Anti-inflammatory Drugs Practice Exam

Anti-inflammatory Drugs Practice Exam

 

1. What are anti-inflammatory drugs used for?

 

• Answer: Anti-inflammatory drugs are used to reduce inflammation, pain, and swelling caused by conditions like arthritis, injuries, and other inflammatory disorders.

 

2. Name the two main types of anti-inflammatory drugs.

 

• Answer: Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.

 

3. Give an example of a nonsteroidal anti-inflammatory drug (NSAID).

• Answer: Ibuprofen, naproxen, aspirin.

 

4. What is the primary mechanism of action of NSAIDs?

• Answer: NSAIDs inhibit the enzyme cyclooxygenase (COX), which leads to reduced production of prostaglandins, compounds that promote inflammation.

 

5. What are corticosteroids commonly used to treat?

• Answer: Inflammatory conditions like asthma, rheumatoid arthritis, and autoimmune diseases.

 

6. What is a common side effect of long-term use of corticosteroids?

• Answer: Osteoporosis, weight gain, and increased risk of infection.

 

7. What is the difference between COX-1 and COX-2 enzymes?

• Answer: COX-1 is involved in protecting the stomach lining, while COX-2 is more associated with inflammation and pain.

 

8. Which NSAIDs selectively inhibit COX-2?

• Answer: Celecoxib (Celebrex) and etoricoxib are COX-2 selective inhibitors.

 

9. What is the risk associated with NSAIDs and gastrointestinal bleeding?

• Answer: NSAIDs can reduce the protective mucus layer in the stomach, increasing the risk of ulcers and gastrointestinal bleeding.

 

10. What is the role of prostaglandins in inflammation?

• Answer: Prostaglandins promote inflammation, pain, and fever at the site of injury or infection.

 

11. What condition is acetaminophen (Tylenol) commonly used to treat?

• Answer: Pain and fever, but it is not an anti-inflammatory drug.

 

12. How do corticosteroids reduce inflammation?

• Answer: By suppressing the immune response and inhibiting the production of inflammatory mediators like cytokines.

 

13. What is a common corticosteroid used for inflammation?

• Answer: Prednisone, hydrocortisone.

 

14. Which NSAID is often used to reduce fever?

• Answer: Ibuprofen or acetaminophen.

 

15. What is the major risk of using NSAIDs in elderly patients?

• Answer: Increased risk of gastrointestinal bleeding, renal damage, and cardiovascular problems.

 

16. What class of drugs does aspirin belong to?

• Answer: NSAIDs.

 

17. What is Reye’s syndrome, and how is it related to anti-inflammatory drugs?

• Answer: Reye’s syndrome is a rare but serious condition that can occur when children take aspirin during a viral illness. It can cause liver damage and swelling in the brain.

 

18. What is the antidote for acetaminophen overdose?

• Answer: N-acetylcysteine (NAC).

 

19. Which anti-inflammatory drug is contraindicated in pregnancy, particularly during the third trimester?

• Answer: NSAIDs, due to their potential to cause premature closure of the ductus arteriosus in the fetus.

 

20. What side effect is associated with NSAIDs and renal function?

• Answer: NSAIDs can cause kidney damage, including acute renal failure, especially in patients with pre-existing kidney disease.

 

21. What is gout, and how is it treated with anti-inflammatory drugs?

• Answer: Gout is a condition caused by the buildup of uric acid crystals in the joints, and it is treated with NSAIDs like ibuprofen or colchicine to reduce inflammation.

 

22. What is the difference between NSAIDs and acetaminophen?

• Answer: NSAIDs reduce inflammation, while acetaminophen only reduces pain and fever without significant anti-inflammatory effects.

 

23. What is the mechanism by which NSAIDs cause cardiovascular problems?

• Answer: By inhibiting COX-2, NSAIDs can disrupt the balance of prostacyclin and thromboxane, which increases the risk of heart attack and stroke.

 

24. Which NSAID is most likely to cause gastrointestinal issues like ulcers?

• Answer: Aspirin is more likely to cause gastrointestinal problems compared to other NSAIDs.

 

25. Why are NSAIDs contraindicated in patients with peptic ulcers?

• Answer: Because NSAIDs can irritate the stomach lining and increase the risk of bleeding and ulceration.

 

26. Which anti-inflammatory drug is often used to treat rheumatoid arthritis?

• Answer: Methotrexate, a disease-modifying antirheumatic drug (DMARD), but NSAIDs and corticosteroids may also be used for symptom relief.

 

27. How does celecoxib differ from other NSAIDs?

• Answer: Celecoxib is a COX-2 selective inhibitor, meaning it targets inflammation with a lower risk of gastrointestinal side effects compared to non-selective NSAIDs.

