Most Asked 100 MCQ from Analgesics and Antipyretics for Staff Nurse

Most Asked 100 MCQ from Analgesics and Antipyretics for Staff Nurse
1. â­-Aminoethylimidazole is?
(a) 2­methyl histamine
(b) Histamine
(c) 2­pyridyl ethylamine
(d) 4­methyl histamine

2. Agents that often cause vasoconstriction include all of the following except
(a) Angiotensin II
(b) Methysergide
(c) PGF2a
(d) Prostacyclin
(e) Thromboxane

3. Inflammation is a complex tissue reaction that includes the release of cytokines, leukotrienes, prostaglandins, and peptides. Prostaglandins involved in inflammatory processes are produced from arachidonic acid by
(a) Cyclooxygenase 1
(b) Cyclooxygenase 2
(c) Glutathione – S – transferase
(d) Lipoxygenase
(e) Phospholipase A2

4. A 60­year­old woman has glaucoma following cataract surgery. Which of the following can be used to reduce intraocular pressure?
(a) Leukotriene LTD4 or its analogs
(b) Prostaglandin E2 or its analogs
(c) Prostaglandin F2a or its analogs
(d) Slow­reacting substance of anaplylaxis (SRS­A)
(e) Thromboxane A2 or its analogs

5. Which of the following is a reversible inhibitor of platelet cyclooxygenase?
(a) Alprostadil
(b) Aspirin
(c) Ibuprofen
(d) LTC4
(e) Misoprostol

6. Vasodilation by prostaglandins involves
(a) Arterioles
(b) Precapillary sphincters
(c) Postcapillary venules
(d) All of the above

7. Fentanyl transdermal patches have been used postoperatively to provide transdermal analgesia. The most dangerous adverse effect of this mode of administration is
(a) Cutaneous reactions
(b) Diarrhea
(c) Hypertension
(d) Relaxation of skeletal muscle
(e) Respiratory depression

8. Opioid analgesics are either contraindicated or must be used with extreme caution in several clinical situations. For morphine, such situations do not include
(a) Aqueous diffusion
(b) Aqueous hydrolysis
(c) Lipid diffusion
(d) Pinocytosis or endocytosis
(e) Special carrier transport

9. Following is an example of paraaminophenol NSAID
(a) Diclofenac
(b) Acetaminophen
(c) Piroxicam
(d) Celecoxib

10. This drug, which does not activate opioid receptors, has been proposed as a maintenance drug in treatment programs for opioid addicts; a singly oral dose will block the effects of injected heroin for up to 48 hours
(a) Amphetamine
(b) Buprenorphine
(c) Naloxone
(d) Naltrexone
(e) Propoxyphene

11. Which one of the following statements about dextromethorphan is accurate?
(a) Activates kappa receptors
(b) Analgesia equivalent to pentazocine
(c) Highly effective antiemetic
(d) Less constipation than codeine
(e) Use requires a prescription

12. Which one of the following effects does not occur in salicylate intoxication ?
(a) Hyperventilation
(b) Hypothemia
(c) Metabolic acidosis
(d) Respiratory alkalosis
(e) Tinnitus

13. Which one of the following drugs is not useful in dysmenorrhea?
(a) Aspirin
(b) Colchicine
(c) Ibuprofen
(d) Rofecoxib
(e) Naproxen

14. Following gold compound is generally administered orally
(a) Aurothioglucose
(b) Auronafin
(c) Gold sodium thiomalate
(d) All of the above

15. The main advantage of ketorolac over aspirin is that ketorolac
(a) Can be combined more safely with an opioid such as codeine
(b) Can be obtained as an over­the­counter agent
(c) Does not prolong the bleeding time
(d) Is available in a parenteral formulation that can be injected intramuscularly or intravenously
(e) Is less likely to cause acute renal failure in patients with some preexisting degree of renal impairment

16. A 45­year­old surgeon has developed symmetric early morning stiffness in her hands. She wishes to take a nonsteroidal anti­inflammatory drug to relieve these symptoms and wants to avoid gastrointestinal side effects. Which one of the following drugs is most appropriate?
(a) Aspirin
(b) Celecoxib
(c) Ibuprofen
(d) Indomethacin
(e) Piroxicam

17. Following is an example of preformed and not lipid derived mast cell mediator of inflammatory process
(a) LTC4
(b) PGD2
(c) PAF
(d) Histamine

18. The toxicity spectrum of aspirin does not include
(a) Increased risk of encephalopathy in children with viral infections
(b) Increased risk of peptic ulcers
(c) Hyperprothrombinemia
(d) Metabolic acidosis
(e) Respiratory alkalosis

