98 Questions
What is the approximate percentage of paracetamol that is protein bound in plasma?
1/4
What is the primary reason why paracetamol is not used in patients with rheumatoid arthritis?
It is relatively ineffective when inflammation is prominent
What is the most common adverse effect of paracetamol in isolated antipyretic doses?
Nausea
Why is paracetamol a better choice than aspirin in certain patients?
It does not prolong bleeding time
What is the recommended dose of paracetamol for children?
10-15 mg/kg, 3-4 times a day
What is the primary advantage of paracetamol over other analgesics in terms of drug interactions?
It does not interact with other medications
What is the primary difference in the anti-inflammatory efficacy of ibuprofen compared to high dose aspirin?
Ibuprofen has a lower anti-inflammatory efficacy
What is a common side effect of propionic acid derivatives that is not commonly seen in peptic ulcer patients?
Fluid retention
What is the primary mechanism of metabolism of propionic acid derivatives in the liver?
Hydroxylation and glucuronide conjugation
What is a contraindication for the use of ibuprofen?
All of the above
What is the primary use of ibuprofen as an 'over-the-counter' drug?
As a simple analgesic and antipyretic
What is a unique characteristic of propionic acid derivatives in terms of their distribution?
They enter the brain, synovial fluid, and cross the placenta
What is the primary mechanism by which ketorolac relieves pain?
A peripheral mechanism
Which of the following adverse effects is piroxicam less likely to cause compared to aspirin?
Faecal blood loss
What is the approximate plasma half-life of piroxicam?
Nearly 2 days
What is the primary organ responsible for metabolizing piroxicam?
Liver
What is the major metabolic pathway for ketorolac?
Glucuronidation
Which of the following conditions is piroxicam suitable for use as a long-term anti-inflammatory drug?
Rheumatoid arthritis
What is the primary reason why selective COX-2 inhibitors should be used with caution in certain patients?
Because they have a high risk of cardiovascular events
What is a key difference between selective COX-2 inhibitors and traditional NSAIDs?
Selective COX-2 inhibitors cause less gastric mucosal damage
What is a unique characteristic of paracetamol compared to aspirin?
It has a weaker peripheral anti-inflammatory component
What is a contraindication for the use of selective COX-2 inhibitors?
All of the above
What is a therapeutic use of paracetamol?
Relief of pain and fever
What is the primary organ responsible for metabolizing propionic acid derivatives?
Liver
What is a contraindication for the use of ibuprofen?
Pregnant women
What is the therapeutic use of ibuprofen as an 'over-the-counter' drug?
Analgesic and antipyretic
What is a unique characteristic of propionic acid derivatives in terms of their distribution?
They can enter brain, synovial fluid and cross placenta
What is a common adverse effect of propionic acid derivatives that can precipitate in subjects sensitive to aspirin?
Asthma
What is the primary route of excretion for nimesulide?
Urine
What is the primary mechanism by which Diclofenac exerts its therapeutic effects?
Inhibiting PG synthesis
What is a common adverse effect of both ketorolac and nimesulide?
Nausea
What is the recommended dose of ketorolac for short-term management of moderate pain when administered orally?
10–20 mg 6 hourly
What is a common adverse effect of Diclofenac?
All of the above
Why was nimesulide withdrawn in several countries?
Due to its association with fulminant hepatic failure
What is the recommended dose of Diclofenac for inflammatory conditions?
100 mg BD
Which of the following is a therapeutic use of Diclofenac?
Rheumatoid arthritis
What is the primary therapeutic use of ketorolac?
In postoperative, dental and acute musculoskeletal pain
What type of NSAID is Diclofenac?
Non-selective COX inhibitor
What is the primary reason for displacement interactions with mephenamic acid?
Its high protein binding
What is the most important dose-related side effect of mephenamic acid?
Diarrhoea
What is the primary therapeutic use of mephenamic acid?
As an analgesic in muscle, joint and soft tissue pain
What is the mechanism of action of piroxicam in reducing leucocyte chemotaxis?
Reversible inhibition of COX
What is the primary advantage of piroxicam over other NSAIDs?
Its long-acting action
What is the primary mechanism by which piroxicam exerts its anti-inflammatory effect?
Inhibiting PG synthesis
Which of the following adverse effects is more likely to occur with ketorolac compared to piroxicam?
Faecal blood loss
What is the primary reason for the suitability of piroxicam as a long-term anti-inflammatory drug in certain conditions?
Its relatively low toxicity
What is the primary difference between the pharmacokinetics of piroxicam and ketorolac?
Half-life
What is the therapeutic use of ketorolac in which it has equalled the efficacy of morphine?
Postoperative pain
What is the primary method of excretion of paracetamol in the body?
Through the liver in a conjugated form
Which of the following is a common adverse effect of paracetamol in high doses?
Nausea and vomiting
What is a therapeutic use of paracetamol in patients with certain medical conditions?
