PROPIONIC ACID DERIVATIVES: Anti-Inflammatory Medications
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Questions and Answers

What is the approximate percentage of paracetamol that is protein bound in plasma?

  • 1/2
  • 1/10
  • 3/4
  • 1/4 (correct)
  • What is the primary reason why paracetamol is not used in patients with rheumatoid arthritis?

  • It is not effective in relieving pain
  • It prolongs bleeding time
  • It has significant drug interactions
  • It is relatively ineffective when inflammation is prominent (correct)
  • What is the most common adverse effect of paracetamol in isolated antipyretic doses?

  • Nausea (correct)
  • Diarrhoea
  • Leukopenia
  • Rashes
  • Why is paracetamol a better choice than aspirin in certain patients?

    <p>It does not prolong bleeding time</p> Signup and view all the answers

    What is the recommended dose of paracetamol for children?

    <p>10-15 mg/kg, 3-4 times a day</p> Signup and view all the answers

    What is the primary advantage of paracetamol over other analgesics in terms of drug interactions?

    <p>It does not interact with other medications</p> Signup and view all the answers

    What is the primary difference in the anti-inflammatory efficacy of ibuprofen compared to high dose aspirin?

    <p>Ibuprofen has a lower anti-inflammatory efficacy</p> Signup and view all the answers

    What is a common side effect of propionic acid derivatives that is not commonly seen in peptic ulcer patients?

    <p>Fluid retention</p> Signup and view all the answers

    What is the primary mechanism of metabolism of propionic acid derivatives in the liver?

    <p>Hydroxylation and glucuronide conjugation</p> Signup and view all the answers

    What is a contraindication for the use of ibuprofen?

    <p>All of the above</p> Signup and view all the answers

    What is the primary use of ibuprofen as an 'over-the-counter' drug?

    <p>As a simple analgesic and antipyretic</p> Signup and view all the answers

    What is a unique characteristic of propionic acid derivatives in terms of their distribution?

    <p>They enter the brain, synovial fluid, and cross the placenta</p> Signup and view all the answers

    What is the primary mechanism by which ketorolac relieves pain?

    <p>A peripheral mechanism</p> Signup and view all the answers

    Which of the following adverse effects is piroxicam less likely to cause compared to aspirin?

    <p>Faecal blood loss</p> Signup and view all the answers

    What is the approximate plasma half-life of piroxicam?

    <p>Nearly 2 days</p> Signup and view all the answers

    What is the primary organ responsible for metabolizing piroxicam?

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

    What is the major metabolic pathway for ketorolac?

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

    Which of the following conditions is piroxicam suitable for use as a long-term anti-inflammatory drug?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    What is the primary reason why selective COX-2 inhibitors should be used with caution in certain patients?

    <p>Because they have a high risk of cardiovascular events</p> Signup and view all the answers

    What is a key difference between selective COX-2 inhibitors and traditional NSAIDs?

    <p>Selective COX-2 inhibitors cause less gastric mucosal damage</p> Signup and view all the answers

    What is a unique characteristic of paracetamol compared to aspirin?

    <p>It has a weaker peripheral anti-inflammatory component</p> Signup and view all the answers

    What is a contraindication for the use of selective COX-2 inhibitors?

    <p>All of the above</p> Signup and view all the answers

    What is a therapeutic use of paracetamol?

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

    What is the primary organ responsible for metabolizing propionic acid derivatives?

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

    What is a contraindication for the use of ibuprofen?

    <p>Pregnant women</p> Signup and view all the answers

    What is the therapeutic use of ibuprofen as an 'over-the-counter' drug?

    <p>Analgesic and antipyretic</p> Signup and view all the answers

    What is a unique characteristic of propionic acid derivatives in terms of their distribution?

    <p>They can enter brain, synovial fluid and cross placenta</p> Signup and view all the answers

    What is a common adverse effect of propionic acid derivatives that can precipitate in subjects sensitive to aspirin?

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

    What is the primary route of excretion for nimesulide?

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

    What is the primary mechanism by which Diclofenac exerts its therapeutic effects?

    <p>Inhibiting PG synthesis</p> Signup and view all the answers

    What is a common adverse effect of both ketorolac and nimesulide?

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

    What is the recommended dose of ketorolac for short-term management of moderate pain when administered orally?

    <p>10–20 mg 6 hourly</p> Signup and view all the answers

    What is a common adverse effect of Diclofenac?

