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Chapter 22: Analgesic Drugs Multiple Choice Questions 1. Which of the following is NOT one of the three therapeutic effects associated with the category of salicylate drugs? a. analgesic b. anticoagulant c. anti-inflammatory d. antipyretic Answer: b. anticoagulant Correct Feedback: Salicylate analgesic drugs have three distinct therapeutic effects: 1. analgesic to provide relief from mild-to-moderate pain by inhibiting the release of prostaglandins from damaged tissue; 2. anti-inflammatory to decrease inflammation, also by inhibiting the release of prostaglandins from damaged tissue; and 3. antipyretic to reduce fever by acting on the hypothalamus to cause vasodilation and sweating, which increases heat loss from the skin and lowers an elevated body temperature. a. analgesic Incorrect Feedback: This is one of the three therapeutic effects of salicylate analgesic drugs. c. anti-inflammatory Incorrect Feedback: This is one of the three therapeutic effects of salicylate analgesic drugs. d. antipyretic Incorrect Feedback: This is one of the three therapeutic effects of salicylate analgesic drugs. 2. The two distinct therapeutic effects of acetaminophen are ______. a. analgesic and anti-inflammatory b. analgesic and antipyretic c. anti-inflammatory and anticoagulant d. antipyretic and anti-inflammatory Answer: b. analgesic and antipyretic Correct Feedback: Acetaminophen has two distinct therapeutic actions: analgesic, although the mechanism by acetaminophen relieves pain is unclear; and antipyretic, reducing fever by acting on the hypothalamus to cause vasodilation and sweating. a. analgesic and anti-inflammatory Incorrect Feedback: Acetaminophen has no an anti-inflammatory effect. c. anti-inflammatory and anticoagulant Incorrect Feedback: Acetaminophen has neither an anti-inflammatory nor an anticoagulant therapeutic effect. d. antipyretic and anti-inflammatory Incorrect Feedback: Acetaminophen has no anti-inflammatory therapeutic effect. 3. NSAID drugs have ________. a. a greater tendency than salicylate drugs to cause stomach irritation and ulcers Incorrect Feedback: This is not correct. b. less of a tendency than salicylate drugs to cause stomach irritation and ulcers Correct Feedback: Nonsteroidal anti-inflammatory drugs (NSAIDs) have less of a tendency than salicylate drugs to cause stomach irritation and ulcers. c. the same tendency as salicylate drugs to cause stomach irritation and ulcers Incorrect Feedback: This is not correct. d. No tendency to cause stomach irritation and ulcers Incorrect Feedback: This is not correct. Answer: b. less of a tendency than salicylate drugs to cause stomach irritation and ulcers Correct Feedback: a. a greater tendency than salicylate drugs to cause stomach irritation and ulcers Incorrect Feedback: This is not correct. c. the same tendency as salicylate drugs to cause stomach irritation and ulcers Incorrect Feedback: This is not correct. d. No tendency to cause stomach irritation and ulcers Incorrect Feedback: This is not correct. 4. In preventing or treating migraine headaches, ergotamine drugs stimulate all of the following receptors EXCEPT _____. a. dopamine b. epinephrine c. norepinephrine d. serotonin Answer: b. epinephrine Correct Feedback: Ergotamine drugs stimulate serotonin receptors, but also act on receptors for norepinephrine and dopamine. Ergotamine drugs are used to prevent or treat migraine headaches. a. dopamine Incorrect Feedback: Ergotamine drugs do stimulate dopamine receptors. c. norepinephrine Incorrect Feedback: Ergotamine drugs do stimulate norepinephrine receptors. d. serotonin Incorrect Feedback: Ergotamine drugs do stimulate serotonin receptors. 5. NSAIDs have an analgesic effect because they inhibit the production of _____. a. dopamine b. epinephrine c. prostaglandins d. serotonin Answer: c. prostaglandins Correct Feedback: Nonsteroidal anti-inflammatory drugs (NSAIDs) have an analgesic effect because they inhibit the production of prostaglandins. a. dopamine Incorrect Feedback: NSAIDs do not inhibit dopamine. b. epinephrine Incorrect Feedback: NSAIDS do not inhibit epinephrine. d. serotonin Incorrect Feedback: NSAIDs do not inhibit serotonin. 6. Ergotamine drugs ________. a. are used to prevent and treat migraine headaches b. constrict the arteries in the brain c. are derived from a fungus d. all of the above Answer: d. all of the above Correct Feedback: Ergotamine drugs constrict the arteries in the brain without significantly reducing blood flow. Ergotamine drugs are used to prevent or treat migraine headaches. Ergotamine is derived from ergot, a fungus that affects rye and other grasses. a. are used to prevent and treat migraine headaches Incorrect Feedback: This is true, but it is not the only correct answer. b. constrict the arteries in the brain Incorrect Feedback: This is true, but it is not the only correct answer. c. are derived from a fungus Incorrect Feedback: This is true, but it is not the only correct answer. 