QUESTION 1. CYCLOOXYGENASE (COX-1, COX-2)
Cyclooxygenase, an enzyme important for prostaglandin formation,
abbreviated COX, has a form that we colloquially refer to as good COX and
bad COX. Which cyclooxygenase is the “bad COX?”
a) COX-1
b) COX-2
c) COX-3
d) COX-4
Answer B. Inhibiting or blocking COX-1, the good COX, can result in bad
things: gastric erosion and ulcers, kidney impairment and bleeding.
Suppresssing COX-2, the bad COX, can result in good things like
suppressing inflammation, reducing pain and fever, and protecting against
colon cancer.
,QUESTION 2. RESULTS OF BLOCKING COX-2
Drugs like ibuprofen, naproxen, and meloxicam affect cyclooxygenase.
When we have inhibition of cyclooxygenase-2 (COX-2) we might expect
all of the following except:
a) Analgesia and antipyresis b) Colorectal cancer protection c) Gastric
ulcers d) Suppressed inflammation
C, Gastric ulcers. A gastric ulcer would likely result from blocking the good
COX, COX-1. However, if we block COX-2, the bad COX, we get analgesia
(pain reduction), antipyresis (fever reduction), colorectal cancer protection,
and suppressed inflammation.
QUESTION 3: IBUPROFEN VS ACETAMINOPHEN
Often patients ask the difference between ibuprofen and acetaminophen.
Acetaminophen and ibuprofen share all of the following therapeutic effects
except:
a) Analgesia b)
b) Antiinflammatory
c) c) Antipyresis d)
d) Pain relief
B, anti-inflammatory. While acetaminophen and ibuprofen can provide pain
,relief (analgesia) and fever reduction (antipyresis), only ibuprofen can
provide anti-inflammatory effects. So we have two basic branches, the drug
that can’t affect inflammation and the one that can.
QUESTION 4. THE CELECOXIB ADVANTAGE
4) What was thought of as a breakthrough was a selective cyclooxygenase
inhibitor that might reduce GI distress from NSAID use. An arthritic patient
with a history of GI distress and bleed might be a candidate for:
a) Celecoxib
b) Ibuprofen
c) Naproxen
) Meloxicam
A, celecoxib. Celecoxib was meant to protect against GI distress, but
cardiac issues came up as patients took it reducing its utilization. Ibuprofen,
naproxen, and meloxicam would likely eventually cause GI distress.
, QUESTION 5. THE DAILY ASPIRIN ISSUE
In pharmacology, the best practice in using a medication can change even
with the most common medicines. What concern about daily aspirin led to a
change in the way prescribers look at it for protecting against cardiac
events?
a) Bleed risk that can outweigh protective benefit
b) No longer suppresses platelet aggregation
c) No longer protects against MI
d) No longer protects against stroke
A, Bleed risk that can outweigh protective benefit. While aspirin still
suppresses platelet aggregation and can work to prevent MI and stroke in
patients, the bleed risk is a concern. The new guidelines don’t apply to those
who had a stroke/heart attack, underwent bypass surgery or had a stend
procedure. These new guidelines apply to otherwise healthy adults and elderly
with a high internal bleed risk.
Cyclooxygenase, an enzyme important for prostaglandin formation,
abbreviated COX, has a form that we colloquially refer to as good COX and
bad COX. Which cyclooxygenase is the “bad COX?”
a) COX-1
b) COX-2
c) COX-3
d) COX-4
Answer B. Inhibiting or blocking COX-1, the good COX, can result in bad
things: gastric erosion and ulcers, kidney impairment and bleeding.
Suppresssing COX-2, the bad COX, can result in good things like
suppressing inflammation, reducing pain and fever, and protecting against
colon cancer.
,QUESTION 2. RESULTS OF BLOCKING COX-2
Drugs like ibuprofen, naproxen, and meloxicam affect cyclooxygenase.
When we have inhibition of cyclooxygenase-2 (COX-2) we might expect
all of the following except:
a) Analgesia and antipyresis b) Colorectal cancer protection c) Gastric
ulcers d) Suppressed inflammation
C, Gastric ulcers. A gastric ulcer would likely result from blocking the good
COX, COX-1. However, if we block COX-2, the bad COX, we get analgesia
(pain reduction), antipyresis (fever reduction), colorectal cancer protection,
and suppressed inflammation.
QUESTION 3: IBUPROFEN VS ACETAMINOPHEN
Often patients ask the difference between ibuprofen and acetaminophen.
Acetaminophen and ibuprofen share all of the following therapeutic effects
except:
a) Analgesia b)
b) Antiinflammatory
c) c) Antipyresis d)
d) Pain relief
B, anti-inflammatory. While acetaminophen and ibuprofen can provide pain
,relief (analgesia) and fever reduction (antipyresis), only ibuprofen can
provide anti-inflammatory effects. So we have two basic branches, the drug
that can’t affect inflammation and the one that can.
QUESTION 4. THE CELECOXIB ADVANTAGE
4) What was thought of as a breakthrough was a selective cyclooxygenase
inhibitor that might reduce GI distress from NSAID use. An arthritic patient
with a history of GI distress and bleed might be a candidate for:
a) Celecoxib
b) Ibuprofen
c) Naproxen
) Meloxicam
A, celecoxib. Celecoxib was meant to protect against GI distress, but
cardiac issues came up as patients took it reducing its utilization. Ibuprofen,
naproxen, and meloxicam would likely eventually cause GI distress.
, QUESTION 5. THE DAILY ASPIRIN ISSUE
In pharmacology, the best practice in using a medication can change even
with the most common medicines. What concern about daily aspirin led to a
change in the way prescribers look at it for protecting against cardiac
events?
a) Bleed risk that can outweigh protective benefit
b) No longer suppresses platelet aggregation
c) No longer protects against MI
d) No longer protects against stroke
A, Bleed risk that can outweigh protective benefit. While aspirin still
suppresses platelet aggregation and can work to prevent MI and stroke in
patients, the bleed risk is a concern. The new guidelines don’t apply to those
who had a stroke/heart attack, underwent bypass surgery or had a stend
procedure. These new guidelines apply to otherwise healthy adults and elderly
with a high internal bleed risk.
