B6-005 Pharmacotherapy of RA and Joint Pain

Question 1

side effects of NSAID

Answer 1

GI distress (nausea, diarrhea)

Question 2

centrally acting, non-narcotic analgesic

Answer 2

acetaminophen

Question 3

side effect of high efficacy opiod

Answer 3

constipation

Question 4

protective effects of aspirin

Answer 4

-decreased incidence of myocardial ischemia
-protective against colon cancer

Question 5

COX inhibition by aspirin is […] and […]

Answer 5

nonselective and irreversible

Question 6

COX inhibition reduces [….] production

Answer 6

prostaglandin

Question 7

inhibit the transcription of inflammatory gene products

Answer 7

corticosteroids

Question 8

sequesters TNF-a cytokines with “decoy” receptors

Answer 8

etanercept

Question 9

COX-2 selective inhibitor

Answer 9

celecoxib

Question 10

contraindicated in cardiovascular patients due to increased risk of clotting

Answer 10

celecoxib

Question 11

blocks the production of IL-2, IL-3 and TNF-a

Answer 11

cyclosporine

Question 12

gout symptoms can be exacerbated by […] diuretics

Answer 12

thiazide

Question 13

inhibits the chemotactic and phagocytic action of neutrophils

Answer 13

colchicine

Question 14

most commonly used gout therapy

Answer 14

NSAIDs

Question 15

indomethacin and other NSAIDs inhibit […] phagocytosis

Answer 15

urate crystal

Question 16

have largely replaced colchicine as drug of choice for gout

Answer 16

NSAIDs

Question 17

gout patients who have failed or cannot tolerate NSAIDs can be given

Answer 17

corticosteroids

Question 18

beneficial to patients when just one or two large joints are affected

Answer 18

intra-articular steroid injection

Question 19

good option in elderly people with many illness to manage who only have pain in one or two joints

Answer 19

intra-articular steroid injection

Question 20

non selective NSAIDs [3]

Answer 20

aspirin
ibuprofen
indomethacin

Question 21

COX-2 selective NSAID

Answer 21

celecoxib

Question 22

nonselective COX inhibitor that irreversibly inhibits COX and platelet aggregation

Answer 22

aspirin

Question 23

aspirin is most effective in reducing mild/moderate pain through reducing

Answer 23

inflammation

Question 24

can have antipyretic effect likely mediated by COX and IL-1 inhibition in the CNS

Answer 24

aspirin

Question 25

most common adverse effect of aspirin

Answer 25

gastric upset, ulcers

Question 26

nonselective COX inhibitor often prescribed in lower doses with analgesic but no anti-inflammatory efficacy

Answer 26

acetaminophen

Question 27

nonselective COX inhibitor that works particularly well for gout and ankylosing spondylitis

Answer 27

indomethacin

Question 28

incidence of cardiovascular thrombotic events is associated with [...] inhibitors

Answer 28

COX2

Question 29

weak inhibitor of peripheral COX enzymes

Answer 29

acetaminophen

Question 30

causes direct CNS analgesic effects

Answer 30

acetaminophen

Question 31

acetaminophen is not [...] at typical doses

Answer 31

anti-inflammatory

Question 32

danger of liver damage due to acetaminophen occurs at doses of

Answer 32

> 4g/day

Question 33

inhibits microtubule aggregation which disrupts leukocyte chemotaxis and phagocytosis

Answer 33

colchicine

Question 34

gout prophylaxis is usually initiated after [...] of symptoms

Answer 34

greater than one year **not used for intial, acute attacks

Question 35

xanthine oxidase inhibitors

Answer 35

allopurinol febuxostat

Question 36

increase renal clearance of uric acid by inhibiting tubular absorption

Answer 36

probenecid

Question 37

probenecid can increase the risk of [...]

Answer 37

kidney stones

Question 38

inhibits URAT1, preventing renal reabsorption of uric acid

Answer 38

lesinurad

Question 39

inhibits AICAR transformylase and thymidylate synthetase affecting polymorphonuclear chemotaxis

Answer 39

methotrexate

Question 40

decreases IgA and IgM rheumatoid factor production

Answer 40

sulfasalazine

Question 41

cell growth arrestor (G1 phase)

Answer 41

leflunomide

Question 42

purine synthesis inhibitor, supresses B and T cell function

Answer 42

azathioprine

Question 43

inhibits IL-1 and IL2 production in T cells

Answer 43

cyclosporine

Question 44

cross links DNA to prevent cell replication

Answer 44

cyclophosphamide

Question 45

gold compounds alter the capabilities of

Answer 45

macrophages

Question 46

Anti TNF agents

Answer 46

etanercept infliximab adalimumab

Question 47

b cell depleting agent

Answer 47

rituximab

Question 48

inhibits receptor-ligand co-stimulation of T cells

Answer 48

abatacept

Question 49

IL-1 inhibitor

Answer 49

anakinra

Question 50

IL-17 inhibitors used for psoriasis [2]

Answer 50

secukinumab ixekizumab

Question 51

what class of drugs inhibits the transcription of genes that encode inflammatory proteins?

Answer 51

steroids

Question 52

strength of opioids

Answer 52

fentanyl > hydromorphone > oxycodone > morphine/methadone > meperidine > codeine