19. Accidental poisonings are common with both aspirin and ibuprofen, two OC drugs available in tasty chewable tablets. In cases of overdose, aspirin is more likely than ibuprofen to cause
(a) Autonomic Instability
(b) Hepatic necrosis
(c) Metabolic acidosis
(d) Thrombocytopenia
(e) Ventricular arrhythmias

20. A drug that decreases blood pressure and has analgesic and spasmolytic effects when given intrathecally is
(a) Atenolol
(b) Clonidine
(c) Morphine
(d) Nitroprusside
(e) Prazosin

21. Cyclooxygenase­1 and –2 are responsible for
(a) The synthesis of prostaglandins from arachidonate
(b) The synthesis of leukotrienes from arachidonate
(c) The conversion of ATP to cAMP
(d) The metabolic degradation of cAMP
(e) The conversion of GTP to cGMP

22. Following agent is generally used in allergic rhinitis
(a) Beclomethasone
(b) Fluticasone
(c) Triamcinolone
(d) All of the above

23. The primary objective for designing drugs that selectively inhibit COX – 2 is to
(a) Decrease the risk of nephrotoxicity
(b) Improve anti­inflammatory effectiveness
(c) Lower the risk of gastrointestinal toxicity
(d) Reduce the cost of treatment of rheumatoid arthritis
(e) Selectively decrease thromboxane A2 without effects on other eicosanoids

24. A newborn was diagnosed as having a congenital abnormality that resulted in transposition of her great arteries. While preparing the infant for surgery, the medical team needed to keep the ductus arteriosus open. They did this by infusing
(a) Cortisol
(b) Indomethacin
(c) Ketorolac
(d) Misoprostol
(e) Tacrolimus

25. Acetyl salicylic acid is soluble in
(a) An aqueous base
(b) Water
(c) An aqueous acid

26. Decomposition of the acetyl salicylic acid at room temperature most likely would occur by
(a) Oxidation of the ester
(b) Reduction of the carboxylic acid
(c) Hydrolysis of the ester

27. Diamprit is an agonist of ______ receptors, except
(a) H1
(b) H2
(c) H3
(d) All of the above

28. Which of the following enzymes is ultimately responsible for the production of prostaglandins associated with inflammatory reactions?
(a) Phospholipase

(b) Lipoxygenase
(c) Cyclooxygenase­I
(d) Cyclooxygenase II
(e) Xanthine oxidase

29. Which of the following prostaglandin analogs is used specifically for the treatment of NSAID induced gastrointestinal ulcertation?
(a) Alprostadil
(b) Misoprostol
(c) Carboprost
(d) Dinoprostone
(e) Epoprostenol

30. Which of the following compounds is most likely to lower circulating levels of leukotrienes?
(a) Zileuton
(b) Montelukast
(c) Carprofen
(d) Aspirin
(e) Allopurinol

31. The action of aspirin that results in its greater efficacy as an antithrombotic (anti­platelet) drug is its ability to
(a) Inhibit lipoxygenase as well as cyclooxygenase
(b) Selectively inhibit cyclooxygenase I
(c) Inhibit leukocyte migration
(d) Promote uric acid excretion
(e) Acetylate cyclooxygenase

32. Which of the following drugs may be effective in the treatment of gouty arthritis by acting by two separate and distinct mechanisms?
(a) Allopurinol
(b) Probenecid
(c) Colchicine
(d) Indomethacin
(e) Sulfinpyrazone

33. Acute or chronic colchicine toxicity may be identified by which of the following signs/symptoms?
(a) Alopecia
(b) Blood dyscrasias
(c) Severe gastrointestinal upset
(d) All of the above
(e) None of the above

34. Patients taking chronic doses of non-selective non-steroidal anti­-inflammatory drugs (NSAIDs) should periodically be screened for which of the following toxicities?
(a) Nephrotoxicity
(b) Peripheral neuropathy
(c) Cardiotoxicity
(d) All of the above
(e) None of the above

35. Which of the following medications would represent arthritis therapy that is least likely to cause gastric ulceration?
(a) Aspirin
(b) Acetaminophen
(c) Piroxicam
(d) Meclofenamate
(e) Rofecoxib

36. In addition to their ability to decrease inflammatory prostaglandin synthesis, some non­steroidal anti-inflammatory drugs (NSAIDs) may owe part of their effects to their ability to
(a) Inhibit leukocyte migration
(b) Inhibit leukotriene synthesis
(c) Stabilize lysosmal membranes
(d) All of the above
(e) None of the above

