NR565 ADVANCED PHARMACOLOGY: MIDTERM STUDY GUIDE
ACTUAL EXAM COMPLETE 160 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
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Naltrexone Dosage Forms✔✔ ANSWER✔✔Naltrexone is available in two
main dosage forms: an oral tablet and a long-acting injectable formulation.
The oral form is taken daily, but adherence can be challenging. The injectable
form, administered once a month, offers a more convenient option with
improved adherence for many patients and provides consistent levels of
medication, enhancing its effectiveness in preventing relapse.
NSAIDs✔✔ ANSWER✔✔- Class of medications commonly used to reduce
inflammation, relieve pain, and lower fever.
- Work by inhibiting the enzymes COX-1 and COX-2, which are involved in the
synthesis of prostaglandins, compounds that promote inflammation, pain,
and fever.
- Common NSAIDs: ibuprofen, naproxen, and aspirin.
NSAIDs: Adverse Effects✔✔ ANSWER✔✔- Can cause several adverse effects,
particularly with long-term use.
- GI issues (such as ulcers and bleeding), increased risk for cardiovascular
events (like heart attack and stroke), kidney damage, and hypertension.
- They can also exacerbate asthma in sensitive individuals and should be
used cautiously in patients with certain medical conditions.
,NSAIDs: Benefits of Second Generation✔✔ ANSWER✔✔- Second-generation
NSAIDs, aka COX-2 inhibitors (ex-celecoxib), selectively inhibit the COX-2
enzyme, reducing pain and inflammation while minimizing GI side effects.
- May still pose a cardiovascular risk.
NSAIDs: First Generation vs Second Generation✔✔ ANSWER✔✔- First-
generation NSAIDs (e.g., ibuprofen, aspirin) inhibit both COX-1 and COX-2
enzymes, providing effective pain and inflammation relief but with a higher
risk of gastrointestinal side effects.
- Second-generation NSAIDs (COX-2 inhibitors) selectively inhibit COX-2,
potentially reducing gastrointestinal harm but are associated with increased
cardiovascular risks.
Nonacetylated Salicylates✔✔ ANSWER✔✔- Nonacetylated salicylates (such
as magnesium salicylate, sodium salicylate, and salsalate) are less potent
inhibitors of COX enzymes compared to other NSAIDs, leading to fewer
gastrointestinal and platelet effects.
- They are often used for mild to moderate pain and inflammatory
conditions, particularly in patients at risk for gastrointestinal bleeding or
those who need to avoid platelet inhibition.
Non-Aspirin NSAIDs✔✔ ANSWER✔✔- Non-aspirin NSAIDs (like ibuprofen
and naproxen) provide similar pain and anti-inflammatory benefits without
the blood-thinning effects of aspirin.
- They are used to treat various conditions, including arthritis, muscle pain,
and menstrual cramps, but still carry risks of gastrointestinal and
cardiovascular side effects.
,NSAID: Ibuprofen✔✔ ANSWER✔✔Ibuprofen is a widely used non-aspirin
NSAID that reduces pain, inflammation, and fever. It is available over the
counter in lower doses and by prescription in higher doses. While effective,
it carries risks for gastrointestinal irritation, cardiovascular events, and
kidney damage, particularly with prolonged use.
Acetaminophen Overdose✔✔ ANSWER✔✔- Acetaminophen overdose can
lead to severe liver damage, potentially resulting in acute liver failure and
death.
- The risk increases with doses exceeding the recommended daily limit
(typically 4,000 mg for adults) or when combined with alcohol or other
hepatotoxic substances.
- Early symptoms may include nausea, vomiting, and abdominal pain,
followed by signs of liver toxicity.
Drug Interactions with Acetaminophen✔✔ ANSWER✔✔- Acetaminophen
can interact with various drugs, including anticoagulants (increasing bleeding
risk), alcohol (enhancing liver toxicity), and certain anticonvulsants (affecting
metabolism).
- It's essential to monitor doses and avoid exceeding the recommended
limits to prevent toxicity, especially when taking other medications that may
impact liver function.
NSAIDs: American Heart Association Recommendations✔✔ ANSWER✔✔The
American Heart Association (AHA) recommends using the lowest effective
dose of NSAIDs for the shortest duration possible to minimize cardiovascular
risks. They suggest using alternatives like acetaminophen for pain relief
when appropriate, especially in patients with known cardiovascular disease
, or risk factors. When NSAIDs are necessary, they recommend choosing
agents with a lower cardiovascular risk profile.
Celecoxib: MOA✔✔ ANSWER✔✔- Celecoxib is a selective COX-2 inhibitor,
meaning it specifically blocks the cyclooxygenase-2 enzyme involved in the
production of prostaglandins, which are chemicals that promote
inflammation and pain.
- By inhibiting COX-2, celecoxib reduces inflammation and pain in conditions
like osteoarthritis while minimizing gastrointestinal side effects associated
with non-selective NSAIDs that also inhibit COX-1.
Celecoxib: Therapeutic Use✔✔ ANSWER✔✔- Celecoxib is used primarily for
the management of pain and inflammation associated with osteoarthritis,
rheumatoid arthritis, ankylosing spondylitis, and acute pain conditions.
- Its selectivity for COX-2 allows it to provide effective symptom relief for
osteoarthritis patients with a potentially lower risk of gastrointestinal
complications compared to non-selective NSAIDs.
Celecoxib: Adverse Effects✔✔ ANSWER✔✔- While celecoxib generally has
fewer gastrointestinal side effects than non-selective NSAIDs, it can still
cause adverse effects, including cardiovascular risks (such as increased risk of
heart attack and stroke), renal impairment, and allergic reactions (especially
in patients with a sulfonamide allergy).
- Patients taking celecoxib should be monitored for signs of cardiovascular,
renal, and hepatic issues.
NSAIDs: Black Box Warning✔✔ ANSWER✔✔Black Box warning for all
prescription-strength NSAIDs: Associated with increased risk for