7. Nonnarcotic drugs are only effective for ________. a. mild pain b. mild-to-moderate pain c. moderately severe pain d. severe pain Answer: b. mild-to-moderate pain Correct Feedback: Nonnarcotic analgesic drugs are only effective for mild-tomoderate pain. a. mild pain Incorrect Feedback: This is not correct. c. moderately severe pain Incorrect Feedback: This is not correct. d. severe pain Incorrect Feedback: This is not correct. 8. Acetaminophen is categorized as a _________. a. narcotic drug b. nonsalicylate drug c. NSAID d. salicylate drug Answer: b. nonsalicylate drug Correct Feedback: Nonsalicylate analgesic drugs include acetaminophen and other drugs that have a different therapeutic effect from that of acetaminophen. a. narcotic drug Incorrect Feedback: Acetaminophen is not a narcotic drug. c. NSAID Incorrect Feedback: Acetaminophen is not an NSAID. d. salicylate drug Incorrect Feedback: Acetaminophen is not a salicylate drug. 9. Prior to the occurrence of a migraine headache _______. a. there are decreased levels of serotonin, then the levels suddenly increase causing rebound dilation of the arteries in the brain and throbbing pain b. there are decreased levels of serotonin, then the levels suddenly decrease causing rebound dilation of the arteries in the brain and throbbing pain c. there are elevated levels of serotonin, then the levels suddenly decrease causing rebound dilation of the arteries in the brain and throbbing pain d. there are elevated levels of serotonin, then the levels suddenly increase causing rebound dilation of the arteries in the brain and throbbing pain Answer: c. there are elevated levels of serotonin, then the levels suddenly decrease causing rebound dilation of the arteries in the brain and throbbing pain Correct Feedback: Prior to the occurrence of a migraine, there are elevated levels of serotonin. The serotonin levels then suddenly decrease, and this causes rebound dilation of the arteries in the brain and throbbing pain. a. there are decreased levels of serotonin, then the levels suddenly increase causing rebound dilation of the arteries in the brain and throbbing pain Incorrect Feedback: This is not correct. b. there are decreased levels of serotonin, then the levels suddenly decrease causing rebound dilation of the arteries in the brain and throbbing pain Incorrect Feedback: This is not correct. d. there are elevated levels of serotonin, then the levels suddenly increase causing rebound dilation of the arteries in the brain and throbbing pain Incorrect Feedback: This is not correct. 10. Which of the following is NOT an advantage for using nonnarcotic analgesic drugs as the first step in pain control? a. These drugs are available over-the-counter and can be purchased without a prescription. b. These drugs can control severe pain. c. These drugs are inexpensive. d. These drugs are nonaddicting. Answer: b. These drugs can control severe pain. Correct Feedback: Nonnarcotic analgesic drugs are the first step in pain control, and their advantages are that they are nonaddicting, inexpensive, and many of them are over-the-counter drugs that can be purchased without a prescription. a. These drugs are available over-the-counter and can be purchased without a prescription. Incorrect Feedback: This is one of the advantages. c. These drugs are inexpensive. Incorrect Feedback: This is one of the advantages. d. These drugs are nonaddicting. Incorrect Feedback: This is one of the advantages. 11. The mechanism by which acetaminophen relieves pain is _______. a. by blocking dopamine receptors b. by inhibiting prostaglandins c. by metabolizing neurotransmitters at the synapse d. unclear Answer: d. unclear Correct Feedback: The mechanism by which acetaminophen relieves pain is unclear. a. by blocking dopamine receptors Incorrect Feedback: Acetaminophen does not block dopamine receptors. b. by inhibiting prostaglandins Incorrect Feedback: Acetaminophen does not inhibit prostaglandins. c. by metabolizing neurotransmitters at the synapse Incorrect Feedback: Acetaminophen does not metabolize neurotransmitters. 12. Which of the following combination nonnarcotic analgesic drugs does NOT contain an antacid? a. Alka-Seltzer with Aspirin Incorrect Feedback: Alka-Seltzer with Aspirin contains aspirin and the antacid sodium bicarbonate. b. Ascriptin Incorrect Feedback: Ascriptin contains aspirin and the antacids aluminum, calcium, and magnesium. c. Bufferin Incorrect Feedback: Bufferin contains aspirin and the antacids calcium and magnesium. d. Tylenol w/Codeine No. 3 Answer: d. Tylenol w/Codeine No. 3 Correct Feedback: Tylenol w/ Codeine No. 3 (acetaminophen, codeine) does not contain an antacid drug. a. Alka-Seltzer with Aspirin Incorrect Feedback: Alka-Seltzer with Aspirin contains aspirin and the antacid sodium bicarbonate. b. Ascriptin Incorrect Feedback: Ascriptin contains aspirin and the antacids aluminum, calcium, and magnesium. c. Bufferin Incorrect Feedback: Bufferin contains aspirin and the antacids calcium and magnesium. 13. The ideal analgesic drug would _______. a. cause no dependence or addiction b. provide maximum pain relief c. produce no side effects d. all of the above Answer: d. all of the above Correct Feedback: The ideal analgesic drug would: 1. provide maximum pain relief, 2. produce no side effects, and 3. cause no dependence or addiction. a. cause no dependence or addiction Incorrect Feedback: This is true, but it is not the only correct answer. b. provide maximum pain relief Incorrect Feedback: This is true, but it is not the only correct answer. c. produce no side effects Incorrect Feedback: This is true, but it is not the only correct answer. 