Pharm 36 Flashcards

What is the pathophysiologic mechanism underlying NSAID-exacerbated respiratory disease?

Inhibition of the ______ pathway by NSAIDs → ______ overproduction → Airway constriction

What effect would the administration of NSAIDs have on patients with low renal blood flow states?

Inhibition of ______ synthesis by NSAIDs → ______ of afferent arterioles and ______ glomerular filtration rate → Possible acute kidney injury

How do NSAIDs affect renal afferent arterioles?

NSAIDs block prostaglandins' _______ effect on afferent arterioles → _______ of afferent arterioles

By blocking prostaglandins, NSAIDs lead to _______ ulcers and _______ ischemia.

Which NSAID is indicated for patent ductus arteriosus in a newborn?

________

What is the mechanism of action of NSAIDs?

________ inhibition of ________ and ________ → Blocks ________ synthesis

What are potential renal side effect of NSAIDs?

Interstitial _______
Renal _______

Name 7 NSAIDs:

I______

I______

N______

K______

D______

M______

P______

Which drug contains CTLA-4 and prevents T-cell activation by binding CD80/CD86?

A. Abatacept

B. Tocilizumab

C. Adalimumab

D. Etanercept

Abatacept prevents which normal costimulatory interaction required for T-cell activation?

A. CTLA-4 with CD28

B. CD28 with CD80/CD86

C. TNF with p55/p75

D. IL-6 with IL-6R

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Abatacept is used to treat which conditions in these notes?

A. SLE and scleroderma

B. Crohn disease and UC

C. Polymyositis and PA

D. RA and juvenile idiopathic arthritis

Which synthetic nonbiologic DMARD acts primarily through the metabolite 6-thioguanine?

A. Azathioprine

B. Methotrexate

C. Cyclophosphamide

D. Sulfasalazine

The major active metabolite responsible for azathioprine's immunosuppressive effects is what?

A. Mycophenolic acid

B. 6-thioguanine

C. Sulfapyridine

D. Adenosine

6-Thioguanine suppresses synthesis of which metabolic intermediate?

A. Thymidylate

B. Adenosine

C. Inosinic acid

D. Folic acid

Which combination of immune effects is produced by 6-thioguanine?

A. Increased B-cell and T-cell function

B. Increased Ig and IL-2 production

C. Increased macrophage activation

D. Suppressed lymphocytes, Ig, and IL-2

A patient has very low thiopurine methyltransferase activity before azathioprine therapy. Which toxicity risk is increased?

A. Hepatic fibrosis

B. Myelosuppression

C. Pulmonary fibrosis

D. Renal failure

Which condition is an indication for azathioprine according to these notes?

A. Crohn disease

B. Osteoarthritis

C. Kidney transplant rejection prevention

D. Bacterial endocarditis

Which group contains only listed indications for azathioprine?

A. RA, asthma, COPD, psoriasis

B. UC, gout, MS, myasthenia

C. JIA, Crohn, AS, psoriasis

D. RA, SLE, polymyositis, scleroderma

Antimalarial drugs are commonly used in which autoimmune disease?

A. SLE

B. Rheumatoid arthritis

C. Reactive arthritis

D. Polymyositis

Why are antimalarials commonly used in SLE?

A. Increase antibody production

B. Reduce mortality and manifestations

C. Increase IL-2 secretion

D. Promote T-cell activation

Which SLE manifestations are improved by antimalarial therapy according to these notes?

A. Nephritis and psychosis

B. Myocarditis and vasculitis

C. Skin, serositis, and joint pain

D. Hemolysis and thrombosis

Which synthetic nonbiologic DMARD cross-links DNA and prevents cellular replication?

A. Azathioprine

B. Methotrexate

C. Sulfasalazine

D. Cyclophosphamide

At the doses used for rheumatoid arthritis, methotrexate inhibits AICAR and which additional enzyme?

A. Thymidylate synthetase

B. TPMT

C. AMP deaminase directly

D. Xanthine oxidase

Methotrexate inhibition of AICAR metabolism causes intracellular accumulation of what molecule?

A. Adenosine

B. AICAR

C. Inosinic acid

D. 6-thioguanine

Accumulated AICAR inhibits which enzyme during low-dose methotrexate therapy?

A. DHFR

B. TPMT

C. AMP deaminase

D. Thymidylate kinase

Inhibition of AMP deaminase by accumulated AICAR causes intracellular accumulation of what?

