Deck 13: Anti-Inflammatory Drugs

Question 1

Which of the following is not a cardinal sign of inflammation?

A)Heat
B)Immunosupression
C)Pain
D)Loss of function

Answer 1

Immunosupression

Question 2

When choosing an intermediate-acting glucocorticoid for use in a cat, which would be a reasonable choice?

A)Cortisone
B)Hydrocortisone
C)Prednisone
D)Prednisolone
E)Dexamethasone

Answer 2

Prednisolone

Question 3

Nutraceuticals are

A)FDA regulated pharmaceuticals.
B)considered safe when administered by label regimens.
C)foodstuffs that contain a health claim.
D)proven effective in treating disease.

Answer 3

foodstuffs that contain a health claim.

Question 4

The inflammatory process results in the five cardinal signs of inflammation: redness, heat, swelling/edema, pain, and loss of function. The redness is caused by

A)vasoconstriction in the area caused by antihistamines.
B)vasodilatation in the area caused by histamines.
C)vasoconstriction caused by WBC infiltration.
D)vasodilation caused by WBC infiltration.

Question 5

Eicosanoids are

A)a group of chemicals the cause platelets to aggregate.
B)a group of chemicals generated by the arachidonic acid cascade.
C)a group of chemicals that are inflammatory mediators.
D)B and C

Question 6

______________ is a short acting glucocorticoid that is converted in the liver to the active form.

A)Prednisone
B)Dexamethasone
C)Cortisone
D)Triamcinolone

Question 7

A 12-year-old dog is presented in your clinic with degenerative joint disease resulting in chronic hip pain. Over the past several years this patient has experienced several instances of gastric upset, requiring repeated administration of sucralfate in addition to ranitidine. In addition, this dog has a history of increased platelet aggregation time because of immune mediated thrombocytopenia. Which of the following medications would be appropriate for use in this patient to help control the joint pain?

A)Aspirin
B)Carprofen
C)Ibuprofen
D)Flunixin meglumine
E)Meloxicam

Question 8

Glucocorticoids reduce inflammation by

A)activating the arachidonic acid cascade.
B)releasing antihistamines.
C)blocking the action of phospholipase.
D)inhibiting COX.

Question 9

Which statement is not true of glucocorticoids?

A)Exogenous glucocorticoids have the same negative feedback effect on the hypothalamus and pituitary gland as the natural cortisol.
B)Glucocorticoids produce their anti-inflammatory effect by inhibiting phospholipase
C)Glucocorticoids have little or no anti-inflammatory effect
D)Glucocorticoids have some effect on almost every cell in the body

Question 10

Which statement is not true of mineralocorticoids?

A)Mineralocorticoids are involved with water and electrolyte balance in the body
B)Mineralocorticoids have little or no anti-inflammatory effect
C)Mineralocorticoids include aldosterone
D)Mineralocorticoids have anti-inflammatory effect

Question 11

What is the main function of hyaluronic acid?

A)Stimulation of prostaglandin production
B)Oral supplement involved in nerve conduction
C)Antimicrobial for equine joint infections
D)Joint cartilage lubricant

Question 12

Which of the statements below are accurate descriptions of the two large groups of anti-inflammatories (Steroidal and nonsteroidal)?

A)Neither act at the level of the central nervous system to block pain
B)Both act at the level of the spinal cord to block pain
C)Both act at the level of the local tissue
D)Both b and c

Question 13

Which of the following statements is not true of Phenylbutazone ("bute")?

A)In horses it is used for relief of musculoskeletal inflammation
B)In horses it nonselectively inhibitis COX enzymes and decreases prostaglandin formation
C)In horses it is as effective in controlling pain from horse colic as some of the other NSAIDs or the opioid analgesics
D)The adverse effects of phenylbutazone are similar to those of other NSAIDs

Question 14

All of the following are hallmark leukocyte findings of a classic stress leukogram except

A)neutropenia.
B)lymphopenia.
C)monocytopenia.
D)eosinopenia.
E)All are findings of a stress leukogram

Question 15

Dimethylsulfoxide (DMSO) functions as an anti-inflammatory drug via the following mode of action:

A)inactivation of macrophage-derived superoxide radicals.
B)inhibition of prostaglandin synthesis via the cyclooxygenase pathway.
C)inhibition of leukotriene synthesis via the lipoxygenase pathway.
D)production of hydroxyl radicals in tissues.

