Question 1

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

Accepted Answer

Prolonged use of large, systemic doses of anti-inflammatory steroids (glucocorticoids) can cause osteoporosis, muscle wasting, hypertension, and diabetes mellitus. Therefore, option E is the correct answer.

Question 2

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 often considered the drug of choice in mild-to-moderate osteoarthritis because it can decrease pain with minimal side effects such as gastric irritation. Aspirin, prednisone, cortisone, and methotrexate may also be used to treat osteoarthritis, but they may have more side effects or be less effective in controlling pain.

Question 3

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 (Rheumatrex,others).

Accepted Answer

NSAIDs such as aspirin, although commonly used for the treatment of rheumatoid arthritis symptoms, do not modify the course of the disease and therefore are not considered disease-modifying antirheumatic drugs.

Question 4

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)nonsteroidal anti-inflammatory drugs (NSAIDs)&#10;C)opioids&#10;D)leukotriene inhibitors&#10;E)anabolic steroids

Accepted Answer

Nonsteroidal anti-inflammatory drugs (NSAIDs) are typically the first line of defense in treating rheumatoid arthritis due to their ability to produce analgesic and anti-inflammatory effects. Acetaminophen may also be used for pain relief, but does not have significant anti-inflammatory effects. Opioids are generally used as a second line treatment due to their potential for dependence and other side effects. Leukotriene inhibitors and anabolic steroids are not commonly used in the treatment of rheumatoid arthritis.

Question 5

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 stop the immune system from attacking the joints in rheumatoid arthritis. Early and aggressive use of DMARDs can prevent the progression of the disease before significant damage occurs in the affected joints. NSAIDs and acetaminophen can provide symptom relief, but do not modify the disease process. Anabolic steroids are not commonly used as a long-term treatment for rheumatoid arthritis due to their side effects. Drugs that increase bone and cartilage destruction would worsen rheumatoid arthritis symptoms.

Question 6

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. The other options (A, B, C, and E) all involve administration of anti-inflammatory drugs, but do not specifically address the lubrication issue in osteoarthritis.

Question 7

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 inhibit cyclooxygenase, which is the enzyme responsible for the synthesis of prostaglandins. Prostaglandins play a role in inflammation, pain, and fever. By inhibiting their production, NSAIDs reduce these symptoms in rheumatoid arthritis.

Question 8

Because they may supply key ingredients needed for the production of articular cartilage and synovial fluid,some patients with osteoarthritis use dietary supplements such as _________.&#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 for patients with osteoarthritis because they are believed to provide the necessary ingredients for the formation of articular cartilage and synovial fluid. Aspirin, acetaminophen, prednisone, methylprednisone, chloroquine, and hydroxychloroquine do not have the same beneficial properties for osteoarthritis.

Deck 16: Pharmacologic Management of Rheumatoid Arthritis and Osteoarthritis