14. The existence of different types of opiate receptors accounts for _______. a. the different types of side effects of narcotic drugs b. the differing levels of pain that patients experience c. the difference in the potential for addiction of narcotic drugs d. a and c Answer: d. a and c Correct Feedback: The existence of different opiate receptors also accounts for the different types of side effects that are seen with narcotic drugs. There are several different types of opiate receptors, and this explains why some narcotic drugs have a stronger potential for addiction than other narcotic drugs. a. the different types of side effects of narcotic drugs Incorrect Feedback: This is true, but it is not the only correct answer. b. the differing levels of pain that patients experience Incorrect Feedback: The level of pain is not related to opiate receptors. c. the difference in the potential for addiction of narcotic drugs Incorrect Feedback: This is true, but it is not the only correct answer. 15. Which narcotic drug is often included with a nonnarcotic drug in combination analgesic drugs? a. cocaine b. morphine c. meperidine d. codeine Answer: d. codeine Correct Feedback: Combination analgesic drugs contain a salicylate analgesic drug (aspirin) and a narcotic analgesic drug (codeine, dihydrocodeine, hydrocodone, oxycodone, pentozocine). a. cocaine Incorrect Feedback: Cocaine is not used in combination analgesic drugs. b. morphine Incorrect Feedback: Morphine is not used in combination analgesic drugs. c. meperidine Incorrect Feedback: Meperidine is not used in combination analgesic drugs. 16. Ibuprofen belongs to what category of drugs? a. nonnarcotic analgesic drugs b. ergotamine drugs c. narcotic analgesic drugs d. nonsteroidal anti-inflammatory drugs Answer: d. nonsteroidal anti-inflammatory drugs Correct Feedback: Ibuprofen belongs to the analgesic drug category known as nonsteroidal anti-inflammatory drugs or NSAIDs. a. nonnarcotic analgesic drugs Incorrect Feedback: Ibuprofen is not a nonnarcotic analgesic drug. b. ergotamine drugs Incorrect Feedback: Ibuprofen is not an ergotamine drug. c. narcotic analgesic drugs Incorrect Feedback: Ibuprofen is not a narcotic analgesic drug. 17. ________ is a beta-blocker drug approved for preventing migraine headaches. a. atenolol (Tenormin) b. metoprolol (Lopressor, Toprol-XL) c. propranolol (Inderal) d. all of the above Answer: d. all of the above Correct Feedback: Beta-blocker drugs keep the arteries dilated to prevent the initial vasoconstriction that is the beginning of a migraine headache. These drugs are used to prevent migraine headaches and include atenolol (Tenormin), metoprolol (Lopressor, Toprol-XL), and propranolol (Inderal). a. atenolol (Tenormin) Incorrect Feedback: This is true, but it is not the only correct answer. b. metoprolol (Lopressor, Toprol-XL) Incorrect Feedback: This is true, but it is not the only correct answer. c. propranolol (Inderal) Incorrect Feedback: This is true, but it is not the only correct answer. 18. The origin of the word morphine comes from the Greek word ________. a. morphology, meaning the structure of the drug b. Morpheus, the Greek god of dreams c. amorphous, an adjective meaning without form d. none of the above Answer: b. Morpheus, the Greek god of dreams Correct Feedback: Because it could cause unconsciousness, morphine was named for Morpheus (the Greek god of dreams, who was the son of Hypnos, the Greek god of sleep). a. morphology, meaning the structure of the drug Incorrect Feedback: This is not the origin of the word morphine. c. amorphous, an adjective meaning without form Incorrect Feedback: This is not the origin of the word morphine. d. none of the above Incorrect Feedback: One of the answers is correct. 19. The word salicylate refers to ________ drugs, which were originally derived from the bark of the willow (the Latin word salix means willow). a. aspirin b. narcotic c. analgesic d. nonnarcotic Answer: a. aspirin Correct Feedback: The drug aspirin is also known by its chemical name and abbreviation acetylsalicylic acid (ASA), which was derived from salix, a Latin word that means willow. b. narcotic Incorrect Feedback: Narcotic drugs were not derived from the willow. c. analgesic Incorrect Feedback: Not all analgesic drugs were derived from the willow. d. nonnarcotic Incorrect Feedback: Not all nonnarcotic drugs were derived from the willow. 20. Common side effects of narcotic drugs include all of the following EXCEPT ________. a. constipation b. sedation c. respiratory depression d. decreased white blood count Answer: d. decreased white blood count Correct Feedback: Common side effects of narcotic drugs include constipation, respiratory depression, sedation, and euphoria. a. constipation Incorrect Feedback: Constipation is a common side effect of narcotic drugs. b. sedation Incorrect Feedback: Sedation is a common side effect of narcotic drugs. c. respiratory depression Incorrect Feedback: Respiratory depression is a common side effect of narcotic drugs. 