As an antipyretic in patients with fever
What is a characteristic of paracetamol that makes it suitable for use in certain patient populations?
It does not prolong bleeding time
What is a unique characteristic of paracetamol compared to other NSAIDs?
It does not have anti-inflammatory action
What is the primary reason why paracetamol is used in combination with other NSAIDs?
To reduce gastrointestinal adverse effects
What is a common use of paracetamol in pediatric patients?
As an antipyretic in patients with fever
What is a characteristic of paracetamol pharmacokinetics?
Only about 1/4th is protein bound in plasma
What is a therapeutic use of paracetamol in patients with certain medical conditions?
As an antipyretic in patients with fever
What is a characteristic of paracetamol that makes it suitable for use in elderly patients?
It does not prolong bleeding time
What is the percentage of plasma protein binding of nimesulide?
99%
In which condition is nimesulide contraindicated?
Fulminant hepatic failure
What type of NSAID is nimesulide?
Partially COX-2 selective
What is the therapeutic use of ketorolac?
Short-term management of moderate pain
What is a common adverse effect of both ketorolac and nimesulide?
Nausea
What is a common characteristic of the pharmacokinetics of propionic acid derivatives?
They are well absorbed orally and distribute into the brain and synovial fluid.
What is a contraindication for the use of ibuprofen?
All of the above
What is a therapeutic use of ibuprofen as an 'over-the-counter' drug?
Simple analgesic and antipyretic
What is a common adverse effect of propionic acid derivatives that can precipitate in subjects sensitive to aspirin?
Asthma
What is the primary reason for displacement interactions with mephenamic acid?
Extensive protein binding
What is a characteristic of naproxen, a propionic acid derivative?
It has a long half-life of 12-16 hours.
What is the therapeutic use of mephenamic acid in which it has an advantage over other analgesics?
Muscle and joint pain
What is the primary pharmacokinetic characteristic of piroxicam that makes it suitable for long-term use?
Long plasma half-life
Which of the following adverse effects is more likely to occur with mephenamic acid?
Diarrhea
What is the primary mechanism by which piroxicam reduces leucocyte chemotaxis?
Reversible inhibition of COX
What is the primary method by which paracetamol is excreted from the body?
Glucuronic acid conjugation and subsequent renal excretion
In which group of patients is paracetamol considered a better alternative to aspirin?
Pregnant or lactating women, and those with bleeding disorders
What is the primary therapeutic use of paracetamol in which its anti-inflammatory action is not required?
Headache and toothache
What is the primary advantage of paracetamol over other NSAIDs?
No significant drug interactions
What is the primary reason why paracetamol is contraindicated in certain patients?
Allergy to the drug
What is the primary reason why single daily administration of piroxicam is sufficient?
It has a long plasma half-life
What is a unique characteristic of ketorolac compared to other NSAIDs?
It has equalled the efficacy of morphine
What is the primary mechanism by which piroxicam relieves pain?
It inhibits PG synthesis and relieves pain primarily by a peripheral mechanism
What is the primary therapeutic use of piroxicam in dentistry?
As a long-term anti-inflammatory drug
What is the primary difference between the adverse effects of piroxicam and aspirin?
Piroxicam is less ulcerogenic and causes less faecal blood loss
What is the primary reason for the shorter duration of action of Diclofenac despite its good tissue penetrability?
Its short plasma half-life of 2 hours
Which of the following conditions is a contraindication for the use of Diclofenac?
Gastric ulceration
What type of NSAID is Diclofenac classified as?
Non-selective COX inhibitor
What is the primary therapeutic use of Diclofenac?
Short-term management of painful inflammatory conditions
What is a common adverse effect of Diclofenac?
All of the above
What is the primary reason for caution when using selective COX-2 inhibitors in certain patients?
History of ischaemic heart disease/hypertension/cardiac failure/cerebrovascular disease
What is the primary advantage of paracetamol over aspirin in certain patients?
Fewer gastrointestinal side effects
What is the primary mechanism of paracetamol's analgesic action?
Increase in pain threshold
Which of the following is an example of a selective COX-2 inhibitor?
Celebrex
What is the primary therapeutic use of paracetamol?
Analgesic and antipyretic
What is a unique characteristic of selective COX-2 inhibitors?
No effect on platelet aggregation
Which of the following is a contraindication for the use of selective COX-2 inhibitors?
History of ischaemic heart disease/hypertension/cardiac failure/cerebrovascular disease
What is the primary difference between selective COX-2 inhibitors and traditional NSAIDs?
Selective COX-2 inhibitors have fewer gastrointestinal side effects
What is a key difference between paracetamol and aspirin?
Paracetamol has weak peripheral anti-inflammatory component
What is the primary therapeutic use of selective COX-2 inhibitors?
Anti-inflammatory
This quiz covers Propionic acid derivatives, including Ibuprofen, Naproxen, Ketoprofen, and Flurbiprofen. It includes their plasma half-lives, dosages, and preparations.
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