentration of free salicylate</p> Signup and view all the answers

What symptom may manifest in severe salicylate intoxication from large doses of salicylate administration?

<p>Restlessness and delirium</p> Signup and view all the answers

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

<p>Acetaminophen has a lower risk of causing Reye syndrome</p> Signup and view all the answers

Which metabolite of acetaminophen can react with sulfhydryl groups and cause liver damage?

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

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

<p>Hepatotoxicity</p> Signup and view all the answers

What happens when NAPQI reacts with the sulfhydryl groups in the liver at normal therapeutic doses of acetaminophen?

<p>Glutathione depletion</p> Signup and view all the answers

Why should acetaminophen be avoided in patients with severe hepatic impairment?

<p>It can exacerbate liver injury</p> Signup and view all the answers

How are acetaminophen and its metabolites primarily eliminated from the body?

<p>Via the kidneys in urine</p> Signup and view all the answers

Which type of NSAID has been associated with an increased risk for cardiovascular events by decreasing PGI2 production mediated by COX-2?

<p>Diclofenac</p> Signup and view all the answers

Why is the use of NSAIDs other than aspirin discouraged in patients with established cardiovascular disease?

<p>They increase TXA2 production.</p> Signup and view all the answers

Which NSAID is suggested to be the least harmful for patients with cardiovascular disease when NSAID treatment cannot be avoided?

<p>Naproxen</p> Signup and view all the answers

What is the primary reason for the cardiovascular protective effect seen with low doses of aspirin?

<p>Decrease in TXA2 production</p> Signup and view all the answers

Which enzyme do NSAIDs inhibit that leads to the suppression of prostaglandin synthesis?

<p>Cyclooxygenases</p> Signup and view all the answers

Inhibition of which molecule's production by COX-2 has been associated with an increased risk for cardiovascular events?

<p>PGI2</p> Signup and view all the answers

What is the primary role of traditional DMARDs in the treatment of rheumatoid arthritis?

<p>Prevent further joint destruction</p> Signup and view all the answers

Which of the following best describes the mechanism of action of methotrexate in treating rheumatoid arthritis?

<p>Inhibits purine nucleotide biosynthesis</p> Signup and view all the answers

In patients with inadequate response to methotrexate monotherapy, what treatment approach may be needed?

<p>Use of TNF inhibitor or non-TNF biologic agent</p> Signup and view all the answers

What is the mainstay of treatment for patients with rheumatoid or psoriatic arthritis?

<p>Traditional DMARDs like methotrexate</p> Signup and view all the answers

What is the recommended initial choice of drug for mono-therapy in treating rheumatoid arthritis?

<p>Methotrexate</p> Signup and view all the answers

Which statement best describes the role of NSAIDs in combination therapies for rheumatoid arthritis?

<p>Mainly used for their anti-inflammatory actions</p> Signup and view all the answers

How does leflunomide exert its immune-modulatory effects in the treatment of RA?

<p>Acting on dihydroorotate dehydrogenase</p> Signup and view all the answers

What is a common adverse effect associated with leflunomide use?

<p>Hypokalemia</p> Signup and view all the answers

Why is leflunomide not recommended in patients with liver disease?

<p>It can be hepatotoxic</p> Signup and view all the answers

Which enzyme does leflunomide inhibit that is necessary for pyrimidine synthesis?

<p>Dihydroorotate dehydrogenase</p> Signup and view all the answers

What monitoring parameters are recommended for patients on leflunomide therapy?

<p>Liver enzymes</p> Signup and view all the answers

What is an adverse effect commonly associated with sulfasalazine use in the treatment of RA?

<p>Anorexia</p> Signup and view all the answers

What is a potential risk associated with adding aspirin to celecoxib therapy?

<p>Increased GI bleeding</p> Signup and view all the answers

Why should patients who have had anaphylactoid reactions to aspirin be cautious when using celecoxib?

<p>Celecoxib may cause similar effects as aspirin</p> Signup and view all the answers

How does fluconazole impact the serum levels of celecoxib?

<p>Increases serum levels</p> Signup and view all the answers

Why is acetaminophen considered useful for patients with gastric complaints concerning NSAIDs?

