BLOOD_GOUT 4

Question 1

is the only over the counter NON-anti-inflammatory analgesic.

Answer 1

acetaminophen

Question 2

• A weak COX-1 and COX-2 inhibitor
• An analgesic and antipyretic agent
• lacks anti-inflammatory or antiplatelet effects

Answer 2

acetaminophen

Question 3

Overdosage of acetaminophen in px with severe liver impairement results to

Answer 3

hepatotoxic

Question 4

Prompt administration of this drug which is a sulfhydryl donor, may be lifesaving after an overdose.

Answer 4

Acetylcysteine

Question 5

People who regularly consume ___ per day are at increased risk of acetaminophen-induced hepatotoxicity.

Answer 5

3 or more alcoholic drinks

Question 6

• has anti-inflammatory actions in several connective tissue disease
• called disease-modifying drugs (reversal joint damage)
• called slow-acting antirheumatic drugs (6 week to 6 months)

Answer 6

Disease-Modifying Antirheumatic Drugs (DMARDS)

Question 7

• anti-inflammatory drugs with an intermediate rate of action
• too toxic for routine chronic use
• reserved for temporary control of severe exacerbations
• long term use in px w/ severe disease not controlled by other agents

Answer 7

Costicosteroids

Question 8

Interfere with the activity of T lymphocytes

Answer 8

• sulfasalazine
• hydroxychloroquine
• cyclosporine
• leflunomide
• mycophenolate
• mofetil
• abatacept

Question 9

Interfere with the activity of B lymphocyte

Answer 9

rituximab

Question 10

Interfere with the activity of macrophage

Answer 10

• gold compounds

Question 11

DMARDS that are given orally.

Answer 11

• sulfasalazine
• hydroxychloroquine
• methotrexate
• cyclosporine
• peniccillamine
• leflunomide

Question 12

DMARDS that are given by injection

Answer 12

• anti TNF-alpha drugs

Question 13

Gold compound are available for parenteral and oral use.

Answer 13

• Parenteral: AuNa thiomalate and aurothioglucose

- Oral: auranofin

Question 14

Are initiated fairly early in px w/ moderate to severe rheumatoid arthritis in an attempt to ameliorate disease progression

Answer 14

methotrexate

Question 15

Short courses of glucocorticoids can cause

Answer 15

• behavioral changes

- - impaired glucose control

Question 16

Toxicity of DMARDs

Answer 16

• severe or fatal toxicities

Question 17

Is associated w/ increased serum conc of uric acid. Acute attacks involve joint inflammation initiated by precipitation of uric acid crystals.

Answer 17

Gout

Question 18

Are effective in inhibiting the inflammation of acute gouty arthritis.

Answer 18

indomethacin

Question 19

A selective inhibitor of microtubule assembly, reduces leukocyte migration and phagocytosis; this drug may also reduce production of leukotrine B4 and decrease radical formation.

Answer 19

Colchicine

Question 20

Toxicity of colchicine.

Answer 20

• significant gastrointestinal disturbance (diarrhea)

- damage the liver and kidney

Question 21

Lower doses of this are used to prevent attacks of gout in px with a history of multiple acute attacks.

Answer 21

colchicine

Question 22

Toxicity of NSAIDs and indomethacin

Answer 22

• renal damage

- bone marrow depression (indomethacin)

Question 23

Mostly of the uric acid is filtered by the kidney is reabsorbed in the

Answer 23

proximal tubules

Question 24

Uricosuric drugs (xanthine oxidase inhibitors) are used orally to treat

Answer 24

chronic gout

Question 25

Toxicity of Uricosuric Agents

Answer 25

- precipitate an attack of acute gout during early phase | - may share allergenicity with other classes of sulfonamides

Question 26

The production of uric acid can be reduced by inhibition of ___, the enzyme that converts hypoxanthine to xanthine and xanthine to uric acid.

Answer 26

xanthine oxidase

Question 27

is converted to oxypurinol (alloxanthine) by xanthine oxidase

Answer 27

allopurinol

Question 28

is an irreversible suicide inhibotr of the xanthine oxidase

Answer 28

alloxanthine

Question 29

is a nonpurine inhibitor od xanthine oxidase that is more selective than allopurinol and alloxanthine which inhibit other enzyme involved in purine and pyrimidine metabolism

Answer 29

febuxostat

Question 30

Is more effective in lowering serum uric acid.

Answer 30

febuxostat

Question 31

Is used as an adjunct to cancer chemotherapy to slow formationn of uric acid from purines released by the death of large numbers of neoplastic cells.

Answer 31

Allopurinol

Question 32

Toxicity of Allopurinol

Answer 32

- gastrointestinal upset - rash - peripheral neuritis - vasculitis - bone marrow dysfunction - aplastic anemia

Question 33

Toxicity of Febuxostat.

Answer 33

- liver function abnormalities - headache - gastrointestinal upset

Question 34

Among NSAIDs, aspirin is unique because it A. irreversibly inhibits its target enzyme B. Prevents episodes of gouty arthritis w/ long term use C. reduces fever D. reduces the risk of colon cancer E. Selectively inhibits the COX-2 enzyme

Answer 34

irreversibly inhibits its target enzyme

Question 35

W/c of the ff is an analgesic and antipyretic drug that lacks an anti-inflammatory action?

Answer 35

Acetaminophen

Question 36

16 y.o girl comes to the ED suffering from the effects of an aspirin overdose. W/c of the ff syndromes is the px most likely to exhibit as a result of this drug overdose?

Answer 36

- Hyperthermia - metabolic acidosis - coma