37. The termination of heparin activity by protamine sulfate is due to
(a) A chelating action
(b) The inhibition of gastrointestinal absorption of heparin
(c) The displacement of heparin­plasma protein binding
(d) An acid­base interaction
(e) The prothrombin­like activity of protamine

38. In gastrointestinal tract, serotonin causes
(a) Contraction of gastrointestinal muscles
(b) Decreased muscle tone
(c) Decreased peristalsis
(d) All of the above

39. A FDA – approved ingredient for protection against painful sensitivity of the teeth due to cold, heat, acids, sweets or contact is
(a) Dicalcium phosphate
(b) Sodium lauryl sulfate
(c) 5% potassium nitrate
(d) Zinc chloride
(e) Calcium carbonate

40. Which local anesthetic should be used to treat symptoms of pain, itching, burning, and disconfort in patients with an established lidocaine allergy?
(a) Tetracaine
(b) Dibucaine
(c) Pramoxine
(d) Benzocaine

41. What is the most commom sign/symptom of hemorrhoids?
(a) Bleeding
(b) Pain
(c) Seepage
(d) Pruritus

42. Which of the following agents is designated as a safe and effective analgesic, anesthetic and antipruritic by the Food and Drug Administration?
(a) Witch hazel
(b) Juniper tar
(c) Hydrocortisone
(d) Phenylephrine

43. A 65­year­old is interested in taking ginkgo. Which of the following statements is correct regarding ginkgo?
(a) Ginkgo is contraindicated in diabetes and pregnancy
(b) There is a drug­herb interaction between ginkgo and aspirin
(c) Toxic effects include hypertension and cardiac arrest
(d) There is a drug­herb interaction between ginkgo and phenelzine
(e) Ginkgo is contraindicated in patients with gallstone pain

44. All of the following medications should not be used routinely in pregnant patients during the third trimester except
(a) Acetaminophen
(b) Nonsteroidal anti­inflammatory drugs
(c) Warfarin
(d) Lithium
(e) Aspirin

45. Which of the following statements best describes the usual course of rheumatoid arthritis?
(a) It is an acute exacerbation of joint pain treated with short­term anti­inflammatory therapy
(b) It is a chronic disease characterized by acute changes within nonsynovial joints
(c) It is an acute disease that is characterized by rapid synovial changes due to inflammation
(d) It is a chronic disease characterized by acuteexacerbations followed by remissions with consequences associated with chronic inflammatory changes
(e) It is a joint disease characterized by a marked loss of calcium from the bones and a resultant thinning of the bones

48. In the treatment of chronic inflammatory diseases, the most important limitation of aspirin is
(a) Acid – base and electrolytc disturbances
(b) Hypersensitivity and idiosyncratic reactions
(c) Gastric mucosal damage
(d) Salicylism

47. Generally the earliest manifestation of salicylism is
(a) Visual disturbance
(b) Excitement
(c) Hyperventillation
(d) Tinnitus

48. All of the following statements concerning an acute gouty arthritis attack are correct except
(a) The diagonosis of gout is assured by a good therapeutic response to colchicines because no other form of arthritis responds to this drug
(b) To be assured of the diagnosis, monosodium urate crystals must be identified in the synovial fluid of the affected joint
(c) Attacks frequently occur in the middle of the night
(d) An untreated attack may last up to 2 weeks
(e) The first attack usually involves only one joint, most frequently the big toe (first metatarsophalangeal joint)

49. TNF­ais an example of eicosanoids

(a) Interleukins
(b) Cytotoxic factors
(c) Interferons
(d) Colony stimulating factors

50. Potential adverse effects associated with aspirin include all of the following except
(a) Gastrointestinal ulceration
(b) Renal dysfunction
(c) Enhanced methotrexate toxicity
(d) Cardiac arrhythmias
(e) Hypersensitivity asthma

51. All of the following facts are true about non­steroidal anti­inflammatory drugs (NSAIDs) except
(a) They are antipyretic
(b) There is a celling effect to their analgesia
(c) They can cause tolerance
(d) They do not cause dependence
(e) They are anti­inflammatory

52. Which of the following narcotics has the longest duration of effect?
(a) Methadone
(b) Controlled­release morphine
(c) Levorphanol
(d) Transdermal fentanyl
(e) Dihydromorphone

53. Cylcoocygenase­II specific inhibitors block the following
(a) Production of cytoprotective prostaglandins
(b) Tumor necrosis factor ­ a
(c) Production of prostaglandins responsible for pain and inflammation