21. Which of the following is a COX-2 inhibitor drug? a. Darvon b. Demerol c. Celebrex d. Tylenol Answer: c. Celebrex Correct Feedback: Celecoxib (Celebrex) is a COX-2 inhibitor drug. Celecoxib was the first drug in this drug category when it was introduced in 1998 as a new way to treat the pain and inflammation of osteoarthritis. a. Darvon Incorrect Feedback: Darvon is not a COX-2 inhibitor drug. b. Demerol Incorrect Feedback: Demerol is not a COX-2 inhibitor drug. d. Tylenol Incorrect Feedback: Tylenol is not a COX-2 inhibitor drug. 22. Which of the following drugs is derived from the venom of the cone snail that lives in the coral reefs around the Philippines? a. meperidine (Demerol) Incorrect Feedback: Meperidine (Demerol) is not derived from the cone snail. b. celecoxib (Celebrex) Incorrect Feedback: Celecoxib (Celebrex) is not derived from the cone snail. c. oxycodone (OxyContin) Incorrect Feedback: Oxycodone (OxyContin) is not derived from the cone snail. d. ziconotide (Prialt) Answer: d. ziconotide (Prialt) Correct Feedback: Ziconotide (Prialt) is derived from the venom of a cone snail that lives in the coral reefs around the Philippines. a. meperidine (Demerol) Incorrect Feedback: Meperidine (Demerol) is not derived from the cone snail. b. celecoxib (Celebrex) Incorrect Feedback: Celecoxib (Celebrex) is not derived from the cone snail. c. oxycodone (OxyContin) Incorrect Feedback: Oxycodone (OxyContin) is not derived from the cone snail. 23. The narcotic drug known as the “lollipop” used to treat the pain of cancer is _______. a. fentanyl (Actiq) b. morphine (MS Contin, Roxanol) c. propoxyphene (Darvon, Darvon-N) d. naproxen (Aleve, Naprosyn) Answer: a. fentanyl (Actiq) Correct Feedback: The narcotic drug fentanyl is available in several different drug forms: tablet, lozenge on a stick, and transdermal patch. Fentanyl (Actiq), which is used to treat breakthrough pain in cancer patients, comes as a lozenge on a stick. Informally, the drug is known as the Actiq lollipop. b. morphine (MS Contin, Roxanol) Incorrect Feedback: Morphine (MS Contin, Roxanol) is not known as the “lollipop.” c. propoxyphene (Darvon, Darvon-N) Incorrect Feedback: Propoxyphene (Darvon, Darvon-N) is not known as the “lollipop.” d. naproxen (Aleve, Naprosyn) Incorrect Feedback: Naproxen (Aleve, Naprosyn) is not a narcotic drug. 24. All of these drugs are used to treat migraine headaches EXCEPT _______. a. methadone (Dolophine, Methadose) b. topramate (Topamax) c. rizatriptan (Maxalt) d. Cafergot (ergotamine, caffeine) Answer: a. methadone (Dolophine, Methadose) Correct Feedback: Methadone is well known for its use in treating recovering narcotic drug addicts. It is a Schedule II narcotic drug that is able to treat severe pain. b. topramate (Topamax) Incorrect Feedback: Topramate (Topamax) is used to treat migraine headaches. c. rizatriptan (Maxalt) Incorrect Feedback: Rizatriptan (Maxalt) is used to treat migraine headaches. d. Cafergot (ergotamine, caffeine) Incorrect Feedback: Cafergot is a combination drug that is used to treat migraine headaches. 25. In which of the following pairs of drugs do both drugs come in the form of transdermal patches? a. oxaprozin (Daypro) and diclofenac (Voltaren, Emulgel) b. pentazocine (Talwin) and sumatriptan (Imitrex) c. diclofenac (Flector) and fentanyl (Duragesic) d. celecoxib (Celebrex) and Ultracet (acetaminophen, tramadol) Answer: c. diclofenac (Flector) and fentanyl (Duragesic) Correct Feedback: : Diclofenac can be given orally as a tablet (Cataflam, Voltaren), topically as a gel (Voltaren Gel, Emulgel), or topically as a transdermal patch (Flector). Fentanyl comes in two different transdermal patch forms: Duragesic and Ionsys. a. oxaprozin (Daypro) and diclofenac (Voltaren, Emulgel) Incorrect Feedback: Neither of these drugs comes as a transdermal patch. b. pentazocine (Talwin) and sumatriptan (Imitrex) Incorrect Feedback: Neither of these drugs comes as a transdermal patch. d. celecoxib (Celebrex) and Ultracet (acetaminophen, tramadol) Incorrect Feedback: Neither of these drugs comes as a transdermal patch. 26. Aspirin and NSAIDs ________. a. inhibit the COX-1 enzyme b. disrupt the protective action that prostaglandins have on the stomach c. inhibit the COX-2 enzyme d. a and b Answer: d. a and b Correct Feedback: Analgesic drugs, such as aspirin and NSAIDs, inhibit the COX-1 enzyme. This blocks the production of the prostaglandins that cause pain, but it also disrupts the protective action that prostaglandins have on the stomach. That is why aspirin and NSAIDs can cause stomach upset and peptic ulcers. a. inhibit the COX-1 enzyme Incorrect Feedback: This is true, but it is not the only correct answer. b. disrupt the protective action that prostaglandins have on the stomach Incorrect Feedback: This is true, but it is not the only correct answer. c. inhibit the COX-2 enzyme Incorrect Feedback: Aspirin and NSAIDs do not inhibit the COX-2 enzyme. 