Pain And Inflammation

Question 1

Name corticosteroids

Answer 1

§ Fludrocortisone

§ Hydrocortisone/dexamethasone

Question 2

MOA of fludrocortisone

Answer 2

Mineralocorticoid (electrolyte and water metabolism)

Question 3

MOA of hydrocortisone

Answer 3

§ Increase lipocortin (inhibits phospholipase A2)

§ Is a glucocorticoid

Question 4

Main effects of glucocorticoids

Answer 4

§ Anti-inflammatory
§ Immunosuppressant
§ Stimulates gluconeogenisis
§ Glycogen deposition
§ Natural protein/lipid/calcium metabolism

Question 5

Use of fludrocortisone

Answer 5

§ Replace aldosterone in adrenal insufficiency (e.g. Addison’s)
§ Congenital adrenal hyperplasia

Question 6

Use of hydrocortisone

Answer 6

§ Anaphylaxis
§ angioedema
§ Rashes
§ Eczema
§ Gout

Question 7

Side effects of fludrocortisone

Answer 7

§ Na & water retension
§ Oedema
§ Hypertension
§ Headache
§ Hypokalaemia
§ Muscle weakness
§ Fatigue
§ Immunosuppression
§ Depression
§ Weight gain

Question 8

Side effects of hydrocortisone

Answer 8

Dryness

Itching

Question 9

Admin of fludrocortisone

Answer 9

Oral

Question 10

Admin of hydrocortisone

Answer 10

Oral, IV, topical

Question 11

Name anti-leukotriene drugs

Answer 11

Zileuton

Montelukast

Question 12

MoA of zileuton

Answer 12

Active inhibitor of 5-lipo-oxygenase

Question 13

MoA of montelukast

Answer 13

Leukotriene receptor antagonist

Question 14

Use of zileuton

Answer 14

Asthma

Co-existent allergic rhinitis

Question 15

Use of montekulast

Answer 15

§ Asthma
§ Co-existent allergic rhinitis
§ Additive interaction with inhaled corticosteroids

Question 16

Zileuton side effects

Answer 16

Sinusitis

Nausea

Question 17

Montekulast side effects

Answer 17

§ GIT disturbances
§ Headaches
§ Hypersensitivity
§ Sleep disorders
§ Bleeding

Question 18

Admin of anti-leukotrienes

Answer 18

Oral

Question 19

Name types of NSAIDs

Answer 19

Non-selective COX-2 inhibitors

Selective COX-2 inhibitors

Question 20

Can NSAIDs be combined?

Answer 20

No

Question 21

Name non-selective COX-2 inhibitors

Answer 21

Aspirin
Diclophenac
Indomethacin
Piroxicam
Ibuprofen 
Naproxen
Mefenamic acid

Question 22

Name selective COX-2 inhibitors

Answer 22

Celecoxib

Etoricoxib

Question 23

MoA of non-selective COX-2 inhibitors

Answer 23

Competitive inhibition of COX-1 and COX-2

Question 24

MoA of selective COX-2 inhibitors

Answer 24

Inhibition of COX-2 only

Question 25

MoA of aspirin

Answer 25

§ Irreversible non-selective COX-2 inhibitor § Inhibit thromboxane production § Biotransformed by glycine conjugation in liver § Excreted in urine

Question 26

MoA of paracetamol

Answer 26

Reversible non-competitive inhibition of COX-1 & COX-2

Question 27

MoA of celecoxib

Answer 27

Selective COX-2 inhibitor

Question 28

Use of non-selective COX-2 inhibitors

Answer 28

Analgesic Antipyretic Anti-inflammatory Closure of ductus arteriosus

Question 29

Use of Selective COX-2 inhibitors

Answer 29

Analgesic Antipyretic Anti-inflammatory Closure of ductus arteriosus

Question 30

Use of aspirin

Answer 30

Analgesic Antipyretic Anti-inflammatory Prevent MI, stroke, & clots

Question 31

Use of paracetamol

Answer 31

Analgesic | Antipyretic

Question 32

Use of celecoxib

Answer 32

Osteoarthritis Rheumatoid arthritis Acute pain Menstrual pain

Question 33

Non-selective COX-2 inhibitor side effects

Answer 33

``` Stomach bleeding & ulceration Increased bleeding time Renal vasoconstriction Prolonged gestation/bleeding if pregnant Hypersensitivity Tinnitus ```

Question 34

Side effects of selective COX-2 inhibitors

Answer 34

Increased Thromboxane A2 Inhibit prostaglandins in renal vasculature MI/stroke

Question 35

Aspirin side effects

Answer 35

``` § Stomach bleeding & ulcers § Increased bleeding time § renal vasoconstriction § prolonged gestation/bleeding if pregnant § hypersensitivity (rash/bronchospasm) § Tinnitus ```

Question 36

Aspirin contraindications

Answer 36

Rey’s syndrome (in children) Pregnancy Gout

Question 37

Paracetamol side effects

Answer 37

(Mild to non-existent) Skin rash Allergic reactions Hepatic necrosis (in acute overdose)

Question 38

Treatment of acute paracetamol overdose

Answer 38

N-acetylcysteine

Question 39

Celecoxib side effects

Answer 39

GI bleeding & ulcers MI/stroke Renal vasoconstriction