 

28. What is the role of NSAIDs in the treatment of osteoarthritis?

• Answer: NSAIDs are used to relieve pain and reduce inflammation in osteoarthritis, but they do not modify the disease.

 

29. What is the main side effect of prolonged corticosteroid use?

• Answer: Long-term use of corticosteroids can lead to weight gain, osteoporosis, diabetes, and cataracts.

 

30. Which NSAID is often recommended for children with fever?

• Answer: Ibuprofen is commonly recommended for children with fever, but acetaminophen is also used as an alternative.

 

31. What does the term “steroid-induced osteoporosis” mean?

• Answer: Osteoporosis that occurs as a result of long-term corticosteroid therapy, leading to weakened bones and increased fracture risk.

 

32. How do corticosteroids affect blood sugar levels?

• Answer: Corticosteroids can increase blood sugar levels, which may lead to steroid-induced diabetes.

 

33. What is the effect of NSAIDs on platelet function?

• Answer: NSAIDs inhibit platelet aggregation, which can increase the risk of bleeding.

 

34. What is the first-line treatment for acute inflammation caused by musculoskeletal injuries?

• Answer: NSAIDs like ibuprofen or naproxen.

 

35. How does aspirin affect the cardiovascular system?

• Answer: Aspirin can reduce the risk of blood clots by inhibiting platelet aggregation, which is why it is often used for heart disease prevention.

 

36. What is the main purpose of colchicine in the treatment of gout?

• Answer: Colchicine is used to reduce the inflammation and pain caused by gout flare-ups.

 

37. What are common adverse effects of corticosteroid injections?

• Answer: Pain at the injection site, infection, tendon rupture, and cartilage damage.

 

38. What is the risk of using NSAIDs in patients with hypertension?

• Answer: NSAIDs can worsen hypertension by causing fluid retention and reducing kidney function.

 

39. What is the role of anti-inflammatory drugs in the treatment of systemic lupus erythematosus (SLE)?

• Answer: Anti-inflammatory drugs like NSAIDs and corticosteroids help control the inflammation and pain associated with SLE.

 

40. Which anti-inflammatory drug is often used to treat allergic rhinitis?

• Answer: Nasal corticosteroids, such as fluticasone or budesonide, are used to treat allergic rhinitis.

 

41. How do corticosteroids help with asthma management?

• Answer: Corticosteroids reduce airway inflammation, making it easier for patients to breathe and reducing asthma flare-ups.

 

42. What are the contraindications for NSAIDs?

• Answer: NSAIDs should be avoided in patients with peptic ulcers, renal disease, gastrointestinal bleeding, or known hypersensitivity to the drug.

 

43. What is a potential complication of using high doses of corticosteroids?

• Answer: Adrenal suppression, which can cause the body to be unable to produce sufficient corticosteroids naturally.

 

44. What role do anti-inflammatory drugs play in cancer therapy?

• Answer: Anti-inflammatory drugs, particularly NSAIDs, may help reduce pain and inflammation associated with cancer, though they are not primary cancer treatments.

 

45. What is the impact of long-term corticosteroid use on the immune system?

• Answer: Long-term corticosteroid use suppresses the immune system, making individuals more vulnerable to infections.

 

46. What is the purpose of combining NSAIDs with proton pump inhibitors (PPIs)?

• Answer: PPIs help reduce the risk of gastrointestinal bleeding in patients taking NSAIDs long-term.

 

47. What are the signs of an NSAID overdose?

• Answer: Symptoms of an overdose include nausea, vomiting, stomach pain, dizziness, and in severe cases, kidney failure.

 

48. What is the role of anti-inflammatory drugs in the treatment of tendinitis?

• Answer: NSAIDs are used to relieve the inflammation and pain associated with tendinitis.

 

49. Why is aspirin not recommended for children with viral infections?

• Answer: Because of the risk of Reye’s syndrome, a rare but serious condition that affects the liver and brain.

 

50. What is the main advantage of topical NSAIDs over oral NSAIDs?

• Answer: Topical NSAIDs target the inflammation directly at the site of pain, which may reduce systemic side effects like gastrointestinal issues.

 

51. What is the most common side effect of nonselective NSAIDs?

• Answer: Gastrointestinal issues, including ulcers, bleeding, and stomach irritation.

 

52. Which NSAID is often recommended for cardiovascular protection?

• Answer: Low-dose aspirin is commonly used for cardiovascular protection to prevent heart attacks and strokes.

 

53. What is the role of glucocorticoids in inflammation?

• Answer: Glucocorticoids (a class of corticosteroids) suppress inflammation by inhibiting the immune response and blocking the release of pro-inflammatory cytokines.

 

54. What is the difference between topical and oral corticosteroids?

• Answer: Topical corticosteroids are applied directly to the skin and are used to treat localized inflammation, while oral corticosteroids are taken systemically and are used for widespread inflammation.

