Deck 5: Nonopioid (Nonnarcotic)Analgesics

Question 1

Which of the following is the best to use in pediatric patients for both its analgesic and antipyretic action?

A) Aspirin
B) Acetaminophen
C) NSAIDs
D) Codeine

Answer 1

Acetaminophen

Question 2

Which of the following raises the pain threshold?

A) Emotional instability
B) Sympathy
C) Sleep
D) Both a and c
E) Both b and c

Answer 2

Both b and c

Question 3

Which of the following is the most common side effect from aspirin?

A) Gastrointestinal effects
B) Bleeding
C) Hepatic and renal effects
D) Hypersensitivity

Answer 3

Gastrointestinal effects

Question 4

Aspirin can be used most safely in patients who:

A) have arthritis.
B) have gout.
C) have ulcers.
D) are pregnant.

Question 5

Which of the following choices has antiinflammatory, antipyretic, analgesic and antiplatelet action?

A) Acetaminophen
B) Codeine
C) Aspirin
D) Hydrocodone

Question 6

Which of the following statements is true regarding aspirin and the clotting mechanism?

A) Aspirin reversibly interferes with the clotting mechanism by reducing platelet adhesiveness.
B) Replacement of all of the affected platelets is required to produce normal clotting.
C) With lower doses of aspirin, 1 1/2 days should elapse to obtain normal clotting.
D) Aspirin stimulates production of prothrombin.

Question 7

Prostacyclin _____ aggregation of platelets and thromboxane A₂ ____ aggregation of platelets.

A) stimulates; stimulates
B) stimulates; inhibits
C) inhibits; stimulates
D) inhibits; inhibits

Question 8

Pain:

A) brings people to the dental office.
B) keeps people from the dental office.
C) can be effectively treated with inactive pills (placebos).
D) does all of the above.

Question 9

The ability of aspirin to reduce fever results from its inhibition of prostaglandin synthesis in the:

A) medulla.
B) hypothalamus.
C) pons.
D) cerebellum.

Question 10

All of the following are characteristics of aspirin toxicity (salicylism)except:

A) dimness of vision.
B) hyperthermia.
C) electrolyte imbalance.
D) hepatic necrosis.
E) tinnitus.

Question 11

Prostaglandins sensitize pain receptors to:

A) diflunisal.
B) salsalate.
C) bradykinin.
D) ketoprofen.

Question 12

Which of the following statements is true concerning the pharmacokinetics of aspirin?

A) Plain, unbuffered aspirin produces its peak effect on an empty stomach in 15 minutes.
B) Buffered aspirin has a slower peak of aspirin than plain aspirin.
C) The half-life of unhydrolyzed aspirin is approximately 90 minutes.
D) Aspirin exhibits zero-order kinetics.

Question 13

A drug interaction between aspirin and _____ can result in significant bleeding.

A) probenecid
B) warfarin
C) methotrexate
D) sulfonylureas

Question 14

Pain relief by nonopioid analgesics is mediated via action:

A) at the central nervous system (CNS).
B) at the peripheral nervous system.
C) both centrally and peripherally.
D) None of the above are correct.

Question 15

Which of the following drugs can be substituted for aspirin in patients displaying the aspirin hypersensitivity triad?

A) Ibuprofen
B) Naproxen
C) Codeine
D) Piroxicam

Question 16

The action of nonopioid analgesics is related to their ability to inhibit:

A) the CNS.
B) prostaglandin synthesis.
C) release of epinephrine.
D) release of acetylcholine.

Question 17

The pain threshold varies greatly in individuals because of different perceptions of pain.

A) Both parts of the statements are true.
B) Both parts of the statements are false.
C) The first part of the statement is true; the second part is false.
D) The first part of the statement is false; the second part is true.

Question 18

What is the usual adult dosage of aspirin for the treatment of pain or fever?

A) 250 mg every 4 hours
B) 3 to 6 g per day
C) 650 mg every 4 hours
D) 800 mg every 4 hours
E) 160 mg per day

Question 19

Synonyms for nonopioid analgesics include:

A) narcotic.
B) central.
C) antipyretic.
D) strong.

Question 20

The incidence of true aspirin allergy is:

A) approximately 10%.
B) between 2% and 5%.
C) less than 1%.
D) unknown; it has not ever been recorded.

Question 21

Oral administration with _____ is indicated only as continuation to intravenous (IV)or intramuscular (IM)therapy.

A) fenoprofen
B) ketorolac
C) naproxen sodium
D) diflunisal

Question 22

Acetaminophen does not possess any of these clinically significant _____ effects: (1)antipyretic, (2)antiinflammatory, (3)analgesic.

A) 1, 2, 3
B) 1 and 2
C) 1 and 3
D) 1
E) 2

Question 23

Adverse cardiovascular effects are thought to be least likely to occur with the use of which of the following nonsteroidal antiinflammatory drugs (NSAIDs)?

A) Celecoxib (Celebrex)
B) Naproxen (Naprosyn)
C) Diclofenac (Voltaren)
D) Ketoprofen (Orudis)

Question 24

Alcohol consumption stimulates the breakdown of acetaminophen, thereby decreasing the toxic potential of acetaminophen use.

A) Both parts of the statement are true.
B) Both parts of the statement are false.
C) The first part of the statement is true; the second part is false.
D) The first part of the statement is false; the second part is true.

Question 25

Dental pain is best managed with which of the following choices?