54. The emetic action of morphine is due to
(a) Irritation of gastrointestinal tract
(b) Stimulation of cerebral cortex
(c) Stimulation of medullary vomiting center
(d) Stimulation of emetic chemoreceptor trigger zone
(e) None of the above

55. Colchicine is used mainly to treat
(a) Gout
(b) Arthiritis
(c) Diabetes
(d) Carcinomas
(e) High blood pressure

56. Which type of patient is most likely to hypersensitive to aspirin?
(a) Intrinsic asthamatic
(b) Extrinsic asthamatic
(c) Chronic bronchitic
(d) Patient with viral injection
(e) Both (c) and (d)

57. Codeine acts as a cough sedative by
(a) Producing mild nausea
(b) Depressing bronchiolar secretions
(c) Depressing pulmonary action
(d) Depressing cough center
(e) Paralyzing sensory nerves of bronchi

58. The greatest threat from morphine poisoning is
(a) Renal shutdown
(b) Paralysis of spinal cord
(c) Respiratory depression
(d) Cardiovascular collapse
(e) None of the above

59. A very common side effect of morphine is
(a) Allergic response
(b) Blood dyscrasias
(c) Constipation
(d) Liver damage
(e) Visceral pain

60. Eicosanoids are a group of _____ carbon unsaturated fatty acids
(a) 20
(b) 10
(c) 25
(d) 35

61. Which of the following durgs is a monamine oxidase inhibitor, but is used to treat hypertension?
(a) Tranylcypromine (Parnate)
(b) Reserpine
(c) Propranolol (Inderal)
(d) Pargyline (Eutonyl)
(e) Imipramine (Tofranil)

62. Autacoids differ from hormones in that
(a) Autacoids are involved only in the causation of pathological states
(b) Autacoids do not have a specific cell/ tissue of origin
(c) Autacoids generally act locally at the site of generation and release
(d) Both (b) and (c)

63. Which of the following eicosanoids is generated through the lipozygenase pathway ?
(a) Prostaglandin E2
(b) Thromboxane A2
(c) Prostacyclin
(d) Leukotriene C4

64. The cyclooxygenase isoenzymes COX­1 and COX­2 differ from each other in that
(a) They catalyse different pathways in prostanoid biosynthesis
(b) COX–1 is inhibited by aspirin but not COX–2
(c) COX–2 is inhibited by ibuprofen but not COX–1
(d) COX–1 is constitutive while COX–2 is inducible

65. Which of the following is an irreversible inhibitor of cyclooxygenase ?
(a) Aspirin
(b) Phenylbutazone
(c) Indomethacin
(d) Piroxicam

66. The prostanoid that consistently constricts blood vessels is
(a) Prostaglandin E2
(b) Prostaglandin F2a
(c) Thromboxane A2
(d) Prostacyclin

67. The following prostanoid is a potent inducer of platelet aggregation
(a) Prostacyclin
(b) Prostaglandin E2
(c) Prostaglandin D2
(d) Thromboxane A2

68. Aspirin in low doses produces longlasting inhibition
(a) Platelets contain low quantity of COX
(b) Platelets cannot synthesize fresh COX molecules

(c) Platelets bind aspirin with high affinity
(d) Platelet COX is inducible

69. The early pregnancy uterus is sensitive to the following oxytocic
(a) Oxytocin
(b) Methylergometrine
(c) Prostaglandin F2a
(d) Both (a) and (b)

70. Cervical priming with prostaglandin results in
(a) Facilitation of sperm movement through cervical canal
(b) Increased cervical tone
(c) Softening of cervix
(d) Increased cervical secretions

71. Corticosteroids exert anti­inflammatory action by inhibiting the following enzyme
(a) Cycloxygenase
(b) Lipozygenase
(c) Phospholipase ­ A
(d) Phosphodiesterase

72. Main effect of sulphinpyrazone in hyperuricaemia is
(a) Suppress the symptoms
(b) Promote the elimination of urate
(c) prevent urate synthesis
(d) All of the above

73. Which of the following glucocorticoids has significant mineralocorticoid activity also ?
(a) Hydrocortisone
(b) Triamcinolone
(c) Dexamethasone
(d) Betamethasone

74. Corticosteroid therapy is practically mandatory in the following condition.
(a) Septic shock
(b) Renal transplant
(c) Rheumatoid arthritis
(d) Ulcerative colitis