 

55. What should be monitored in patients taking long-term corticosteroids?

• Answer: Bone density (for osteoporosis), blood sugar levels (for diabetes), and signs of infection (due to immune suppression).

 

56. What is the most common use of NSAIDs in pediatric patients?

• Answer: NSAIDs are commonly used to treat fever and pain in children, particularly ibuprofen.

 

57. How do NSAIDs contribute to renal damage?

• Answer: NSAIDs inhibit the production of prostaglandins that maintain blood flow to the kidneys, which can lead to kidney injury, especially in patients with existing renal conditions.

 

58. What is the role of TNF inhibitors in inflammatory conditions?

• Answer: TNF inhibitors are biologic drugs used to treat autoimmune diseases like rheumatoid arthritis by inhibiting the tumor necrosis factor (TNF), a key player in inflammation.

 

59. How do NSAIDs affect the cardiovascular system?

• Answer: Non-selective NSAIDs can increase the risk of heart attack, stroke, and high blood pressure due to their effect on prostaglandins, which are involved in vascular health.

 

60. Which corticosteroid is most commonly used for acute asthma attacks?

• Answer: Prednisone or methylprednisolone is commonly used for acute asthma flare-ups due to their potent anti-inflammatory effects.

 

61. What is a common side effect of high-dose or long-term corticosteroid use?

• Answer: Weight gain, moon face (rounding of the face), and fat redistribution, leading to “Cushingoid” appearance.

 

62. What is the role of anti-inflammatory drugs in treating chronic inflammatory diseases?

• Answer: They help control the symptoms of chronic diseases like rheumatoid arthritis, Crohn’s disease, and psoriasis by reducing inflammation and improving quality of life.

 

63. What is the mechanism by which NSAIDs cause ulcers?

• Answer: NSAIDs inhibit COX-1, leading to reduced production of prostaglandins that protect the stomach lining, resulting in ulcer formation.

 

64. What is the role of hydroxychloroquine in inflammatory diseases?

• Answer: Hydroxychloroquine is used in the treatment of autoimmune conditions like lupus and rheumatoid arthritis due to its anti-inflammatory and immunomodulatory effects.

 

65. What should be considered when prescribing NSAIDs to patients with a history of peptic ulcers?

• Answer: NSAIDs should be used cautiously, with co-prescription of proton pump inhibitors (PPIs) or other agents to reduce gastrointestinal risk.

 

66. What is the primary benefit of using COX-2 inhibitors over non-selective NSAIDs?

• Answer: COX-2 inhibitors are associated with fewer gastrointestinal side effects and a lower risk of stomach ulcers compared to non-selective NSAIDs.

 

67. What is the effect of anti-inflammatory drugs on wound healing?

• Answer: Prolonged use of anti-inflammatory drugs like corticosteroids can delay wound healing due to their immunosuppressive effects.

 

68. What role do NSAIDs play in the treatment of osteoarthritis?

• Answer: NSAIDs help manage pain and inflammation in osteoarthritis, though they do not alter the progression of the disease.

 

69. Which anti-inflammatory drug is considered the gold standard for treating acute gout attacks?

• Answer: Colchicine is considered the gold standard for managing acute gout attacks, along with NSAIDs.

 

70. What is the primary purpose of using low-dose aspirin in patients with cardiovascular disease?

• Answer: Low-dose aspirin is used to reduce the risk of blood clot formation, thereby preventing heart attacks and strokes.

 

71. What is the role of methotrexate in inflammatory arthritis?

• Answer: Methotrexate is a disease-modifying antirheumatic drug (DMARD) used to slow the progression of rheumatoid arthritis and other autoimmune conditions.

 

72. What are common adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs)?

• Answer: Gastrointestinal irritation, kidney damage, increased risk of cardiovascular events, and allergic reactions.

 

73. What is the benefit of using corticosteroid injections for localized inflammation?

• Answer: Corticosteroid injections provide potent, targeted anti-inflammatory effects with fewer systemic side effects compared to oral steroids.

 

74. How do NSAIDs reduce pain in addition to reducing inflammation?

• Answer: NSAIDs inhibit the production of prostaglandins, which are involved in pain signaling, thereby reducing pain perception.

 

75. What is the role of biologics in treating inflammatory diseases?

• Answer: Biologic drugs, including TNF inhibitors and interleukin inhibitors, target specific molecules involved in inflammation and are used for conditions like rheumatoid arthritis, Crohn’s disease, and psoriasis.

 

76. What is the recommended treatment for severe rheumatoid arthritis flare-ups?

• Answer: A combination of corticosteroids for immediate relief and disease-modifying antirheumatic drugs (DMARDs) for long-term management.