27. The first topical gel approved by the FDA for treating the pain of osteoarthritis was ________. a. Voltaren b. Indocin c. Bayer Aspirin d. Empirin w/Codeine Answer: a. Voltaren Correct Feedback: The nonsteroidal anti-inflammatory drug diclofenac(Voltaren) is now available as a topical gel to treat the pain of osteoarthritis. It is the first prescription topical skin gel approved by the FDA for treating the pain of osteoarthritis. b. Indocin Incorrect Feedback: Indocin does not come as a topical gel. c. Bayer Aspirin Incorrect Feedback: Aspirin does not come as a topical gel. d. Empirin w/ Codeine Incorrect Feedback: Empirin w/Codeine does not come as a topical gel. 28. Which of the following statements is FALSE? a. Some narcotic drugs have a stronger potential for addiction than other narcotic drugs. b. The symbol S on the drug label indicates that this is a Schedule drug. c. Narcotic drugs are assigned to schedules (Schedule II to IV). d. All narcotic drugs are schedule drugs. Answer: b. The symbol S on the drug label indicates that this is a Schedule drug. Correct Feedback: The symbol C indicates that the drug is a controlled substance and therefore a schedule drug. Some narcotic drugs have a stronger potential for addiction than other narcotic drugs. This difference in the potential for addiction led to the creation of different categories of schedule drugs. All narcotic drugs are schedule drugs (Schedules II to IV). a. Some narcotic drugs have a stronger potential for addiction than other narcotic drugs. Incorrect Feedback: This is a true statement. c. Narcotic drugs are assigned to schedules (Schedule II to IV). Incorrect Feedback: This is a true statement. d. All narcotic drugs are schedule drugs. Incorrect Feedback: This is a true statement. 29. The nonsteroidal anti-inflammatory drug indomethacin (Indocin) is used to treat ______. a. osteoarthritis and rheumatoid arthritis b. persistent patent ductus arteriosus in newborns c. gout d. all of the above Answer: d. all of the above Correct Feedback: Nonsteroidal anti-inflammatory drug used to treat the pain and inflammation of osteoarthritis, rheumatoid arthritis, bursitis, tendinitis, gout and ankylosing spondylitis. Used to close a persistent patent ductus arteriosus in newborns. a. osteoarthritis and rheumatoid arthritis Incorrect Feedback: This is true, but it is not the only correct answer. b. persistent patent ductus arteriosus in newborns Incorrect Feedback: This is true, but it is not the only correct answer. c. gout Incorrect Feedback: This is true, but it is not the only correct answer. 30. Methadone is used to treat recovering narcotic drug addicts because ________. a. it prevents the addict from experiencing withdrawal symptoms b. it does not produce euphoria like other narcotic drugs c. it slowly decreases the addict’s psychological dependence on narcotic drugs. d. all of the above Answer: d. all of the above Correct Feedback: Methadone is well known for its use in treating recovering narcotic drug addicts. It is a Schedule II narcotic drug that is able to treat severe pain but, because it does not produce the high degree of euphoria that other narcotic drugs do, it is not generally a drug of abuse. It prevents the addict from experiencing narcotic withdrawal symptoms while it slowly decreases the addict’s psychological dependence on narcotic drugs. a. it prevents the addict from experiencing withdrawal symptoms Incorrect Feedback: This is true, but it is not the only correct answer. b. it does not produce euphoria like other narcotic drugs Incorrect Feedback: This is true, but it is not the only correct answer. c. it slowly decreases the addict’s psychological dependence on narcotic drugs. Incorrect Feedback: This is true, but it is not the only correct answer. 31. The phrase low-dose aspirin refers to ________. a. the 81 mg dose of aspirin b. the trade name drug that is only made by Bayer c. aspirin that is taken to prevent heart attacks and strokes d. a and c Answer: d. a and c Correct Feedback: The phrase low-dose aspirin was coined when it was discovered that a daily 81 mg dose of aspirin could prevent heart attacks and strokes. Besides Bayer, many other drug companies also make low-dose 81 mg tablets. a. the 81 mg dose of aspirin Incorrect Feedback: This is true, but it is not the only correct answer. b. the trade name drug that is only made by Bayer Incorrect Feedback: Many drug companies make low-dose aspirin tablets. c. aspirin that is taken to prevent heart attacks and strokes Incorrect Feedback: This is true, but it is not the only correct answer. 32. Acetaminophen is a nonsalicylate analgesic drug that is not related to aspirin or any of the other salicylate drugs. Answer: True Feedback: Acetaminophen is a nonsalicylate analgesic drug that is not related to aspirin or any other salicylate drugs. 33. Some of the similarities between aspirin and acetaminophen are that they both relieve pain, but they both can cause upset stomach and stomach irritation. Answer: False Feedback: Acetaminophen does not cause the stomach irritation that aspirin does, and so patients who cannot take aspirin because of stomach upset can take acetaminophen. 34. Because NSAIDs are structurally different than aspirin, patients who are allergic to aspirin can safely take NSAIDs. Answer: False Feedback: NSAIDs are structurally similar enough to aspirin that patients who are allergic to aspirin should not take NSAIDs. 