A) Codeine 60 mg
B) Ibuprofen 400 mg
C) Acetaminophen 650 mg
D) Aspirin 650 mg
E) Placebo

Question 26

Which of the following agents is known to have a drug interaction with lithium?

A) Aspirin
B) Naproxen
C) Acetaminophen
D) Oxycodone

Question 27

Who is most likely to experience the most cases of accidental overdose with acetaminophen?

A) Infants
B) Children
C) Young adults
D) Older adults

Question 28

A person should _____ aspirin if he or she suspects he or she may be having a heart attack provided there is not an aspirin allergy, hypersensitivity, or another contraindication.

A) completely avoid
B) chew one low dose
C) take the maximum daily recommended dose of 4,000 mg of
D) take 325 to 650 mg every 4 hours of

Question 29

Which of the following statements is true concerning adverse reactions of NSAIDs?

A) NSAIDs will decrease acid secretion in the stomach.
B) Tolerance develops to the use of NSAIDs.
C) NSAIDs irreversibly inhibit platelet aggregation because they inhibit thromboxane A2 production.
D) NSAIDs have precipitated renal insufficiency.

Question 30

Which of the following is true regarding these pharmacologic effects of therapeutic doses of acetaminophen?
(1)No effect on the cardiovascular system
(2)Does not produce gastric bleeding
(3)Does not affect platelet adhesiveness
(4)Does not affect uric acid excretion

A) 1, 2, 3, 4
B) 1, 2, 3
C) 2, 3, 4
D) 1 only

Question 31

Which of the following NSAIDs is designated U.S. Food and Drug Administration (FDA)pregnancy category B?

A) Naproxen (Naprosyn)
B) Diflunisal (Dolobid)
C) Tolmetin (Tolectin)
D) Mefanamic acid (Ponstel)

Question 32

Caffeine is often combined with aspirin because caffeine potentiates the analgesic effect of aspirin and other analgesics.

A) Both parts of the statement are true.
B) Both parts of the statement are false.
C) The first part of the statement is true; the second part is false.
D) The first part of the statement is false; the second part is true.

Question 33

Which of the following statements is true regarding the pharmacokinetics of acetaminophen?

A) Acetaminophen is slowly and incompletely absorbed from the gastrointestinal tract.
B) Acetaminophen is excreted with a half-life of 8 to 12 hours.
C) When large doses of acetaminophen are ingested, an intermediate metabolite is produced that is thought to be hepatotoxic.
D) Acetaminophen is less potent and efficacious than aspirin.

Question 34

Which of the following choices is currently the most popular COX II-specific agent on the market?

A) Celecoxib
B) Rofecoxib
C) Valdecoxib
D) Indomethacin

Question 35

Which of the following NSAIDs is considered the drug of choice for management of dental pain when a NSAID is indicated?

A) Naproxen
B) Naproxen sodium
C) Ibuprofen
D) Diflunisal

Question 36

Which of the following statements is true of COX II?

A) It is a widely distributed constitutive enzyme.
B) It is responsible for the adverse reactions of the NSAIDs.
C) It is synthesized only when inflammation occurs.
D) It is not an enzyme.

Question 37

Which of the following is true concerning NSAIDs?

A) Many authors agree that the NSAIDs are the most useful drug group for the treatment of dental pain.
B) Unlike aspirin, NSAIDs do not inhibit the enzyme cyclooxygenase (COX).
C) Most NSAIDs reach a peak blood level in approximately 20 minutes.
D) NSAIDs do not have a significant antiinflammatory effect.

Question 38

Which of the following agents would be least useful in alleviating fever?

A) Piroxicam
B) Acetaminophen
C) Diflunisal
D) Probenecid
E) Aspirin

Question 39

Which of the following NSAIDs is the drug of choice for treating a nursing woman?

A) Naproxen
B) Diflunisal
C) Ibuprofen
D) Fenoprofen

Question 40

An acute overdose with acetaminophen may damage the:

A) eyes.
B) liver.
C) spleen.
D) kidney.

Question 41

Probenecid and allopurinol both inhibit the synthesis of uric acid.

Question 42

Salicylates' mechanism of action involves inhibiting prostaglandin synthesis.

Question 43

Two components of pain include perception and reaction.

Question 44

Which of the following agents is intended to treat an acute attack of gout?

A) Probenecid
B) Codeine
C) Colchicine
D) Acetaminophen
E) Both a and c

Question 45

Which of the following agents is a xanthine oxidase inhibitor?

A) Colchicine
B) Ibuprofen
C) Allopurinol
D) Probenecid

Question 46

The Food and Drug Administration (FDA)recently issued a safety announcement regarding the risk of three rare, but potentially fatal, skin reactions associated with:

A) aspirin and salicylates.
B) NSAIDs.
C) acetaminophen.
D) colchicine.

Question 47

Raising the pain threshold increases one's reaction to pain.

Question 48

Low-dose aspirin therapy is recommended for which of the following? (Select all that apply.)

A) People who have had heart bypass surgery
B) Men aged 45 to 79 with no history of heart disease
C) Women aged 55 to 79 with no history of heart disease
D) A person with gastroesophageal reflux disease (GERD)

Question 49

Salicylism is a toxic effect from acetaminophen.

Question 50

NSAIDs carry "black box warnings" for which of the following types of events? (Select all that apply.)

A) Respiratory
B) Gastrointestinal
C) Cardiovascular
D) Endocrine

Question 51

Aspirin should not be given to children until they are 18 years of age.