    <p>All of the above</p> Signup and view all the answers

    Why was nimesulide withdrawn in several countries?

    <p>Due to its association with fulminant hepatic failure</p> Signup and view all the answers

    What is the recommended dose of Diclofenac for inflammatory conditions?

    <p>100 mg BD</p> Signup and view all the answers

    Which of the following is a therapeutic use of Diclofenac?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    What is the primary therapeutic use of ketorolac?

    <p>In postoperative, dental and acute musculoskeletal pain</p> Signup and view all the answers

    What type of NSAID is Diclofenac?

    <p>Non-selective COX inhibitor</p> Signup and view all the answers

    What is the primary reason for displacement interactions with mephenamic acid?

    <p>Its high protein binding</p> Signup and view all the answers

    What is the most important dose-related side effect of mephenamic acid?

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

    What is the primary therapeutic use of mephenamic acid?

    <p>As an analgesic in muscle, joint and soft tissue pain</p> Signup and view all the answers

    What is the mechanism of action of piroxicam in reducing leucocyte chemotaxis?

    <p>Reversible inhibition of COX</p> Signup and view all the answers

    What is the primary advantage of piroxicam over other NSAIDs?

    <p>Its long-acting action</p> Signup and view all the answers

    What is the primary mechanism by which piroxicam exerts its anti-inflammatory effect?

    <p>Inhibiting PG synthesis</p> Signup and view all the answers

    Which of the following adverse effects is more likely to occur with ketorolac compared to piroxicam?

    <p>Faecal blood loss</p> Signup and view all the answers

    What is the primary reason for the suitability of piroxicam as a long-term anti-inflammatory drug in certain conditions?

    <p>Its relatively low toxicity</p> Signup and view all the answers

    What is the primary difference between the pharmacokinetics of piroxicam and ketorolac?

    <p>Half-life</p> Signup and view all the answers

    What is the therapeutic use of ketorolac in which it has equalled the efficacy of morphine?

    <p>Postoperative pain</p> Signup and view all the answers

    What is the primary method of excretion of paracetamol in the body?

    <p>Through the liver in a conjugated form</p> Signup and view all the answers

    Which of the following is a common adverse effect of paracetamol in high doses?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is a therapeutic use of paracetamol in patients with certain medical conditions?

    <p>As an antipyretic in patients with fever</p> Signup and view all the answers

    What is a characteristic of paracetamol that makes it suitable for use in certain patient populations?

    <p>It does not prolong bleeding time</p> Signup and view all the answers

    What is a unique characteristic of paracetamol compared to other NSAIDs?

    <p>It does not have anti-inflammatory action</p> Signup and view all the answers

    What is the primary reason why paracetamol is used in combination with other NSAIDs?

    <p>To reduce gastrointestinal adverse effects</p> Signup and view all the answers

    What is a common use of paracetamol in pediatric patients?

    <p>As an antipyretic in patients with fever</p> Signup and view all the answers

    What is a characteristic of paracetamol pharmacokinetics?

    <p>Only about 1/4th is protein bound in plasma</p> Signup and view all the answers

    What is a therapeutic use of paracetamol in patients with certain medical conditions?

    <p>As an antipyretic in patients with fever</p> Signup and view all the answers

    What is a characteristic of paracetamol that makes it suitable for use in elderly patients?

    <p>It does not prolong bleeding time</p> Signup and view all the answers

    What is the percentage of plasma protein binding of nimesulide?

    <p>99%</p> Signup and view all the answers

    In which condition is nimesulide contraindicated?

    <p>Fulminant hepatic failure</p> Signup and view all the answers

    What type of NSAID is nimesulide?

    <p>Partially COX-2 selective</p> Signup and view all the answers

    What is the therapeutic use of ketorolac?

    <p>Short-term management of moderate pain</p> Signup and view all the answers

    What is a common adverse effect of both ketorolac and nimesulide?

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

    What is a common characteristic of the pharmacokinetics of propionic acid derivatives?

    <p>They are well absorbed orally and distribute into the brain and synovial fluid.</p> Signup and view all the answers

    What is a contraindication for the use of ibuprofen?

    <p>All of the above</p> Signup and view all the answers

    What is a therapeutic use of ibuprofen as an 'over-the-counter' drug?

    <p>Simple analgesic and antipyretic</p> Signup and view all the answers

    What is a common adverse effect of propionic acid derivatives that can precipitate in subjects sensitive to aspirin?

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

    What is the primary reason for displacement interactions with mephenamic acid?