35. Serotonin receptor agonist drugs are used to prevent migraine headaches from occurring. Answer: False Feedback: Serotonin receptor agonist drugs are used to treat migraine headaches once they have occurred. 36. One of the benefits of ergotamine drugs for migraine headaches is that they constrict the arteries in the brain without significantly reducing blood flow. Answer: True Feedback: Ergotamine drugs constrict the arteries in the brain without significantly reducing blood flow. 37. The drug tramadol (Ultram) activates narcotic receptors in the brain and spinal cord, although it does not have the potential for addiction that narcotic drugs have. Answer: True Feedback: Tramadol inhibits the neurotransmitters norepinephrine and serotonin. It also activates narcotic receptors in the brain and spinal cord to relieve pain, although it does not have the potential for addiction that narcotic drugs have. 38. The regular use of aspirin can cause stomach ulcers and cataracts. Answer: True Feedback: Because aspirin is an acid (acetylsalicylic acid) and is irritating to the stomach, long-term use may cause stomach ulcers. Aspirin used regularly for longer than 10 years has been linked to the development of cataracts in the eyes. 39. The Schedule III combination drug Suboxone, used to treat narcotic addiction, contains both a narcotic drug (buprenorphine) and a narcotic antagonist drug (naloxone). Answer: True Feedback: Suboxone, a Schedule III combination drug, contains a narcotic drug (buprenorphine) and a narcotic antagonist drug (naloxone). 40. Beta-blocker drugs keep the blood vessels constricted to prevent the initial vasodilation that is the beginning of migraine headaches. Answer: False Feedback: Beta-blocker drugs keep the arteries dilated to prevent the initial vasoconstriction that is the beginning of a migraine headache. 41. Antidepressant drugs have been found helpful in treating migraine and tension headaches. Answer: True Feedback: Antidepressant drugs treat depression and depression associated with anxiety, but have been found to be helpful in treating migraine and tension headaches. 42. One of the common side effects of narcotic drugs, an antitussive effect, is used as a therapeutic effect by including narcotic drugs in some prescription cough syrups. Answer: True Feedback: Another common narcotic side effect, suppression of the cough center (antitussive effect), is used as a therapeutic effect by using a narcotic drug as a prescription cough syrup (e.g., Hycodan). 43. Calcium channel blocker drugs used to prevent migraine headaches slow the movement of calcium ions and, with less calcium in the cells, the smooth muscles relax, and the arteries remain dilated. Answer: True Feedback: Calcium channel blocker drugs slow the movement of calcium ions through calcium channels and into the smooth muscle around the arteries in the brain. With less calcium available within the cells, the smooth muscles relax, and the arteries remain dilated. These drugs are used to prevent migraine headaches. 44. Caffeine is a stimulant drug that is often included in combination analgesic drugs. Answer: True Feedback: Combination analgesic drugs contain a vasoconstrictor drug (ergotamine, isometheptene), an analgesic drug (acetaminophen), a stimulant drug (caffeine), and/or a sedative drug (dichloralphenazone). 45. Even though it can only be obtained with a prescription, the narcotic drug nalbuphine is NOT a schedule drug. Answer: True Feedback: The narcotic drug nalbuphine is not a schedule drug (although it can only be obtained with a prescription). 46. Serotonin receptor agonist drugs for migraine headaches stimulate serotonin receptors on the arteries and cause the arteries to constrict and also stimulate serotonin receptors on the trigeminal nerve to treat the pain of migraine headaches. Answer: True Feedback: Serotonin receptor agonist drugs stimulate serotonin receptor sites on the arteries and cause them to constrict again. These drugs also stimulate serotonin receptors on the trigeminal nerve to treat the pain of migraine headaches. 47. Elderly people who regularly take an NSAID or aspirin are less likely to develop Alzheimer’s disease. Answer: True Feedback: Studies have shown that elderly people who regularly take an NSAID or aspirin are 55 percent less likely to develop Alzheimer’s disease. 48. Diclofenac is the only nonsteroidal anti-inflammatory drug that can be given orally, topically as a gel, or as a transdermal patch. Answer: True Feedback: All nonsteroidal anti-inflammatory drugs can be given orally as a capsule or tablet. However, only diclofenac can be given in all of these drug forms and routes of administration: orally as a tablet (Cataflam, Voltaren), topically as a gel (Voltaren Gel, Emulgel), or topically as a transdermal patch (Flector). 49. Acetaminophen does not have any anti-inflammatory effect or anticoagulant effect. Answer: True Feedback: Acetaminophen does not have the anti-inflammatory properties that aspirin has, and so acetaminophen cannot be used to treat inflammation. Acetaminophen does not have the anticoagulant effect that aspirin has, and so acetaminophen cannot be used to prevent a heart attack or stroke. 