<p>It has weak anti-inflammatory activity</p> Signup and view all the answers

What is a distinguishing feature of acetaminophen compared to traditional NSAIDs?

<p>Weak anti-inflammatory activity</p> Signup and view all the answers

What differentiates the therapeutic use of acetaminophen from traditional NSAIDs?

<p>Treatment of fever and pain relief</p> Signup and view all the answers

What is a distinguishing feature of the metabolism of celecoxib as mentioned in the text?

<p>Requires dose adjustment in renal impairment</p> Signup and view all the answers

What is the main reason for avoiding NSAIDs like celecoxib in the third trimester of pregnancy?

<p>Potential closure of the ductus arteriosus in the fetus</p> Signup and view all the answers

What makes Celecoxib different from aspirin in terms of COX enzyme inhibition?

<p>Aspirin has irreversible inhibition of COX-1</p> Signup and view all the answers

What is a significant advantage of Celecoxib over traditional NSAIDs for pain management?

<p>Minimal effect on renal function</p> Signup and view all the answers

Why should Celecoxib dosage be adjusted in patients with moderate hepatic impairment?

<p>Impaired metabolism leading to drug accumulation</p> Signup and view all the answers

What distinguishes the excretion route of Celecoxib metabolites as mentioned in the text?

<p>Excreted via biliary excretion</p> Signup and view all the answers

What is the potential consequence of large doses of acetaminophen leading to depletion of available glutathione in the liver?

<p>Hepatic necrosis</p> Signup and view all the answers

Which patient population is specifically mentioned to be at higher risk of acetaminophen-induced hepatotoxicity?

<p>Patients with hepatic disease or a history of alcoholism</p> Signup and view all the answers

What is the primary reason for avoiding acetaminophen in patients with severe hepatic impairment?

<p>Depleted glutathione levels</p> Signup and view all the answers

Which metabolite of acetaminophen is responsible for causing liver damage by reacting with sulfhydryl groups?

<p>N-acetyl-pbenzoquinoneimine (NAPQI)</p> Signup and view all the answers

In cases of acetaminophen overdose, what substance reacts with NAPQI to form a nontoxic product?

<p>Glutathione</p> Signup and view all the answers

Which part of the body is particularly affected by large doses of acetaminophen that lead to hepatic necrosis?

<p>Liver</p> Signup and view all the answers

What is the primary mechanism of action of methotrexate in the treatment of rheumatoid arthritis?

<p>Inhibition of purine nucleotide biosynthesis</p> Signup and view all the answers

What is the mainstay of treatment for patients with rheumatoid or psoriatic arthritis?

<p>Methotrexate</p> Signup and view all the answers

What is the mechanism of action of leflunomide in the treatment of rheumatoid arthritis?

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

In patients with suboptimal response to methotrexate monotherapy, what other agents can be added?

<p>TNF inhibitors</p> Signup and view all the answers

What is a common adverse effect of leflunomide therapy in patients with rheumatoid arthritis?

<p>Hepatotoxicity</p> Signup and view all the answers

What is a common adverse effect associated with traditional Disease-Modifying Antirheumatic Drugs?

<p>Renal toxicity</p> Signup and view all the answers

Why is leflunomide contraindicated in pregnancy?

<p>It can lead to fetal harm and birth defects</p> Signup and view all the answers

Why is mono-therapy with methotrexate generally preferred over other traditional DMARDs?

<p>Increased safety and efficacy</p> Signup and view all the answers

Which adverse effect is NOT commonly associated with leflunomide use in rheumatoid arthritis?

<p>Weight gain</p> Signup and view all the answers

What is the primary reason for initiating treatment with traditional DMARDs as soon as possible after diagnosing rheumatoid arthritis?

<p>To reduce joint destruction</p> Signup and view all the answers

What monitoring parameters are recommended for patients on leflunomide therapy?

<p>Liver enzymes</p> Signup and view all the answers

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

<p>1 to 3 months</p> Signup and view all the answers

More Quizzes Like This

Use Quizgecko on...
Browser
Browser