A. GMP

B. IMP

C. ADP

D. AMP

Extracellular AMP generated during methotrexate therapy is converted into what potent anti-inflammatory molecule?

A. Adenosine

B. Guanosine

C. Inosine

D. Cytidine

The anti-inflammatory action of low-dose methotrexate suppresses functions of which cells?

A. Erythrocytes and platelets

B. Neutrophils, macrophages, DCs, lymphocytes

C. Osteocytes and chondrocytes

D. Cardiomyocytes and hepatocytes

At higher doses, methotrexate additionally inhibits which enzyme?

A. TPMT

B. AMP deaminase

C. Dihydrofolate reductase

D. Xanthine oxidase

Mycophenolate mofetil is converted into which active compound?

A. Sulfapyridine

B. 6-thioguanine

C. Adenosine

D. Mycophenolic acid

Mycophenolic acid inhibits which adhesion molecules according to these notes?

A. P-selectin, E-selectin, ICAM-1

B. CD28, CD80, CD86

C. p55, p75, TNF

D. IL-6R, CD4, CD8

Which sulfasalazine metabolite is most likely responsible for benefit in rheumatoid arthritis?

A. 5-aminosalicylic acid

B. Sulfapyridine

C. Mycophenolic acid

D. 6-thioguanine

Which sulfasalazine moiety is active in inflammatory bowel disease?

A. Sulfapyridine

B. Adenosine

C. 5-aminosalicylic acid

D. AICAR

Tocilizumab is a humanized antibody directed against which target?

A. TNF-alpha

B. CD80/CD86

C. p55 and p75

D. IL-6 receptors

Tocilizumab binds which forms of the IL-6 receptor?

A. Soluble and membrane-bound

B. Cytoplasmic and nuclear

C. Presynaptic and postsynaptic

D. Intracellular and mitochondrial

Tocilizumab is indicated for adults with moderate-to-severe RA who have failed what?

A. One antibiotic

B. One or more DMARDs

C. Corticosteroids only

D. TNF inhibitors exclusively

Tocilizumab can be used in patients older than two years with which conditions?

A. SLE and scleroderma

B. Crohn and ulcerative colitis

C. Systemic or polyarticular JIA

D. Reactive and psoriatic arthritis

Which drug is a fully human IgG1 monoclonal antibody against TNF-alpha?

A. Certolizumab

B. Etanercept

C. Tocilizumab

D. Adalimumab

Adalimumab prevents TNF-alpha from interacting with which receptors?

A. p55 and p75

B. CD80 and CD86

C. IL-6R and ICAM-1

D. P-selectin and E-selectin

Blocking TNF-alpha with adalimumab downregulates which immune-cell functions?

A. Neutrophils and eosinophils

B. Macrophages and T cells

C. B cells and platelets

D. Mast cells and basophils

TNF-alpha blocking agents are particularly useful for treating which disease?

A. Scleroderma

B. Polymyositis

C. Rheumatoid arthritis

D. Rheumatic fever

Which group contains additional indications for TNF-alpha blockade listed in these notes?

A. SLE, PA, scleroderma

B. Gout, OA, lupus, MS

C. JIA, myocarditis, vasculitis

D. AS, IBD, psoriatic arthritis

Which TNF-alpha inhibitor is a PEG-conjugated recombinant humanized Fab fragment?

A. Certolizumab

B. Adalimumab

C. Etanercept

D. Tocilizumab

Certolizumab neutralizes which forms of TNF-alpha?

A. Intracellular and cytoplasmic

B. Membrane-bound and soluble

C. Nuclear and cytoplasmic

D. Receptor-bound and soluble

Certolizumab neutralizes TNF-alpha in what type of relationship?

A. Time-independent

B. Receptor-independent

C. Dose-dependent

D. Irreversible

Which group contains only listed indications for certolizumab?

A. SLE, scleroderma, polymyositis

B. JIA, gout, OA, lupus

C. Psoriasis, myocarditis, vasculitis

D. RA, Crohn, AS, psoriatic arthritis

Which TNF inhibitor consists of two soluble TNF receptor moieties fused to human IgG1 Fc?

A. Etanercept

B. Adalimumab

C. Certolizumab

D. Tocilizumab

Etanercept binds TNF-alpha and additionally inhibits which inflammatory mediator?

A. IL-1 beta

B. Lymphotoxin-alpha

C. IL-6

D. BLyS

Which drug is a recombinant TNF-receptor fusion protein that also inhibits lymphotoxin-alpha?