50. Aspirin was the first drug to have a plastic safety seal on the top of the drug container. Answer: False Feedback: Tylenol was the first drug company to put a plastic safety seal on the top of each drug container to prevent tampering with the drug prior to purchase by the consumer. 51. Heroin was used extensively to treat pain during the Civil War, but is now a Schedule I drug with no medical uses. Answer: True Feedback: Heroin is classified as a Schedule I drug with no medical uses because of its high potential for physical and psychological addiction. 52. The suffix __________ is common to generic nonsteroidal anti-inflammatory drugs. Answer: –profen Feedback: The suffix –profen is common to generic nonsteroidal antiinflammatory drugs. 53. The suffix __________ is common to serotonin receptor agonist drugs used to treat migraines. Answer: –triptan Feedback: The suffix –triptan is common to serotonin receptor agonist drugs used to treat migraines. 54. Narcotic drugs produce a sense of well-being or ________, which is what causes some narcotic drugs to be more psychologically addicting than others. Answer: euphoria Feedback: Narcotic drugs are used to treat moderate-to-severe pain, and they also produce sedation and a sense of well-being (euphoria). It is the presence of significant euphoria that causes some narcotic drugs to be more psychologically addicting than others. 55. Aspirin prolongs the clotting time of the blood by inhibiting __________, a substance in the blood that normally causes platelets to form a clot. Answer: thromboxane Feedback: Aspirin prolongs the clotting time of the blood by inhibiting thromboxane, a substance in the blood that normally causes platelets to aggregate and form a clot. 56. A/an ________ drug, like a salicylate drug or a narcotic drug, is a drug that provides relief from pain. Answer: analgesic Feedback: Analgesic drugs used to treat pain include nonnarcotic analgesic drugs (salicylate analgesic drugs, nonsalicylate analgesic drugs, nonsteroidal anti-inflammatory drugs) and narcotic analgesic drugs. 57. With their ______ effect, salicylate drugs reduce fever by acting on the hypothalamus. Answer: antipyretic Feedback: Salicylate drugs have three distinct therapeutic effects, including an antipyretic effect to reduce fever by acting on the hypothalamus. 58. __________ is a neurotransmitter that normally constricts the arteries in the brain. It is this neurotransmitter that is focus of a category of drugs used to treat migraine headaches. Answer: Serotonin Feedback: Serotonin is a neurotransmitter that normally constricts the arteries in the brain. Serotonin receptor agonist drugs are used to treat migraine headaches. 59. The difference between Tylenol w/ Codeine, Tylenol w/ Codeine No. 2, Tylenol w/ Codeine No. 3, and Tylenol w/ Codeine No. 4 is the amount of _______ they contain. Answer: codeine Feedback: Tylenol w/ Codeine comes in several strengths. Tylenol w/Codeine is the first strength, and it contains 12 mg of codeine. Tylenol w/ Codeine No. 2 is the second strength, and it contains 15 mg of codeine. Tylenol w/ Codeine No. 3 is the third strength and it contains 30 mg of codeine. Tylenol w/ Codeine No. 4 is the fourth strength and it contains 60 mg of codeine. 60. Narcotic drugs activate the same receptor sites as ______, the natural opiate-like substances that produce a feeling of pain relief in the body. Answer: endorphins Feedback: Natural opiate-like substances in the body known as endorphins were designed to occupy specific receptor sites in the body and produce a natural feeling of pain relief without the use of drugs. Narcotic drugs activate these same receptor sites. 61. The trade name MS Contin contains the abbreviation MS, which stands for the generic drug _________, and Contin, which refers to the fact that the drug provides continuous pain relief as a controlled-release tablet. Answer: morphine sulfate Feedback: MS Contin reflects the abbreviation for morphine sulfate (MS) and the fact that the drug provides continuous pain relief (Contin, as a controlled-release tablet). 62. The combination drugs Fioricet and Ultracet give a clue in their trade names that they contain the generic analgesic drug _______. Answer: acetaminophen Feedback: The combination drugs Fioricet and Ultracet give a clue in their trade names as to what generic analgesic drug they contain. Their trade drugs names both end in the suffix –cet, which stands for acetaminophen. 63. Define these abbreviations. ASA __________________ NSAID _________________ Answer: acetylsalicylic acid, nonsteroidal anti-inflammatory drug, Feedback: The drug aspirin is also known by its chemical name and abbreviation acetylsalicylic acid (ASA). Nonsteroidal anti-inflammatory drugs (NSAIDs) have an analgesic effect. 64. Give a trade names for these common generic drugs. acetaminophen ______________ aspirin ______________ enteric-coated aspirin _______________ meperidine _________________ Answer: Panadol, Tylenol; Bayer Aspirin, Ecotrin, Empirin; Ecotrin; Demerol Feedback: acetaminophen (Panadol, Tylenol); aspirin (Bayer Aspirin, Ecotrin, Empirin); aspirin is available as an enteric-coated tablet (trade name Ecotrin) that dissolves only in the higher pH environment of the duodenum; meperidine (Demerol). 