NSAIDs Quiz: Pharmacology of Non-Steroidal Anti-Inflammatory Drugs

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Questions and Answers

What is the primary reason for restricting the larger dose of acetaminophen?

Concerns about liver toxicity (correct)

Risk of addiction

Gastrointestinal side effects

Inadequate pain relief

Why is acetaminophen often combined with an opioid analgesic agent for postsurgical dental pain?

To counteract the side effects of opioids

To provide a synergistic effect for pain relief (correct)

To increase the potency of the opioid

To reduce the risk of opioid addiction

What is the rationale behind combining opioids with acetaminophen in dental pain management?

To increase the potency of acetaminophen

To reduce the dosage of opioids

To reduce the risk of opioid addiction

To provide a synergistic effect for pain relief (correct)

What is the main effect of NSAIDs on prostacyclin and thromboxane A2 synthesis?

They inhibit prostacyclin synthesis and do not affect thromboxane A2 synthesis. Signup and view all the answers

What is a significant advantage of NSAIDs over opioids in dental pain management?

NSAIDs have a more favorable efficacy and safety profile Signup and view all the answers

Why is acetaminophen not a good choice for reducing inflammation and pain?

It is not an anti-inflammatory drug. Signup and view all the answers

Which of the following is NOT a concern with using opioids in dental pain management?

Liver toxicity Signup and view all the answers

What is the rationale behind combining NSAIDs with acetaminophen?

To enhance the analgesic effect of either drug alone. Signup and view all the answers

What is the primary mechanism of action of NSAIDs?

Inhibition of cyclooxygenase (COX) enzyme Signup and view all the answers

Three FDA-approved NSAIDs are:

Aspirin, ibuprofen, and naproxen Signup and view all the answers

What is the advantage of combining opioids with NSAIDs or acetaminophen?

It invokes different, complementary mechanisms of pain relief. Signup and view all the answers

What is the main difference between COX-1 and COX-2?

COX-1 is constitutive, while COX-2 is induced during inflammation Signup and view all the answers

What is the result of combining 100 mg of enteric-coated diclofenac with 1000 mg of acetaminophen?

A superior analgesic effect compared to either drug alone. Signup and view all the answers

Which of the following NSAIDs causes irreversible inhibition of COX?

Aspirin Signup and view all the answers

What is the main anti-inflammatory effect of NSAIDs due to?

Inhibition of COX-2 Signup and view all the answers

What is the ceiling effect observed with aspirin and acetaminophen?

A plateau in analgesic effect at approximately 1 g total dose. Signup and view all the answers

What is a characteristic of selective COX-2 inhibitors (Coxibs)?

They are considered gastric-friendly and are associated with a higher incidence of cardiovascular thrombotic events Signup and view all the answers

Which of the following is NOT a characteristic of non-selective COX inhibitors?

They are considered gastric-friendly Signup and view all the answers

What is the primary mechanism of action of NSAIDs in combating pain?

Interfering with production of biochemical mediators that cause sensitization of nerve endings Signup and view all the answers

Why are NSAIDs preferred over opioid drugs for pain treatment?

NSAIDs have fewer undesirable CNS depressant effects Signup and view all the answers

What is the maximum duration of consecutive dosing for pain, as per OTC package insert guidelines?

10 days Signup and view all the answers

Why have some dentists started substituting acetaminophen for aspirin in postoperative dental pain treatment?

Acetaminophen has fewer adverse effects than aspirin Signup and view all the answers

What is the primary advantage of combining NSAIDs with opioids in pain treatment?

Complementary actions on pain perception Signup and view all the answers

Which of the following NSAIDs has not been approved by the FDA for OTC use?

Celecoxib Signup and view all the answers

What is an advantage of combination analgesics for dental pain?

They provide a synergistic effect, increasing their efficacy Signup and view all the answers

What is the mechanism of analgesia of salicylates?

Inhibition of cyclooxygenase enzyme Signup and view all the answers

Which analgesic is best prescribed for a child with dental pain and febrile viral illness?

Acetaminophen Signup and view all the answers

What is a common adverse reaction of salicylates?

Nausea and vomiting Signup and view all the answers

What is the primary use of combination analgesics in dentistry?

Relief of dental pain Signup and view all the answers

How do salicylates interact with other drugs?

They increase the effect of anticoagulants Signup and view all the answers

Study Notes

NSAIDs in Dentistry

NSAIDs inhibit prostacyclin (PGI2) synthesis, which may increase the risk of cardiovascular events.
NSAIDs are often the first choice for pain relief in dental practice due to their anti-inflammatory efficacy.

Combination Analgesics for Dental Pain

Aspirin and acetaminophen are sometimes combined, but a ceiling effect occurs when the total amount approaches 1g.
Combining an NSAID with acetaminophen has some justification, as seen in the superior analgesic effect of 100mg diclofenac with 1000mg acetaminophen in impacted third molar surgery.

Opioid and Non-Opioid Analgesics

Combining NSAIDs or acetaminophen with opioids has a sound scientific basis, as they invoke different, complementary mechanisms of pain relief.
NSAIDs combat pain by interfering with biochemical mediators, while opioids alter CNS perception and reaction to pain.

Efficacy and Safety Profile of NSAIDs

Short-term use of NSAIDs (≤ 1 week) has been highly efficacious and safe for pain and inflammation accompanying dental surgical procedures.
NSAIDs lack undesirable CNS depressant effects seen with opioid-containing agents, leading to FDA approval for OTC use.

FDA-Approved NSAIDs

Ibuprofen
Naproxen
Ketoprofen

Rationale of Opioids and Acetaminophen Combination

Combining opioids with acetaminophen is rational due to different, complementary mechanisms of pain relief.

Advantages and Drawbacks of Combination Analgesics

Advantages: superior analgesic effect, complementary mechanisms of pain relief
Drawbacks: ceiling effect, potential for adverse reactions

Mechanism of Analgesia of Salicylates

Salicylates inhibit cyclooxygenase (COX) enzyme, responsible for prostaglandin biosynthesis.
COX-1 is constitutive, found in most tissues, while COX-2 is induced during inflammation.

Child with Dental Pain and Febrile Viral Illness

Acetaminophen is often prescribed for dental pain in children due to its minor anti-inflammatory effects and lower risk of adverse reactions.

NSAIDs in Dentistry: Intended Learning Outcomes

Be familiar with the pharmacology of NSAIDs.
Identify the implications of NSAIDs in dentistry.
Know how to manage dental pain by NSAIDs.
Know the hazards of NSAIDs in long-term pain management.

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Description

Test your knowledge on the pharmacology of NSAIDs, their implications in dentistry, and their role in managing dental pain. This quiz covers the mechanism of action of NSAIDs, including the inhibition of cyclooxygenase (COX) enzyme and its isoforms COX-1 and COX-2.

Pharmacology of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

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