A. Golimumab

B. Certolizumab

C. Etanercept

D. Tofacitinib

Which group contains only indications for etanercept?

A. RA, JIA, psoriasis, ankylosing spondylitis

B. SLE, gout, UC, psoriasis

C. RA, CAPS, Crohn, gout

D. SLE, JIA, UC, scleroderma

Golimumab is best described as which type of drug?

A. Human anti-TNF monoclonal antibody

B. Recombinant IL-1 receptor antagonist

C. Selective JAK inhibitor

D. Soluble IL-1 decoy receptor

Golimumab has high affinity for which forms of TNF-alpha?

A. Intracellular and nuclear

B. Soluble and membrane-bound

C. Cytoplasmic and secreted

D. Receptor-bound and degraded

Golimumab combined with methotrexate is indicated for which rheumatologic condition?

A. Mild osteoarthritis

B. Active gout

C. Moderate-severe active RA

D. Systemic lupus erythematosus

Which additional disease is listed as an indication for golimumab?

A. Crohn disease

B. Psoriasis

C. CAPS

D. Ulcerative colitis

Tofacitinib inhibits which intracellular signaling enzyme family?

A. Janus kinases

B. Cyclooxygenases

C. Lipoxygenases

D. Phospholipases

Tofacitinib blocks which major intracellular signaling pathway?

A. MAPK pathway

B. JAK-STAT pathway

C. NF-kB pathway

D. Complement pathway

At therapeutic concentrations, tofacitinib predominantly inhibits which JAK isoform?

A. JAK1

B. JAK2

C. JAK3

D. TYK2

Tofacitinib inhibits which kinase to a lesser degree than JAK3?

A. JAK2

B. TYK2

C. SRC

D. JAK1

The JAK-STAT pathway plays an important role in the pathogenesis of which disease?

A. Rheumatoid arthritis

B. Osteoarthritis

C. Gout

D. Fibromyalgia

Tofacitinib is approved in these notes for which severity of rheumatoid arthritis?

A. Mild RA

B. Moderate-severe RA

C. Preclinical RA

D. Remitted RA

Anakinra is a recombinant form of which molecule?

A. IL-6 receptor

B. TNF receptor

C. IL-1 receptor antagonist

D. BLyS receptor

Anakinra blocks the effects of which cytokines?

A. IL-6 and IL-8

B. TNF-alpha and TNF-beta

C. IL-2 and IL-4

D. IL-1alpha and IL-1beta

What overall immune effect results from anakinra therapy?

A. Increased T-cell activation

B. Decreased immune response

C. Increased antibody production

D. Increased complement activation

Anakinra is now rarely used for rheumatoid arthritis but is indicated for which conditions?

A. SLE and scleroderma

B. UC and Crohn disease

C. CAPS and gout

D. Psoriasis and ankylosing spondylitis

Rilonacept primarily binds and neutralizes which cytokine?

A. TNF-alpha

B. IL-6

C. BLyS

D. IL-1beta

How does rilonacept reduce inflammation?

A. Prevents IL-1beta receptor binding

B. Blocks JAK3 signaling

C. Inhibits TNF receptor synthesis

D. Prevents BLyS secretion

Which CAPS subtype is an indication for rilonacept?

A. Adult Still disease

B. Familial cold autoinflammatory syndrome

C. Systemic juvenile arthritis

D. Reactive arthritis

Which additional CAPS subtype can be treated with rilonacept?

A. Behçet syndrome

B. Sjögren syndrome

C. Muckle-Wells syndrome

D. Felty syndrome

Rilonacept is approved for the listed CAPS syndromes in patients older than what age?

A. 2 years

B. 6 years

C. 8 years

D. 12 years

Belimumab specifically inhibits which B-cell survival mediator?

A. BLyS

B. IL-1beta

C. TNF-alpha

D. IL-6

Belimumab is approved for adult patients with which disease?

A. Seronegative RA

B. Seropositive SLE

C. Ankylosing spondylitis

D. Psoriatic arthritis

Selective COX-2 inhibitors increase the risk of which adverse effects?

A. Edema, hypertension, cardiovascular events

B. Neutropenia, anemia, thrombocytopenia

C. Hypotension, edema, bradycardia

D. Bronchospasm, fever, leukopenia

Which drugs are listed as selective COX-2 inhibitors?

A. Ibuprofen and ketoprofen

B. Celecoxib and meloxicam

C. Piroxicam and diflunisal

D. Aspirin and ibuprofen

Which selective COX-2 inhibitor carries a black-box warning for cardiovascular risk?