65.The salicylate drug aspirin has a therapeutic effect that is not shared by any of the other salicylate drugs. Name that therapeutic effect: ________. Answer: anticoagulant Feedback: The salicylate drug aspirin has a fourth therapeutic action that is unique and not shared by any of the other salicylate drugs: anticoagulant. 66. 1. acetaminophen (Panadol, Tylenol) A. salicylate analgesic drug with anticoagulant effect 2. aspirin (Bayer Aspirin, Ecotrin, Empirin)B. narcotic analgesic drug 3. hydromorphone (Dilaudid) C. nonsalicylate analgesic drug 4. ibuprofen (Advil, Motrin) D. nonsteroidal anti-inflammatory drug 5. magnesium salicylate (Doan’s) E. salicylate analgesic drug Answer: C Answer: A Answer: B Answer: D Answer: E Feedback: These drugs and their categories are found throughout the chapter. 67. 1. almotriptan (Axert) A. antidepressant drug for migraine headaches 2. amitriptyline B. beta-blocker drug for migraine headaches 3. atenolol (Tenormin) C. calcium channel blocker drugs for migraine headaches 4. dihydroergotamine (Migranal)D. ergotamine drugs for migraine headaches 5. diltiazem (Cardizem) E. serotonin receptor agonist drug for migraine headaches Answer: E Answer: A Answer: B Answer: D Answer: C Feedback: These drugs and their categories are found throughout the chapter. 68. Briefly explain how narcotic analgesic drugs work. Answer: Narcotic drugs are used to treat moderate-to-severe pain, and they also produce sedation and a sense of well being (euphoria). Narcotic drugs relieve pain by binding to opiate receptor sites in the brain, thus blocking pain impulses coming to the brain from nerves in the body. 69. What is the reason that a person with the aches and pains of a viral illness should not be given aspirin? Answer: The use of aspirin to treat the aches and pains of a viral illness has been linked to the occurrence of Reye’s syndrome. Reye’s syndrome causes liver damage, increased serum levels of ammonia, and encephalitis. Therefore, treating the symptoms of a viral illness (cold, flu, chickenpox) with aspirin is no longer recommended. Instead, acetaminophen (Tylenol) is used. 70. Why is acetaminophen not recommended for a patient having a heart attack or stroke? Answer: Acetaminophen does not have the anticoagulant effect that aspirin has, and so acetaminophen cannot be used to prevent a heart attack or stroke. 71. If the generic drug oxycodone and its trade names OxyContin and Roxicodone all contain the same narcotic drug, why do drug addicts prefer to abuse OxyContin? Answer: Oxycodone is available under several other trade names besides OxyContin, but addicts use OxyContin because it is a time-release formula that contains up to 10 times more narcotic than other forms of oxycodone. The time-release formula is meant to control pain for 12 hours; however, addicts crush the tablet and then snort the powder or dissolve the tablet and then inject the liquid intravenously so that the full narcotic dose takes effect immediately and produces a “high.” 72. Explain the rationale behind prescribing a combination drug that contains both a narcotic and nonnarcotic to relieve pain. Answer: Nonnarcotic and narcotic drugs are often given in combination with each other for two reasons: 1. The nonnarcotic drug provides a foundation of pain relief upon which the narcotic drug can build and therefore, less narcotic drug is needed to effectively control the pain; 2. the therapeutic actions of this combination of drugs treat the two components of pain—pain from the stimulation of nerve endings and pain that is heightened by anxiety. 73. Percodan and Percocet both contain the same amount of the narcotic oxycodone. What is the difference between these two drugs? Answer: Percocet contains acetaminophen, and Percodan contains aspirin. 74. If a person had Darvocet-N, Percocet, and Tylenol at home to take p.r.n. for pain, what observation might you make about the similarity of these three drugs (besides that they are all used to treat pain)? Answer: Darvocet-N (acetaminophen, propoxyphene), Percocet (acetaminophen, oxycodone), and Tylenol (acetaminophen) all contain acetaminophen as the analgesic nonnarcotic drug. 75. Describe the four therapeutic effects of aspirin. Answer: The four therapeutic effects are: 1. analgesic, providing relief from mild-to-moderate pain by inhibiting the release of prostaglandins from damaged tissue; 2. anti-inflammatory, decreasing inflammation also by inhibiting the release of prostaglandins from damaged tissue; 3. antipyretic, reducing fever by acting on the hypothalamus to cause vasodilation and sweating which increases heat loss from the skin and lowers an elevated body temperature; and 4. anticoagulant, prolonging the clotting time of the blood by inhibiting thromboxane, a substance in the blood that normally causes platelets to aggregate and form a clot. Test Bank for Understanding Pharmacology for Health Professionals Susan M. Turley 9780135145708, 9780133911268