Question 16

Cortisol is a natural, short-lived glucocorticoid. Chronic usage of glucocorticoids causes decreased hypothalamic-pituitary-adrenal gland function by disturbing natural glucocorticoid feedback mechanisms. To circumvent this disruption of feedback, a clinician decides to use the exogenous corticosteroid prednisone to decrease chronic inflammation in a dog. What is wrong with this rationale?

A)Exogenous glucocorticoids aren't anti-inflammatory
B)Prednisone is an endogenous glucocorticoid
C)This feedback mechanism doesn't exist
D)Exogenous glucocorticoids also feedback to the hypothalamus and pituitary gland

Question 17

Flunixin meglumine is also called

A)phenylbutazone.
B)naproxen.
C)carprofen.
D)Banamine.

Question 18

Glucocorticoids are often dosed at supraphysiologic levels which results in

A)decreased production of hormone from the adrenal gland.
B)no interference since these are exogenous hormones on the adrenal gland.
C)increased production of ACTH.
D)a decrease in blood glucose.

Question 19

Which of the following regarding acetaminophen is false?

A)The relative toxic dose for felines is less than most animals
B)The drug is considered an anti-inflammatory
C)Toxicity may result from hepatic accumulation of an acetaminophen metabolite
D)Results in decreases in pain perception

Question 20

Phenylbutazone is a highly (99%) protein-bound drug. What is a substantial consequence of this characteristic in its ability to decrease tissue inflammation?

A)Enhanced therapeutic movement of drug into inflamed tissues.
B)Increased drug availability with hyperproteinemia.
C)Decreased drug availability with hypoproteinemia.
D)No consequence in animals experiencing disease such as protein-losing enteropathy.

Question 21

All of the following are true except about acetaminophen

A)a single extra strength acetaminophen tablet (i.e., 500 mg) can kill an average-size cat.
B)it does cause the GI upset, ulcers, or interference with platelet clumping associated with NSAIDs.
C)in toxicosis increased red blood cell hemolysis and Heinz bodies are evident on blood smears.
D)toxic metabolite accumulates in the liver and other tissues, producing cellular destruction.

Question 22

Clients should be advised not to use human OTC pain relief products for their animals without veterinary supervision for all of the following reasons except:

A)ibuprofen and naproxen consistently produce vomiting in dogs after a few days of treatment.
B)feline liver do not biotransform these NSAID consistently.
C)there is enough variability from veterinary patient to veterinary patient that is it almost impossible to determine how the animal is going to respond to a dose of these drugs.
D)these drugs have no effect in animals.

Question 23

All of the following statements are true about COX enzymes except

A)COX-1 always exists in the kidney, stomach, and other organs of the body, where it produces prostaglandins.
B)COX-2 is an enzyme that is only created when there is trauma or inflammation.
C)most NSAIDs work by blocking the activity of COX enzymes and thus inhibiting the production of prostaglandins.
D)animals are more sensitive to the side effects of glucocorticoids than humans so many NSAIDs have been developed for animals to control chronic inflammation.

Question 24

The veterinary technician should be sure to educate the client whenever an animal leaves the clinic with an NSAID about the most common side effects of NSAID related to the GI tract. Advice should include:

A)be prepared for vomiting every day but continue to administer the medication.
B)watch for dark tarry stools and discontinue the medication if they are observed.
C)give the animal a double dose if they seem to be in pain.
D)not worry these are super safe drugs.

Question 25

Which of the following statements about nutraceuticals is true?

A)They are regulated by the FDA.
B)By law, the compound is to be used as a therapeutic agent.
C)They have been clinical proven to be efficacious.
D)None of the above are true