Post 3 Inflam

When comparing antihistamines such as the classic diphenhydramine (BENADRYL) to the more recently marketed fexofenadine (ALLEGRA), you would say that fexofenadine is:

A. Less expensive
B. Available by more routes of administration (oral, intravenous, topical)
C. More likely to cause sedation
D. Less likely to cause dry mouth



Atheletes have been known to abuse steroids for body building purposes. The mechanism behind this is:

A. Glucocorticoids cause protein synthesis in exercising muscles.
B. Glucocorticoids inhibit insulin from carrying glucose into muscle cells.
C. Glucocorticoids stimulate the uptake of proteins from the GI tract.
D. Glucocorticoids are not the type of steroids abused by athletes.



When ASPIRIN is used to reduce fever in an adult, the usual dose is:

A. 80-325 mg each day
B. 80 mg as needed
C. 650 mg as neeeded
D. 4 grams as neeeded



In rheumatoid arthritis, valdecoxib (BEXTRA) may be preferred over a traditional NSAID such as naproxen (ALEVE), because:

A. COX-2 inhibitors are associated with a high rate of GI bleeding
B. Once-a-day dosing is possible.
C. It is less expensive.
D. It works in both women and men.



A transplant patient receiving immunosupression with drugs such as corticosteroids with tacrolimus, mycophenolate or cyclosporine is at greatest risk for which adverse effect?

A. Sedation
B. Infection
C. Blood clots
D. Hypotension

General Feedback: Suppressing the immune system decreases the chance of rejecting the transplanted organ but also suppresses the ability to fight off infection.


Loratadine (CLARITIN) is an antihistamine useful in treating:

A. arthritis
B. ulcers
C. runny nose associated with allergies
D. headache associated with migraines



In the treatment of allergic rhinitis, nasal sprays of fluticasone are preferred over oral pills of prednisone because:

A. the cost is significantly lower
B. absorption is better
C. risk of addiction is lower
D. there are fewer side effects

General Feedback: Steroids have significant side effects and should be given locally, not systemically when possible.


Naproxen (ALEVE) works by:

A. Stimulating the release of leukotrines from white blood cells.
B. Blocking the enzyme lipo-oxygenase.
C. Inhibiting prostaglandin synthesis.
D. All of the above




If a patient had a tumor that was secreting adrenocorticotropin (ACTH), what would happen if dexamethasone was given for several days?

A. The tumor would increase secretion of ACTH.
B. Blood levels of the body's natural glucocorticoid, (cortisol) would remain high.
C. Blood levels of the body's natural glucocorticoid, (cortisol) would drop.
D. The tumor would decrease secretion of ACTH.

General Feedback: When the body's only supply of ACTH is from the pituitary, giving a glucocorticosteroid like dexamethasone, creates a negative feedback loop so the pituitary puts out less ACTH and thus less cortisol is released from the adrenal gland. ACTH secreting tumors are not responsive to this negative feedback loop and keep secreting ACTH, thus keeping cortisol levels up.



When glucocorticoid drugs have been given systemically in high dose for several weeks or more:

A. The patient will probably have liver failure which will not resolve on discontinuation of the drug.
B. The patient will probably have liver failure which will resolve on discontinuation of the drug.
C. The patient will have a life-time dependency on the drugs.
D. The dose should be tapered off slowly when the patient no longer needs the steroid.




Newer generation antihistamines, such as fexofenadine (ALLEGRA), are less likely to enter __________ tissue than the older drugs such as the classic diphenhydramine (BENADRYL).

A. liver
B. renal
C. brain
D. fat




When systemic steroids are given for replacement (as in Addison's disease), doses are generally _____________ than when they are given for inflammation (such as in an acute asthma attack).

A. larger and given for a longer period of time
B. larger and given for a shorter period of time
C. smaller and given for a longer period of time
D. smaller and given for a shorter period of time




Mr. Kim has had a kidney transplant and has been taking cyclosporin. His serum creatinine is going up. What is the best explanation of this?

A. He is having an allergic reaction to the drug.
B. He is having a very common adverse reaction to the drug.
C. He is rejecting his transplanted kidney.
D. Adverse drug reaction and transplant rejection must both be considered.




A patient is to recieve ketorolac (TORADOL) for 3 days after surgery. This drug will act to:

A. Stimulate the release of leukotrines from white blood cells.
B. Block the enzyme lipo-oxygenase.
C. Inhibit prostaglandin synthesis.
D. All of the above




Glucocorticoid preparations are available by which routes?

A. Oral and intraveneous only
B. Topical and oral only
C. direct injection into a joint or lesion and inhaled only
D. all of the above routes are available



Additional Questions courtesy of Vanessa Kelly and Lily Sok, Thanks!!! (added 12/2)




Indications for H1 blockers include all of the following EXCEPT:

A. Asthma
B. Nasal allergies
C. Itching
D. Motion sickness



Let's assume a patient's only supply of adrenocorticotropin (ACTH) is from the pituitary. In other words, they do not have and ACTH-secreting tumor. What would happen if dexamethasone was given for several days?

A. Blood levels of the body's natural glucocorticoid, (cortisol) would remain high.
B. The pituitary would be stimulated to secrete more ACTH.
C. The adrenal gland would be stimulated to secrete ACTH.
D. Blood levels of the body's natural glucocorticoid, (cortisol) would drop.



A patient with frequent bruising and fat deposits on the cheeks and shoulders, is being evaluated for Cushing's Syndrome. Dexamethasone is given for several days. What would be tested next?

1. Urine and or cortisol levels.
2. Fasting blood sugar.
3. Hemoglobin A1C
4. Platelets and cholesterol.