 

77. What are the signs of a corticosteroid-induced adrenal crisis?

• Answer: Fatigue, weakness, low blood pressure, and confusion, especially when corticosteroid doses are reduced too quickly.

 

78. What is the effect of NSAIDs on blood pressure?

• Answer: NSAIDs can cause fluid retention, which may lead to elevated blood pressure and worsen pre-existing hypertension.

 

79. What is the role of NSAIDs in treating dysmenorrhea (painful menstruation)?

• Answer: NSAIDs are commonly used to relieve the pain and discomfort associated with dysmenorrhea by reducing uterine contractions and inflammation.

 

80. How do corticosteroids affect electrolyte balance?

• Answer: Corticosteroids can cause sodium retention, leading to fluid retention and increased blood pressure, while also causing potassium depletion.

 

81. Why are NSAIDs avoided in patients with asthma?

• Answer: Some individuals with asthma may experience exacerbation of symptoms due to NSAIDs, which can trigger bronchospasm or an asthma attack.

 

82. What is a common symptom of a corticosteroid withdrawal syndrome?

• Answer: Symptoms of corticosteroid withdrawal include fatigue, muscle weakness, and hypotension, which can be life-threatening without proper tapering.

 

83. What is the role of anti-inflammatory drugs in treating inflammatory bowel disease (IBD)?

• Answer: Anti-inflammatory drugs, including corticosteroids and biologics, are used to control inflammation and manage flare-ups in conditions like Crohn’s disease and ulcerative colitis.

 

84. What is the risk of using NSAIDs during the perioperative period?

• Answer: NSAIDs can increase the risk of bleeding and interfere with wound healing, so they are often discontinued prior to surgery.

 

85. What are corticosteroid side effects that patients should be educated about?

• Answer: Weight gain, mood changes, insomnia, elevated blood sugar, and an increased risk of infections.

 

86. What is the role of naproxen in treating musculoskeletal injuries?

• Answer: Naproxen, an NSAID, is used to reduce inflammation, pain, and swelling associated with conditions like sprains, strains, and muscle injuries.

 

87. Why should NSAIDs be avoided in pregnancy, especially in the third trimester?

• Answer: NSAIDs can cause premature closure of the ductus arteriosus, leading to complications like fetal heart failure.

 

88. What is the mechanism of action of methotrexate in rheumatoid arthritis?

• Answer: Methotrexate inhibits the enzyme dihydrofolate reductase, suppressing the immune system and reducing inflammation in rheumatoid arthritis.

 

89. What is the relationship between NSAIDs and asthma in sensitive individuals?

• Answer: NSAIDs may exacerbate asthma symptoms in some individuals, leading to bronchospasm and worsening respiratory function.

 

90. How do NSAIDs affect bone healing in fractures?

• Answer: NSAIDs may delay bone healing by inhibiting prostaglandin production, which is involved in the repair process.

 

91. What is a common side effect of celecoxib (a COX-2 inhibitor)?

• Answer: Celecoxib is associated with a lower risk of gastrointestinal side effects but may still pose a risk for cardiovascular problems.

 

92. How are corticosteroids tapered to avoid withdrawal symptoms?

• Answer: Corticosteroids should be gradually reduced over a period of time to allow the adrenal glands to recover their ability to produce cortisol.

 

93. What is the role of antimalarial drugs like hydroxychloroquine in treating lupus?

• Answer: Hydroxychloroquine is used to reduce inflammation and prevent flares in patients with systemic lupus erythematosus (SLE).

 

94. What are the risks of using systemic corticosteroids for long-term inflammation management?

• Answer: Long-term use increases the risk of diabetes, cataracts, osteoporosis, and infection due to immunosuppression.

 

95. What should be monitored in patients on long-term NSAIDs?

• Answer: Renal function, gastrointestinal health, and blood pressure should be monitored regularly.

 

96. What is the mechanism of action of biologic drugs like TNF inhibitors?

• Answer: TNF inhibitors target and block tumor necrosis factor (TNF), a cytokine involved in systemic inflammation in autoimmune conditions.

 

97. How do NSAIDs affect the gastrointestinal system?

• Answer: By inhibiting COX-1, NSAIDs reduce the production of protective prostaglandins in the stomach, increasing the risk of ulcers and bleeding.

 

98. What is the role of corticosteroids in the treatment of skin inflammation?

• Answer: Topical corticosteroids are used to reduce inflammation, redness, and swelling in conditions like eczema, psoriasis, and dermatitis.

 

99. Why are corticosteroids effective in treating autoimmune diseases?

• Answer: Corticosteroids suppress the immune system, reducing the overactive immune response that characterizes autoimmune diseases.

 

100. What is a major risk of using NSAIDs for long-term pain management in older adults?

• Answer: The increased risk of gastrointestinal bleeding, renal impairment, and cardiovascular events.