Pharmacology Study Set 3
Quiz 20 :
Nonnarcotic Analgesics Anti-Inflammatory, and Antigout Drugs
Non-opioid analgesics differe from opioid analgesics in many ways one of such ways is that these analgesics are not related to morphine either structurally or chemically. Secondly these analgesics are not effective in treating sever or visceral pain. Also these analgesics produce analgesia through both central nervous system as well as peripheral nervous system. The fourth difference is that these analgesics do not produce tolerance or dependency with chronic use. The salicyclates, such as aspirin and salicylic acid are non opioid analgesics that also produce antipyretic and antyinflammation effects. In early times salicyclates were obtained naturally from willow tree bark and were used to treat headache and toothache. Most of the salicyclates are administrated orally and easily absorbed by gastrointestinal system but methyl salicyclate is admintrated topically as it is poisonous when taken orally.
Many NSAIDs are generally available as over the counter drug and does not have serious adverse effect unless taken in large doses for long time. a. Large doses of salicylates drugs are more frequently associated toxic reaction that can harm body in many ways. Over dose of salicylates can depress the medullary respiratory centers so that patient can not remove carbon dioxide from their lungs quickly which leads to respiratory acidosis. Renal function is disturbed due to accumulation of acid in the body. Due to respiratory and metabolic acidosis pH level of urine and blood reduces. Excessive sweating can cause dehydration and loss of sodium, potassium and protein can increase from urine. Vasodilation and hypotension can be caused by depression in cardiovascular function. Hence it can be considered that patient is suffering from salicylate overdose. b. In some cases patient due to gastrointestinal irritation and CNS stimulation by acetaminophen can cause vomiting. The chronic use of large doses of acetaminophen can cause development of toxicity. Also it is not given to children in higher doses because of reported liver failure incidents in children. FDA has put a compulsion to write warning about risk of developing liver injury. So the patient may have toxicity related to acetaminophen overdose.
Ibuprofen is a drug under the category of non-steroidal anti-inflamatory drug (NSAID). Ibuprofen is used treat pain, fever, or inflammatory condition such as headache, pain in menstrual periods, back pain, any type of injuary, pain and inflammation in the case of rheumatoid artritis etc. These NSAIDS act through by inhibiting the cycloxygenase (COX) enzymes. COX convert arachidonic acid to prostaglandins. This prostaglandin H2 (PGH2) is again converted by other enzymes to several other prostaglandins and to thromboxane A2. Prostaglandins are pain mediators, fever inducer and inflammatory mediator. And thromboxane stimulates platelets aggregation for blood clotting. By blocking this key enzyme in the pathway of inflammation, the Ibuprofen prevents fever, inflammation, and pain. So, Ibuprofen is used as a universally accepted as Non-Steroidal Anti-Inflammatory Drug (NSAID). Febuxostat is drug used for lowering uric acid levels in the body. The drug is prescribed to prevent the Gout. It is a xanthine oxidase inhibitor in the purine metabolic pathway. Xanthine oxidase oxidize hypoxanthine to xanthine and xanthine to uric acid. By inhibiting xanthine oxidase, it reduces the production of uric acid in the body. So, option A is incorrect. Allopurinol is also a xanthine oxidase inhibitor. This is used to treat in the preventive measures of gout. Allopurinol lower the production of uric acid production there by used in the case of Gout and case of uric acid-based kidney stones treatment. So, option B is incorrect. Probenecid is a drug used in the treatment of gout. The drug helps the kidney to eliminate the elevated uric acid through urine, in the case of gout. Probenecid inhibit kidney's Organic Anion Transporter (OAT), which prevent the uric acid to returns to plasma from urine. OAT binds to probenecid instead of uric acid in the urine, thereby uric acid is excreted through urine instead of reabsorption to the plasma. So option D is incorrect. Pamabrom is diuretic drug which induce urination there by elimination of over water from the body. Pambrom is chemically bromotheophylline and aminoisobutanol. The drug is used to treat puffiness, blotting, and other water weight gain associated with menstrual cycle. So, option E is incorrect. So, among the options the correct answer is option - Ibuprofen, which is pharmacologically considered as an anti-inflammatory drug.