75. For limiting cerebral edema due to brain tumour, the preferred corticosteroids are
betamenthasone/dexamethasone because
(a) They do not cause Na+ and water retention
(b) They are more potent
(c) They can be administered intravenously
(d) They inhibit brain tumours

76. Systemic corticosteroid therapy is not used routinely and is reserved only for severe cases of
(a) Exfoliative dermatitis
(b) Posterior uveitis
(c) Acute rheumatic fever
(d) Hodgkin’s disease

77. The following adverse effect of corticosteroids is due to their mineralocorticoid action
(a) Osteoporosis
(b) Rise in blood pressure
(c) Moon face
(d) Increased susceptibility to infection

78. Which of the following bones is affected more by glucocorticoid induced osteoporosis?
(a) Femur
(b) Humerus
(c) Radius
(d) Lumber vertebra

79. Morphine produces analgesia by acting at
(a) Peripheral pain receptors
(b) A spinal site
(c) Suspraspinal sites
(d) Both (b) and (c)

80. In man sedation caused by morphine is characterized by
(a) Initial excitement
(b) Little or no motor incoordination
(c) Rise in seizure threshold
(d) All of the above

81. Instead of depressing, morphine stimulates
(a) Vasomotor centre
(b) Edinger westphal nucleus
(c) Temperature regulating centre
(d) Cough centre

82. In a comatose patient suspected of poisoning, which of the following findings would be against the drug
being morphine
(a) Selegiline
(b) Chlorgiline
(c) Moclobemide
(d) Tranylcypromine

83. Instead of being effective in hyperuricaemia following drug is contradictred in the treatment of gout
(a) Indomethacin
(b) Diclofenac
(c) Piroxicam
(d) Aspirin

84. Morphine dependence is characterized by
(a) Marked drug seeking behavior
(b) Physical dependence without psychic dependence
(c) Physical as well as psychic dependence
(d) Both (a) and (c)

85. Morphine is contraindicated in head injury because
(a) It does not relieve the pain of head injury
(b) It can raise intracranial tension
(c) It can cause constipation
(d) It is liable to cause addiction

86. Which of the following opioids is more potent than morphine ?
(a) Pethidine
(b) Fentanyl
(c) Dextropropoxyphene
(d) Tramadol

87. Which of the following opioid analgesics is similar to codeine in pharmacological profile but is less constipating ?
(a) Methadone
(b) Buprenorphine
(c) Butorphanol
(d) Dextropropoxyphene

88. Select the analgesic which acts through opioids as well as additional spinal monoaminergic mechanisms.
(a) Tramadol
(b) Ethoheptazine
(c) Dextropropoxyphene
(d) Alfentanil

89. An opioid analgesic is preferred over aspirin like analgesic in the following condition.
(a) Acute gout
(b) Burn
(c) Toothache
(d) Neuralgia

90. Morphine has high affinity for the following opioid receptor(s).
(a) µ (Mu)
(b) k (Kappa)
(c) d (Delta)
(d) All of these

91. Which of the following is an agonistantagonist type of opioid analgesic
(a) Pethidine
(b) Pentazocine
(c) Fentanyl
(d) Buprenorphine

92. Pentazocine differs from morphine in that
(a) It is inactive by the oral route
(b) It does not produce physical dependence
(c) It has a lower ceiling of analgesic effect
(d) Its action is not blocked by naloxone

93. Which action of morphine is incompletely reversed by naloxone ?
(a) Analgesia
(b) Respiratory depression
(c) Sedation
(d) Miosis

94. Lower dose of naloxone is required to
(a) Antagonise the actions of nalorphine
(b) Antagonise the actions of pentazocine
(c) Precipitate withdrawal in mildly morphine dependent subjects
(d) Precipitate withdrawal in highly morphine dependent subjects

95. Following mediators are involved in acute inflammation except
(a) Histamine
(b) Leukotrienes
(c) Interferons
(d) Bradykinin

96. The distinctive feature of the isoenzyme cyclooxygenase­2 is
(a) It is not inhibited by indomethacin
(b) It is inducible
(c) It generates cytoprotective prostagladins in gastric mucosa
(d) It is found only in foetal tissues

97. Aspirin produces analgesia by
(a) Preventing sensitization of peripheral pain receptors
(b) Affecting gating of pain impulses at spinal level
(c) Raising pain threshold at subcortical level
(d) Both (a) and (b)

98. Aspirin reduces fever by
(a) Decreasing heat production in the body
(b) Enhancing cutaneous blood flow
(c) Inducing sweating
(d) Both (b) and (c)

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