Question 1

NSAIDs are effective in treating rheumatoid arthritis because these drugs inhibit the _______ enzyme that initiates ______synthesis.&#10;A) cyclooxygenase; prostaglandin&#10;B) cyclooxygenase; steroid&#10;C) monoamine oxidase; dopamine&#10;D) monoamine; norepinephrine&#10;E) choline acetyltransferase; acetylcholine

Accepted Answer

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) are effective in treating rheumatoid arthritis due to their ability to inhibit the cyclooxygenase enzyme, which initiates prostaglandin synthesis. Prostaglandins are responsible for inflammation, pain, and fever, so by inhibiting their production, NSAIDs can reduce the symptoms of rheumatoid arthritis.

Question 2

By producing analgesic and anti-inflammatory effects,_____ is/are usually considered the first line of defense in treating rheumatoid arthritis.&#10;A) acetaminophen&#10;B) NSAIDs&#10;C) opioids&#10;D) leukotriene inhibitors&#10;E) anabolic steroids

Accepted Answer

NSAIDs (nonsteroidal anti-inflammatory drugs) are usually considered the first line of defense in treating rheumatoid arthritis due to their analgesic and anti-inflammatory effects. Acetaminophen may provide some pain relief, but does not have significant anti-inflammatory properties. Opioids are usually reserved for more severe pain that is not responsive to other treatments. Leukotriene inhibitors are typically used in the treatment of asthma and allergies, and anabolic steroids are not recommended for the treatment of rheumatoid arthritis.

Question 3

Early and aggressive use of ______ can slow the progression of rheumatoid arthritis in many patients before there is extensive damage to affected joints.&#10;A) NSAIDs&#10;B) acetaminophen&#10;C) anabolic steroids&#10;D) disease-modifying antirheumatic drugs&#10;E) drugs that increase bone and cartilage destruction

Accepted Answer

Disease-modifying antirheumatic drugs (DMARDs) can slow or halt the progression of rheumatoid arthritis by suppressing the immune system's attack on the joints. Early and aggressive use of DMARDs is recommended to prevent extensive damage to affected joints. NSAIDs and acetaminophen can help relieve symptoms, but they do not slow the progression of the disease. Anabolic steroids are not recommended for long-term use due to their side effects. Drugs that increase bone and cartilage destruction would worsen the condition of rheumatoid arthritis.

Question 4

When treating an acute exacerbation of rheumatoid arthritis in a specific joint,anti-inflammatory steroids (glucocorticoids)can be injected directly into the joint,but the number of injections should be limited to _____ per year.

A) 2-3
B) 5-6
C) 8-10
D) 12-15

Accepted Answer

The number of injections of glucocorticoids into a joint should be limited to no more than 2-3 per year to prevent long-term damage to the joint and potential side effects from repeated injections.

Question 5

Because of its ability to decrease pain with minimal side effects such as gastric irritation,________ is often considered the drug of choice in mild-to-moderate osteoarthritis.&#10;A) aspirin&#10;B) acetaminophen&#10;C) prednisone&#10;D) cortisone&#10;E) methotrexate

Accepted Answer

Acetaminophen is known for its analgesic effects and is considered the drug of choice for mild-to-moderate osteoarthritis due to its ability to decrease pain with minimal side effects such as gastric irritation. Aspirin, cortisone, and methotrexate have more potential side effects and are not typically used as first-line treatments for osteoarthritis. Prednisone is a steroid medication that may be used for joint pain in some cases, but it is not considered a first-line treatment for osteoarthritis.

Question 6

Anti-inflammatory steroids (glucocorticoids)are often effective in controlling inflammation in rheumatoid arthritis,but prolonged use of large,systemic doses can cause&#10;A) osteoporosis&#10;B) muscle wasting&#10;C) hypertension&#10;D) diabetes mellitus&#10;E) all of the above are true

Accepted Answer

Prolonged use of large, systemic doses of glucocorticoids can cause a range of adverse effects, including osteoporosis, muscle wasting, hypertension, and diabetes mellitus. Therefore, all the choices (A, B, C, and D) are correct.

Question 7

All of the following drugs are considered &#34;disease-modifying&#34; antirheumatic drugs EXCEPT&#10;A) NSAIDs such as aspirin&#10;B) gold compounds such as auranofin (Ridaura),&#10;C) tumor necrosis factor-alpha inhibitors such as etanercept (Enbrel)&#10;D) antimalarials such as chloroquine (Aralen)&#10;E) methotrexate

Accepted Answer

NSAIDs such as aspirin are not considered disease-modifying antirheumatic drugs, as they primarily provide symptomatic relief and do not act to alter the underlying course of the disease.

Question 8

Because they may supply key ingredients needed for the production of articular cartilage and synovial fluid,dietary supplements such as _________ are used by some patients with osteoarthritis.&#10;A) aspirin and acetaminophen&#10;B) prednisone and methylprednisone&#10;C) chloroquine and hydroxychloroquine&#10;D) ibuprofen and ketoprofen&#10;E) glucosamine and chondroitin

Accepted Answer

Glucosamine and chondroitin are commonly used dietary supplements by patients with osteoarthritis because they are believed to provide key ingredients needed for the production of articular cartilage and synovial fluid. These supplements may help to reduce joint pain and inflammation associated with osteoarthritis. Aspirin, acetaminophen, prednisone, methylprednisone, chloroquine, hydroxychloroquine, ibuprofen, and ketoprofen are not known to provide the specific nutrients needed for cartilage and synovial fluid production.

Question 9

In certain patients with osteoarthritis,viscosupplementation is preformed to restore the lubricating properties of synovial fluid by&#10;A) administering oral anti-inflammatory steroids&#10;B) administering oral NSAIDs&#10;C) injecting anti-inflammatory steroids directly into the affected joint&#10;D) injecting hyaluronan directly into the affected joint&#10;E) injecting NSAIDs directly into the affected joint

Accepted Answer

Viscosupplementation involves injecting hyaluronan directly into the affected joint to restore the lubricating properties of synovial fluid. This helps to reduce pain and improve function in patients with osteoarthritis. Oral anti-inflammatory steroids or NSAIDs are not effective in restoring synovial fluid properties, and injecting anti-inflammatory steroids or NSAIDs directly into the joint may have limited benefits but also carries a higher risk of side effects.

Deck 16: Pharmacologic Management of Rheumatoid Arthritis and Osteoarthritis