A. Meloxicam

B. Piroxicam

C. Celecoxib

D. Diflunisal

Which newer NSAIDs generally do NOT inhibit platelet aggregation?

A. Aspirin derivatives

B. Nonselective NSAIDs

C. Salicylates

D. COX-2 selective agents

Diflunisal is particularly useful for pain associated with which condition?

A. Bone metastases

B. Migraine aura

C. Neuropathic pain

D. Renal colic

Diflunisal is also effective for pain control following which procedure?

A. Cataract surgery

B. Third-molar dental surgery

C. Coronary bypass surgery

D. Appendectomy

Low-dose oral ibuprofen below 2400 mg/day provides primarily which effect?

A. Anti-inflammatory

B. Antiplatelet

C. Analgesic effect

D. Immunosuppressive effect

At low oral doses, ibuprofen lacks substantial which efficacy?

A. Analgesic

B. Antipyretic

C. Platelet

D. Anti-inflammatory

Ibuprofen can be used in premature infants to close which structure?

A. Patent ductus arteriosus

B. Foramen ovale

C. Ventricular septal defect

D. Atrial septal defect

For PDA closure in preterm infants, ibuprofen has similar efficacy to which drug?

A. Celecoxib

B. Indomethacin

C. Piroxicam

D. Diflunisal

Giving ibuprofen with aspirin antagonizes which aspirin effect?

A. COX-2 inhibition

B. Gastric irritation

C. Irreversible platelet inhibition

D. Renal vasoconstriction

Concurrent ibuprofen may also decrease which aspirin-associated therapeutic effect?

A. Platelet destruction

B. Renal perfusion

C. Gastric protection

D. Total anti-inflammatory effect

Ketoprofen inhibits which enzymes?

A. COX and lipoxygenase

B. JAK and STAT

C. COX-2 only

D. Phospholipase and elastase

How does ketoprofen inhibit cyclooxygenase activity?

A. COX-1 selectively

B. Nonselectively

C. COX-2 selectively

D. Irreversibly only

Piroxicam belongs to which NSAID category?

A. COX-2 selective inhibitor

B. Salicylate

C. Nonselective COX inhibitor

D. TNF inhibitor

At high concentrations, piroxicam inhibits migration of which cells?

A. Eosinophils

B. Macrophages

C. Platelets

D. PMN leukocytes

Which additional effect occurs with high concentrations of piroxicam?

A. Decreased oxygen radical production

B. Increased IL-2 secretion

C. Increased lymphocyte function

D. Increased neutrophil migration

Piroxicam at high concentrations has what effect on lymphocytes?

A. Activates proliferation

B. Inhibits lymphocyte function

C. Increases antibody secretion

D. Enhances T-cell signaling

Piroxicam is primarily indicated for which category of disease?

A. Bacterial infections

B. Malignancies

C. Rheumatic diseases

D. Viral illnesses

Which adverse-effect profile is particularly associated with piroxicam?

A. Cardiomyopathy and arrhythmia

B. Nephrolithiasis and gout

C. Pulmonary fibrosis and cough

D. Peptic ulcers and bleeding

How are NSAIDs typically transported in the bloodstream?

A. Free in plasma

B. Protein-bound

C. Bound to erythrocytes

D. Bound to platelets

Aspirin is indicated for which cardiovascular conditions in these notes?

A. Stable hypertension and HF

B. Pericarditis and myocarditis

C. Aortic stenosis and MVP

D. Unstable angina and coronary thrombosis

Long-term aspirin use may reduce the incidence of which malignancy?

A. Colon cancer

B. Lung cancer

C. Prostate cancer

D. Pancreatic cancer

Which gastrointestinal complications can result from aspirin therapy?

A. Pancreatitis and diarrhea

B. Constipation and ileus

C. GI bleeding and ulcers

D. Cholangitis and jaundice

Which additional major organ complication can occur with prolonged aspirin use?

A. Renal failure

B. Pulmonary fibrosis

C. Heart failure

D. Hepatic adenoma

Celecoxib is primarily metabolized by which cytochrome P450 enzyme?

A. CYP3A4

B. CYP2C9

C. CYP2D6

D. CYP1A2

Why does celecoxib relatively spare the gastric mucosa?

A. Preferential COX-2 inhibition

B. Irreversible COX-1 blockade

C. Increased prostaglandin degradation

D. Direct platelet inhibition

Celecoxib metabolism creates an important interaction with which medication?

