NSAIDs

Question 1

Most likely true of excretion of salicylates?

A. excretion depends on the dose and urinary pH

B. excretion is high at pH 8 & 6

C. GFR is high at pH 8

D. All of the above

Answer 1

D.

Question 2

Patient is on antiplatelet dose and at the same time, he is taking aspirin? What is the t 1/2 of aspirin?

A. 2-3 hr
B. 20 min
C. 12 hr
D. 15-30 hr

Answer 2

A. On antiplatelet doses 2-3 hr

20 min= plasma t 1/2
12 hr= anti-inflammatory doses
15-30 hr= high therapeutic doses or intoxication

Question 3

Detoxication of salicylates during overdose.

A. Hemodialysis
B. Hemofiltration Techniques
C. Both A & B
D. None of the above

Answer 3

C.

Question 4

Significant adverse effects of Aspirin is seen on?

A. > 300 ug/mL
B. 400 ug/mL
C. > 200 ug/mL
D. 500 ug/mL

Answer 4

A

Question 5

The analgesic-antipyretic dose of aspirin for adults?

Answer 5

325-1000 mg OD q 4-6 hr

Question 6

The anti-inflammatory dose of aspirin?

Answer 6

4-8 g/d in divided doses

Question 7

The max recommended daily dose of aspirin for adults and children is ?

Answer 7

4 g

Question 8

Maintenance dose of diflusinal should not exceed?

Answer 8

250-1000 mg/day

Question 9

Potent anti-inflammatory drug but NO antipyretic effects, 3-4x times more potent than aspirin?

Answer 9

Diflusinal

Question 10

Salicylates that causes auditory side effects

Answer 10

Diflusinal

Question 11

Plasma concentration of salicylates that causes hepatic injury?

Answer 11

> 150 ug/mL

Question 12

Large doses of salicylates can cause?

Answer 12

Hyperglycemia
Glycosuria
Deplete liver and muscle glycogen

Question 13

Dose of salicylates that lowers the plasma concentration of iron and shorten erythrocyte survival time.

Answer 13

3-4 g/day

Question 14

Aspirin can cause _______ in px with G6PD deficient

Answer 14

Mild Hemolysis

Question 15

Dose of sodium salicylate or aspirin the causes dearh in adults

Answer 15

10-30 g

Question 16

Trimester that is avoided in salicylate used in pregnancy

Answer 16

3rd trimester

Question 17

Specific antidote for salicylate poisoning

Answer 17

NO

Question 18

Active metabolite of phenacetin

Answer 18

Acetaminophen

Question 19

The maximum FDA-recommended dose of acetaminophen

Answer 19

4 g/d

Question 20

Acetaminophen undergoes CYP-mediated N-hydroxylation to forming the highly reactive

Answer 20

NAPQI

if large doses of acetaminophen is taken, it depletes GSH = toxic overdose

Question 21

The conventional oral dose of acetaminophen

Answer 21

325-650 mg q 4-6 hr

Question 22

Daily dose of Acetaminophen should not exceed

Answer 22

4 g

Question 23

For chronic alcoholics, daily dose of Acetaminophen should not exceed

Answer 23

2 g/d

Question 24

Most serious acute adverse effect of overdosage of acetaminophen

Answer 24

Fatal hepatic necrosis

Question 25

Dose in adults that cause hepatotoxicity

Answer 25

10-15 g (150-250 mg/kg) | doses > 20-25 are fatal

Question 26

T 1/2 of Diclofenac

Answer 26

1-2 hr

Question 27

Opthalmic solution of this drug will treat postoperative inflammation following cataract extraction

Answer 27

Diclofenac

Question 28

Reactive metabolite of Diclofenac that is similar with NAPQI that depletes GSH

Answer 28

Benzoquinone Imines

Question 29

20x times more potent than aspirin, intolerance limits its use

Answer 29

Indomethacin

Question 30

Only COX-2 inhibitor approved in the US

Answer 30

Celecoxib

Question 31

Selective COX-2 inhibitors loses GI advantage over the NSAIDs alone when in used in conjunction with

Answer 31

Aspirin

Question 32

Peak plasma level of Celecoxib

Answer 32

2-4 hr

Question 33

Recommended dose of Celecoxib for Osteoarthritis

Answer 33

200 mg/d SD or DD

Question 34

Recommended dose of Celecoxib for rheumatoid arthritis

Answer 34

100-200 mg BID

Question 35

T 1/2 of Etoricoxib

Answer 35

20-26 hr

Question 36

T 1/2 of Celecoxib

Answer 36

11.2 hr

Question 37

Aspirin is deacetylated in?

Answer 37

Intestinal Wall RBC Liver

Question 38

Aspirin is deacetylated through?

Answer 38

Hydrolysis and Esterases

Question 39

In px with RA, salicylate can cause?

Answer 39

Hypoalbuminemia

Question 40

MOA of salicylate

Answer 40

interferes transcription binding to COX-2 promoter

Question 41

Oral salicylates are absorbed rapidly in the?

Answer 41

Small Intestine

Question 42

Peak plasma level of salicylates is about?

Answer 42

1 hr

Question 43

Salicylates are transported out of the CSF

Answer 43

Actively across choroid plexus

Question 44

Salicylate are transported to tissues by?

Answer 44

pH-dependent processes

Question 45

Rate of absorption of salicylates are determined by the?

Answer 45

Disintegration & Dissolution rates of Tablets pH mucosal surface gastric emptying time

Question 46

Causes pseudoresistance of salicylates

Answer 46

food and enteric coating

Question 47

pH that will increase the solubility and dissolution of salicylates and its ionization

Answer 47

alkaline (rise in pH)

Question 48

Acetate ester of salicylic acid

Answer 48

Aspirin

Question 49

T 1/2 of Diflusinal

Answer 49

8-12 hr

Question 50

T 1/2 of Acetaminophen and Indomethacin

Answer 50

2 hr

Question 51

T 1/2 of Sulindac

Answer 51

``` 7 hr 18 hr (active sulfone metabolite) ```

Question 52

T 1/2 of Etodolac

Answer 52

7 hr

Question 53

T 1/2 of Tolmetin

Answer 53

5 hr

Question 54

T 1/2 of Ketorolac

Answer 54

4-6 hr

Question 55

T 1/2 of topical epolamine patch of Diclofenac

Answer 55

12 hr

Question 56

T 1/2 of Nabumetone in Elderly

Answer 56

22-38 hr

Question 57

T 1/2 of Nabumetone

Answer 57

19-26 h