Applied pharma chap 5 Flashcards

The perception of pain is the patient’s emotional or psychological response to pain and varies greatly from individual to individual. The reaction to pain is the physical component to the message of pain as it is carried through the nervous system and is the same for everyone.

The primary site of action for nonopioid analgesics is

1. within the central nervous system.
2. in the hypothalamus.
3. at the peripheral nerve endings.
4. in the brainstem.

The primary action of the nonopioid analgesics is depression of the central nervous system. The inhibition of prostaglandin synthesis reduces the perception of pain.

All are classifications of nonopioid analgesics except; which is the exception?

1. Narcotics Correct
2. Salicylates
3. Nonsalicylate/nonnarcotics
4. Nonsteroidal antiinflammatory drugs (NSAIDs)

Which best describes the mechanisms of action for the salicylates?

1. Antidyspeptic, antipyretic, antiinflammatory, antiplatelet
2. Analgesic, antipyretic, antiinflammatory, antiplatelet
3. Sedative, analgesic, antiinflammatory, antiplatelet
4. Analgesic, antitussive, antiinflammatory, antiplatelet

All are adverse drug effects of aspirin except; which is the exception?

1. Gastrointestinal upset and bleeding
2. Increased bleeding time
3. Reye’s syndrome
4. Constipation
5. Problems during pregnancy and delivery
6. Hepatic and renal damage

What is the most common adverse reaction to aspirin?

1. Tachycardia
2. Gastrointestinal upset
3. Dizziness Incorrect
4. Headache
5. Hepatoxity
6. Renal problems

Dangerous bleeding can occur when which drug is combined with warfarin?

1. Aspirin
2. Ibuprofen
3. Acetaminophen
4. Codeine

What is the drug of choice for inflammatory dental pain?

1. Aspirin
2. Ibuprofen
3. Acetaminophen
4. Codeine

NSAIDs and aspirin reduce inflammation by inhibiting the synthesis of

1. interleukin.
2. prostaglandins.
3. cytokines.
4. histamine.

Acetaminophen has these pharmacologic actions except; which is the exception?

1. Analgesia
2. Antipyretic
3. Antiinflammatory
4. Hepatoxic

What is the drug of choice for fever reduction in children?

1. Codeine
2. Aspirin
3. Ibuprofen
4. Acetaminophen

Which analgesic would be best for a patient with asthma for relief of a headache or other mild to moderate pain?

1. Aspirin
2. Ibuprofen
3. Acetaminophen
4. Codeine

Which nonopioid analgesic is recommended for prevention of coronary artery disease and treatment of myocardial infarction?

1. Aspirin
2. Ibuprofen
3. Acetaminophen
4. Codeine

Which statement is true regarding the effects of combining caffeine and aspirin?

1. Caffeine has no effect on the analgesic properties of aspirin.
2. Caffeine potentiates the antipyretic properties of aspirin.
3. Caffeine potentiates the analgesic properties of aspirin.
4. Caffeine decreases the analgesic properties of aspirin.

All statements are true about pain except; which is the exception?

1. Pain represents a protective reflex for self-preservation.
2. Pain is a diagnostic symptom of an underlying pathologic condition.
3. A decrease in the pain threshold or greater reaction to pain has been said to be associated with emotional stability.
4. The pain threshold is increased by sleep, sympathy, activities, and analgesics.
5. The sensation of pain makes the body aware of the presence of tissue damage.

Nonopioid analgesic drugs can be divided into which groups?

1. Acetaminophen, NSAIDs (Non-steroidal antiinflammatory drugs), Salicylates (aspirin-like group)
2. Salicylates (aspirin-like group), NSAIDS, Steroidal antiinflammatory drugs
3. Steroidal antiinflammatory drugs, NSAIDS, acetaminophen
4. All are correct

Which groups of analgesics are most closely related?

1. Acetaminophen and the salicylates
2. Salicylates and the opioids
3. Salicylates and NSAIDs
4. Acetaminophen and NSAIDs
5. NSAIDs and opioids

Aspirin has all effects except; which is the exception?

1. Analgesic
2. Antipyretic
3. Antiinflammatory
4. Central nervous system depression
5. Antiplatelet

Aspirin and ibuprofen are most effective against which type of pain?

1. Neurologic or stabbing
2. Throbbing or inflammatory
3. Spasmodic, muscular
4. Chronic, noninflammatory

Aspirin is absorbed rapidly from the

1. blood plasma.
2. hepatic portal system.
3. stomach and small intestine.
4. small intestine and large intestine.

Aspirin has a long history of use for relief of mild to moderate pain such as a headache or toothache, and aspirin’s worth as an analgesic is well recognized by the lay public.

Fever is regulated in which area of the body?

1. Adrenal medulla
2. Adrenal cortex
3. Hypothalamus
4. Spinal cord

Which statement is most correct regarding the use of aspirin as an antipyretic?

1. Aspirin reduces fever by inducing central vasodilation.
2. Aspirin reduces elevated and normal temperatures.
3. Aspirin reduces fever by inducing peripheral vasodilation and sweating.
4. Aspirin reduces elevated temperature but has no effect on normal body temperature.

Aspirin can have adverse drug interactions with which drugs?

1. Probenecid
2. Warfarin
3. Methotrexate
4. Sulfonylureas
5. Antihypertensives
6. All are correct

Buffered aspirins claim to produce fewer gastrointestinal adverse effects. Numerous clinical studies support this claim.