A. Penicillin

B. Methotrexate

C. Colchicine

D. Warfarin

Celecoxib can inhibit CYP2C9, which raises warfarin levels in the body and increases the risk of ________.

Ibuprofen, diclofenac, and diflunisal inhibit which two enzymes?

Which renal complication can result from NSAID treatment?

A. Renal papillary necrosis

B. Minimal change disease

C. Renal artery thrombosis

D. Nephrogenic diabetes insipidus

Which important adverse effect is associated with abatacept?

A. Hyperuricemia

B. Retinal toxicity

C. Serious infection

D. Hemorrhagic cystitis

Before starting abatacept, patients should be screened for which latent infections?

A. CMV and EBV

B. HSV and VZV

C. Influenza and RSV

D. Tuberculosis and viral hepatitis

Combining abatacept with which drug class particularly increases serious infection risk?

A. Antimalarials

B. TNF-alpha antagonists

C. Salicylates

D. Uricosuric agents

Chloroquine and hydroxychloroquine were originally developed to treat which infection?

A. Tuberculosis

B. Influenza

C. Malaria

D. Candidiasis

Which organ is particularly susceptible to toxicity from hydroxychloroquine?

A. Eyes

B. Kidneys

C. Pancreas

D. Lungs

Besides blocking cell replication, cyclophosphamide markedly reduces the function of which cells?

A. Platelets and neutrophils

B. Macrophages and eosinophils

C. Mast cells and basophils

D. T cells and B cells

Which description best characterizes cyclosporine's mechanism?

A. Inhibits JAK-STAT signaling

B. Inhibits calcineurin and cytokine receptors

C. Blocks TNF-alpha directly

D. Depletes CD20 B cells

Cyclosporine decreases production of receptors for which cytokines according to these notes?

A. IL-4 and IL-5

B. IL-6 and IL-8

C. IL-1 and IL-2

D. IL-12 and IL-23

Cyclosporine is metabolized predominantly by which cytochrome enzyme?

A. CYP3A

B. CYP2C9

C. CYP2D6

D. CYP1A2

Which dietary product should be avoided with cyclosporine because of CYP3A interactions?

A. Milk

B. Cranberry juice

C. Green tea

D. Grapefruit juice

Which hematologic complication is listed for cyclosporine?

A. Polycythemia

B. Myelosuppression

C. Thrombocytosis

D. Eosinophilia

Leflunomide inhibits which enzyme?

A. Xanthine oxidase

B. IMP dehydrogenase

C. Dihydroorotate dehydrogenase

D. Dihydrofolate reductase

How does leflunomide's inhibition of the enzyme dihydroorotate dehydrogenase help in treating inflammatory conditions?

Inhibition of dihydroorotate dehydrogenase stops ______ synthesis → Suppresses ______-cell proliferation

Which gastrointestinal adverse effect is associated with leflunomide?

A. Constipation

B. Diarrhea

C. Pancreatitis

D. GI hemorrhage

Which laboratory studies should be monitored during leflunomide therapy?

A. Troponins

B. Thyroid studies

C. Liver function tests

D. Coagulation studies

Why are liver function tests monitored during leflunomide therapy?

A. Hepatotoxicity

B. Nephrotoxicity

C. Cardiotoxicity

D. Retinal toxicity

Which hematologic abnormalities can occur with methotrexate therapy?

A. Thrombocytosis and polycythemia

B. Leukopenia and anemia

C. Eosinophilia and basophilia

D. Neutrophilia and erythrocytosis

Mycophenolic acid inhibits which enzyme?

A. Xanthine oxidase

B. Dihydrofolate reductase

C. IMP dehydrogenase

D. Calcineurin

Inhibition of IMP dehydrogenase by mycophenolate primarily interferes with what?

A. Purine synthesis in lymphocytes

B. Cholesterol synthesis in hepatocytes

C. Heme synthesis in erythrocytes

D. Pyrimidine synthesis in neutrophils

Which lymphocyte populations are particularly affected by mycophenolate-mediated purine inhibition?

A. NK cells

B. Neutrophils and monocytes

C. Eosinophils and mast cells

D. B cells and T cells

Rituximab depletes B lymphocytes expressing which surface marker?

A. CD3

B. CD20

C. CD28

D. CD80

Which cutaneous adverse effect is associated with rituximab?

A. Alopecia

B. Bullae

C. Rash

D. Vitiligo

Which hematologic toxicities can occur with tocilizumab?

