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Chapter 36: NSAIDs, Acetaminophen, & Drugs Used in Rheumatoid Arthritis & Gout

Among NSAIDs, aspirin is unique because it

(A) Irreversibly inhibits its target enzyme

(B) Prevents episodes of gouty arthritis with long-term use

(C) Reduces fever

(D) Increases the risk of colon cancer

(E) Selectively inhibits the COX-2 enzyme

Aspirin differs from other NSAIDs by irreversibly inhibiting cyclooxygenase. The answer is A.

Which of the following is an analgesic and antipyretic drug that lacks an anti-inflammatory action?

(A) Acetaminophen

(B) Celecoxib

(C) Colchicine

(D) Indomethacin

(E) Probenecid

Acetaminophen is the only drug that fits this description. Indomethacin is a nonselective COX inhibitor and celecoxib is a COX-2 inhibitor; both have analgesic, antipyretic, and anti-inflammatory effects. Colchicine is a drug used for gout that also has an anti-inflammatory action. Probenecid is a uricosuric drug that promotes the excretion of uric acid. The answer is A.

A 16-year-old girl comes to the emergency department suffering from the effects of an aspirin overdose. Which of the following syndromes is this patient most likely to exhibit as a result of this drug overdose?

(A) Bone marrow suppression and possibly aplastic anemia

(B) Fever, hepatic dysfunction, and encephalopathy

(C) Hyperthermia, metabolic acidosis, and coma

(D) Rapid, fulminant hepatic failure

(E) Rash, interstitial nephritis, and acute renal failure

Salicylate intoxication is associated with metabolic acidosis, dehydration, and hyperthermia. If these problems are not corrected, coma and death ensue. The answer is C.

Which of the following drugs is most likely to increase serum concentrations of conventional doses of methotrexate, a weak acid that is primarily cleared in the urine?

(A) Acetaminophen

(B) Allopurinol

(C) Colchicine

(D) Hydroxychloroquine

(E) Probenecid

Like other weak acids, methotrexate depends on active tubular excretion in the proximal tubule for efficient elimination. Probenecid competes with methotrexate for binding to the proximal tubule transporter and thereby decreases the rate of ...

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