This group of analgesics is believed by many prescribers to be the most useful analgesia to treat dental pain.

1. Narcotics
2. Salicylates
3. Acetaminophen
4. NSAIDs

NSAIDs are similar in their analgesic, antipyretic, and anti-inflammatory actions to the salicylates. They differ in their

1. platelet binding ability.
2. effect on serum uric acid.
3. metabolism and excretion.
4. adverse gastrointestinal effects.

Which is the mechanism by which the salicylates and the NSAIDs cause gastrointestinal irritation, pain, and bleeding problems?

1. Acidity of the medications
2. Directly increase in acid secretion
3. Increase production of harmful prostaglandins
4. Inhibition of the production of cytoprotective mucus in the stomach

Which statement is true regarding NSAIDs?

1. These agents are addictive.
2. Some patients experience central nervous system side effects.
3. Tolerance to NSAIDs may develop.
4. Withdrawal syndrome may occur with NSAIDs. Incorrect
5. All are correct

How long before the procedure should a patient scheduled for oral surgery avoid ibuprofen?

1. No waiting period Incorrect
2. 1 day
3. 2 days
4. 3 days
5. 2 weeks

NSAIDs can dangerously decrease renal blood flow and glomerular filtration in what patient population?

1. Patients with normal kidney function
2. Patients with renal disease
3. Patients with normal hepatic function
4. Patients with cardiovascular disease

NSAIDs may increase drug effects and toxicity when given with these medications EXCEPT; which is the EXCEPTION?

1. Lithium
2. Digoxin
3. Cyclosporine
4. Methotrexate Incorrect
5. Angiotensin-converting enzyme (ACE) inhibitors
6. All are correct

NSAIDs are indicated for which conditions?

1. Asthma
2. Osteoarthritis
3. Cardiovascular or renal diseases with fluid retention
4. Peptic ulcers Incorrect
5. Ulcerative colitis

All of these drugs are NSAIDs except; which is the exception?

1. Paracetamol
2. Fenoprofen
3. Ketorolac
4. Ibuprofen
5. Naproxen and naproxen sodium

The primary advantage of the cyclooxygenase II (COX II)-specific inhibitors is that these agents are

1. safer.
2. lower cost.
3. more effective than nonspecific COX II inhibitors.
4. have no real therapeutic advantage over nonselective NSAIDs.

Acetaminophen has therapeutic indications EXCEPT; which is the EXCEPTION?

1. Analgesic
2. Antiinflammatory
3. Antipyretic Incorrect
4. Antiplatelet
5. All are correct

Which is the maximal safe dose of alcohol that may be ingested with 2 grams of acetaminophen(APAP) in a normal adult?

1. No alcohol is safe with acetaminophen
2. Less than one drink a day
3. Less than two drinks a day
4. Less than three drinks a day

The risk of nephrotoxicity is highest with which pattern of analgesic usage?

1. Occasional
2. Chronic, long term
3. Concurrent use of acetaminophen, aspirin, and NSAIDs

Both NSAIDs and colchicine are used to prevent attacks of gout. Probenecid and allopurinol are agents used to treat acute gout attacks.

The patient discloses on the medical history that he is taking 8 extra-strength (500 mg each) acetaminophen every day for his chronic back pain. What information should the dental hygienist give this patient?

1. Follow the specific dose directions for acetaminophen.
2. No alcohol should be consumed.
3. The dose being taken can lead to liver toxicity.
4. Do not increase the dose or take more than recommended in a 24 hour period. Incorrect
5. All are correct

Acetaminophen has many drug interactions at usual therapeutic doses. The hepatoxicity of acetaminophen can be potentiated by drugs that induce hepatic microsomal enzymes, such as barbiturates, carbamazepine, phenytoin, and rifampin.

Which statements are true concerning acetaminophen?

1. Children are susceptible to accidental overdose.
2. Normal doses over extended periods can lead to toxicity.
3. Patients who consume three or more alcohol beverages should avoid acetaminophen.
4. The most common form of accidental overdose in children is use of the wrong dose form.
5. All are correct

The primary advantage of ketorolac (Toradol) over other NSAIDs is

1. increased efficacy.
2. decreased bleeding effects.
3. can by administered parenterally or enterally.
4. less expensive than other NSAIDs.

All NSAIDs decrease the risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke. This effect is increased with longer duration of use.

Disease Modifying-Antirheumatic Drugs (DMARDs) slow down and can stop the progression of rheumatoid arthritis (RA). These drugs work by increasing the body’s immune and inflammatory systems to slow disease progression.

All are examples of Tumor Necrosis Factor-α (TNF-α) Inhibitors used to treat rheumatoid arthritis except; which is the exception?

1. adalimumab (Humira)
2. certolizumab (Cimzia)
3. auranofin (Ridaura)
4. golimumab (Simponi)
5. infliximab (Remicade)

Which is the MOST important dental hygiene consideration for patients taking Disease Modifying-Antirheumatic Drugs (DMARDs)?

1. Carefully monitor vital signs due to the risk of elevated blood pressure and heart rate.
2. Allow position modifications to ensure patient comfort.
3. Monitor patient carefully for signs of infection.
4. Provide prophylactic antibiotic premedication to avoid bacteremias.
5. All are correct.