A. Neutropenia and thrombocytopenia

B. Polycythemia and thrombocytosis

C. Eosinophilia and basophilia

D. Lymphocytosis and neutrophilia

Tocilizumab therapy may reactivate which latent infections?

A. HSV and VZV

B. EBV and CMV

C. Influenza and RSV

D. Tuberculosis and hepatitis B

Which drug, like adalimumab, is an anti-TNF-alpha monoclonal antibody?

A. Etanercept

B. Infliximab

C. Anakinra

D. Tofacitinib

What major adverse effect is shared by TNF-alpha blocking agents?

A. Severe hyperuricemia

B. Retinal degeneration

C. Reactivation of latent infections

D. Renal papillary necrosis

TNF-alpha blockers increase susceptibility to which type of infection?

A. Opportunistic infections

B. Only viral infections

C. Only fungal infections

D. Only bacterial infections

Ustekinumab antagonizes which cytokines?

A. IL-1 and IL-6

B. IL-4 and IL-5

C. IL-17 and TNF

D. IL-12 and IL-23

Secukinumab targets which inflammatory pathway according to these notes?

A. IL-6 receptor

B. IL-17 receptor

C. TNF receptor

D. IL-1 receptor

Anakinra, rilonacept, and canakinumab all target which inflammatory cytokine pathway?

A. TNF-alpha

B. IL-6

C. IL-1

D. IL-17

Acetaminophen is described in these notes as a potent what?

A. Analgesic

B. Anticoagulant

C. Anti-inflammatory

D. Immunosuppressant

Colchicine produces its therapeutic effect by binding to which protein?

A. Actin

B. Myosin

C. Collagen

D. Tubulin

What happens to microtubules when colchicine binds tubulin?

A. Polymerization increases

B. Polymerization is inhibited

C. Breakdown is inhibited

D. Formation remains unchanged

Inhibiting microtubule polymerization with colchicine decreases what inflammatory process?

A. Antibody synthesis

B. Complement activation

C. Leukocyte migration

D. Platelet aggregation

Which gastrointestinal adverse effects are associated with colchicine?

A. Nausea, vomiting, abdominal pain

B. Constipation, jaundice, hematemesis

C. Dysphagia, reflux, melena

D. Pancreatitis, ileus, ascites

Which serious hematologic complications may occur with colchicine?

A. Polycythemia and thrombocytosis

B. Hemolysis and leukocytosis

C. Eosinophilia and neutrophilia

D. Bone marrow suppression and DIC

Probenecid and sulfinpyrazone lower uric acid by inhibiting what renal process?

A. Uric acid filtration

B. Uric acid reabsorption

C. Uric acid secretion

D. Uric acid synthesis

Where do probenecid and sulfinpyrazone inhibit uric acid reabsorption?

A. Collecting duct

B. Loop of Henle

C. Proximal convoluted tubule

D. Distal convoluted tubule

What is the mechanism of action of allopurinol?

A. Competitive xanthine oxidase inhibition

B. Selective COX-2 inhibition

C. Uricase replacement

D. Tubulin inhibition

Allopurinol can increase serum concentrations of which medications?

A. Penicillin and aspirin

B. Methotrexate and colchicine

C. Ibuprofen and celecoxib

D. Azathioprine and 6-MP

Febuxostat inhibits which enzyme?

A. IMP dehydrogenase

B. Xanthine oxidase

C. Dihydroorotate dehydrogenase

D. Calcineurin

How is febuxostat's inhibition of xanthine oxidase described?

A. Competitive

B. Irreversible

C. Selective

D. Nonselective

Pegloticase is best described as which type of therapy?

A. Recombinant uricase

B. Xanthine analog

C. Uricosuric agent

D. COX inhibitor

Pegloticase converts uric acid into which product?

A. Hypoxanthine

B. Xanthine

C. Adenosine

D. Allantoin

Which serious adverse reaction can occur with pegloticase?

A. Retinopathy

B. Anaphylaxis

C. Pancreatitis

D. Pulmonary fibrosis

Interference with penicillin excretion by probenecid (gout med) may result in which problem?

A. Toxic drug accumulation

B. Reduced absorption

C. Increased renal clearance

D. Loss of antibacterial activity

Which reaction may occur if penicillin accumulates excessively during probenecid therapy according to these notes?

A. Hemolytic crisis

B. Renal infarction

C. Pulmonary edema

D. Hypersensitivity reaction