18
(d)
10. Which of the following anti-inflammatory agents does NOT act
primarily by inhibiting activity of prostaglandin synthetase?
a.
Diflunisal
b.
Ibuprofen
c.
Triamcinolone
d.
Oxyphenbutazone
e.
Acetylsalicylic acid
(c) triamcinolone is a corticosteroid. Corticosteroids inhibit
phospholipase A2, the enzymatic step that precedes
prostaglandin synthetase. Diflunisal is a salicylate analgesic, like
aspirin.
11. A nonsteroidal, anti-inflammatory agent that appears to produce fewer
gastrointestinal disturbances than high does of aspirin is
a. Ibuprofen
b. Probenecid
c. Pentazocine
d. Acetaminophen
e. Phenylbutazone
(a) you might be tempted to answer acetaminophen, because it
doesn’t cause GI upset, but remember it is also not anti-
inflammatory. The answer is ibuprofen. Tricky – you had to sort
through two distinguishing characteristics. Good question!
12. Prolonged use of which of the following drugs does NOT cause a
predisposition to gastric irritation and bleeding?
a.
Phenytoin
b.
Ibuprofen
c.
Indomethacin
d.
Phenylbutazone
e.
Acetylsalicylic acid
(a) This is a straight drug identification question. Answers 2-5
are all non-steroidal antiinflammatory drugs which cause gastric
irritation and bleeding due to their effects on prostaglandin
synthesis in the mucosal wall of the gut. # , phenytoin, is an
anti-convulsant-its major side effect that often appears as a
question on boards is the production of gingival hyperplasia.
13. Each of the following agents has been associated with gastric
irritation EXCEPT
a.
Aspirin
b.
Alcohol
c.
Ibuprofen
d.
Indomethacin
e.
Acetaminophen
(e) note the difference in this question and #11 and 12.
Ibuprofen was previously the answer to “shows reduced GI
irritation”, but it does cause some, which you have to remember
to answer #12 and this question. So aspirin and ibuprofen are
out. Indomethacin is a very strong NSAID that causes lots of GI
irritation, so much that use is limited in humans, so it is out.
What about alocohol vs. acetaminophen. Well, you should really
know that acetaminophen is usually the answer to these types
of analgesics questions, but if you didn’t know that, perhaps you
may know that alcohol also causes GI irritation, so it is out.
14. Which of the following is NOT produced by excessive doses of
acetylsalicylic acid?
a.
Delirium
b.
Tinnitus
c.
Hypothermia
d.
Hyperventilation
e.
Metabolic acidosis
(c) it only lowers your temperature if you have a fever,, taking
aspirin does not have any effect on body temperature in the
non-feverish patient, but high doses can cause all the other
effects listed.
15. All of the following are pharmacologic and toxicologic properties of
aspirin EXCEPT
a. Tinnitus
b. Analgesia
c. Salicylism
d. Antipyresis
e. Suppression of the immune response
(e)
16. Therapeutic effects of aspirin include
a.
Analgesia
b.
Tranquilization
c.
Pyretic action
d.
Anti-inflammatory action
e.
Antirheumatic action
i. (a), (b) and (c)
ii. (a), (c) and (d)
iii. (a), (d) and (e)
iv. (b), (c) and (d)
v. (b), (d) and (e)
(iii)
17. All of the following are pharmacologic or toxicologic properties of
acetylsalicylic acid EXCEPT
a. Tinnitus
b. Analgesia
c. Antipyresis
d. Methemoglobinemia
e. Inhibition of prostaglandin synthesis
(d)
18. All of the following are possible effects of aspirin EXCEPT
a. Reduction of fever
b. Shortening of bleeding time
c. Suppression of inflammatory response
d. Bleeding from the gastronintestinal tract
e. Increase in the renal excretion of uric acid at high doses
(e)
19. Of the following, aspirin does NOT cause
a. Occult bleeding
b. Nausea and vomiting
c. Acid-base disturbance
d. Suppression of the cough reflex
e. Decreased tubular reabsorption of uric acid
(d) Answer is (d)- (a) & (b) are the major side effects of aspirin
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