    <p>Extensive protein binding</p> Signup and view all the answers

    What is a characteristic of naproxen, a propionic acid derivative?

    <p>It has a long half-life of 12-16 hours.</p> Signup and view all the answers

    What is the therapeutic use of mephenamic acid in which it has an advantage over other analgesics?

    <p>Muscle and joint pain</p> Signup and view all the answers

    What is the primary pharmacokinetic characteristic of piroxicam that makes it suitable for long-term use?

    <p>Long plasma half-life</p> Signup and view all the answers

    Which of the following adverse effects is more likely to occur with mephenamic acid?

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

    What is the primary mechanism by which piroxicam reduces leucocyte chemotaxis?

    <p>Reversible inhibition of COX</p> Signup and view all the answers

    What is the primary method by which paracetamol is excreted from the body?

    <p>Glucuronic acid conjugation and subsequent renal excretion</p> Signup and view all the answers

    In which group of patients is paracetamol considered a better alternative to aspirin?

    <p>Pregnant or lactating women, and those with bleeding disorders</p> Signup and view all the answers

    What is the primary therapeutic use of paracetamol in which its anti-inflammatory action is not required?

    <p>Headache and toothache</p> Signup and view all the answers

    What is the primary advantage of paracetamol over other NSAIDs?

    <p>No significant drug interactions</p> Signup and view all the answers

    What is the primary reason why paracetamol is contraindicated in certain patients?

    <p>Allergy to the drug</p> Signup and view all the answers

    What is the primary reason why single daily administration of piroxicam is sufficient?

    <p>It has a long plasma half-life</p> Signup and view all the answers

    What is a unique characteristic of ketorolac compared to other NSAIDs?

    <p>It has equalled the efficacy of morphine</p> Signup and view all the answers

    What is the primary mechanism by which piroxicam relieves pain?

    <p>It inhibits PG synthesis and relieves pain primarily by a peripheral mechanism</p> Signup and view all the answers

    What is the primary therapeutic use of piroxicam in dentistry?

    <p>As a long-term anti-inflammatory drug</p> Signup and view all the answers

    What is the primary difference between the adverse effects of piroxicam and aspirin?

    <p>Piroxicam is less ulcerogenic and causes less faecal blood loss</p> Signup and view all the answers

    What is the primary reason for the shorter duration of action of Diclofenac despite its good tissue penetrability?

    <p>Its short plasma half-life of 2 hours</p> Signup and view all the answers

    Which of the following conditions is a contraindication for the use of Diclofenac?

    <p>Gastric ulceration</p> Signup and view all the answers

    What type of NSAID is Diclofenac classified as?

    <p>Non-selective COX inhibitor</p> Signup and view all the answers

    What is the primary therapeutic use of Diclofenac?

    <p>Short-term management of painful inflammatory conditions</p> Signup and view all the answers

    What is a common adverse effect of Diclofenac?

    <p>All of the above</p> Signup and view all the answers

    What is the primary reason for caution when using selective COX-2 inhibitors in certain patients?

    <p>History of ischaemic heart disease/hypertension/cardiac failure/cerebrovascular disease</p> Signup and view all the answers

    What is the primary advantage of paracetamol over aspirin in certain patients?

    <p>Fewer gastrointestinal side effects</p> Signup and view all the answers

    What is the primary mechanism of paracetamol's analgesic action?

    <p>Increase in pain threshold</p> Signup and view all the answers

    Which of the following is an example of a selective COX-2 inhibitor?

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

    What is the primary therapeutic use of paracetamol?

    <p>Analgesic and antipyretic</p> Signup and view all the answers

    What is a unique characteristic of selective COX-2 inhibitors?

    <p>No effect on platelet aggregation</p> Signup and view all the answers

    Which of the following is a contraindication for the use of selective COX-2 inhibitors?

    <p>History of ischaemic heart disease/hypertension/cardiac failure/cerebrovascular disease</p> Signup and view all the answers

    What is the primary difference between selective COX-2 inhibitors and traditional NSAIDs?

    <p>Selective COX-2 inhibitors have fewer gastrointestinal side effects</p> Signup and view all the answers

    What is a key difference between paracetamol and aspirin?

    <p>Paracetamol has weak peripheral anti-inflammatory component</p> Signup and view all the answers

    What is the primary therapeutic use of selective COX-2 inhibitors?

    <p>Anti-inflammatory</p> Signup and view all the answers

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