PharmD Training | O1E1 | Drug Information Center

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1. Explain Why: Low Dose Aspirin has anti-platelet effect more than high dose aspirin *

2. Mention 2 Mechanisms by which NSAIDs affect CVS *

3. Although Aspirin Toxicity causes hyperthermia (unexpctedly), yet not treated by NSAIDs *

4. A 68-year-old with heart failure and CKD stage 3 requires analgesia. Which sequence of drugs from safest to riskiest (renal) is correct? *

A. Paracetamol → Ibuprofen → Celecoxib → Naproxen

B. Paracetamol → Celecoxib → Ibuprofen → Naproxen

C. Ibuprofen → Paracetamol → Naproxen → Diclofenac

D. Paracetamol → Naproxen → Ibuprofen → Celecoxib

5. Aspirin’s irreversible inhibition of COX-1 causes all of the following EXCEPT: *

A. Decreased TXA₂ synthesis

B. Prolonged bleeding time

C. Reduced renal perfusion

D. Decreased gastric acid secretion

6. Which statement about COX isoenzymes is true? *

A. COX-2 is constitutive in gastric mucosa and platelets.

B. COX-1 inhibition mediates anti-inflammatory benefits.

C. COX-3 is a splice variant of COX-1 mRNA mainly in CNS.

D. COX-2 produces “good prostaglandins” essential for protection.

7. In a cardiovascular patient on warfarin, which analgesic is safest? *

A. Aspirin 325 mg

B. Naproxen

C. Paracetamol

D. Diclofenac

8. Which of the following explains why COX-2 inhibitors may increase thrombotic events? *

A. They reduce both PGI₂ and TXA₂ synthesis equally.

B. They selectively inhibit vascular PGI₂ synthesis, leaving TXA₂ unopposed.

C. They enhance COX-1 activity in platelets.

D. They decrease prostacyclin receptor sensitivity.

9. Which drug combination is most likely to precipitate acute kidney injury in a dehydrated elderly patient? *

A. Paracetamol + Losartan

B. Ibuprofen + Furosemide

C. Celecoxib + PPIs

D. Naproxen + Sucralfate

10. Which NSAID has the highest ulcerogenic potential? *

A. Piroxicam

B. Naproxen

C. Ibuprofen

D. Celecoxib

11. Which analgesic shows the lowest risk of medication-overuse headache when used ≤15 days/month? *

A. Naproxen

B. Paracetamol

C. Diclofenac

D. Combination analgesics

12. A patient taking high-dose NSAIDs for arthritis develops melena. The most appropriate preventive measure for future therapy is: *

A. Add a proton pump inhibitor

B. Switch to Aspirin 325 mg daily

C. Add Paracetamol concurrently

D. Increase NSAID dose but with meals

13. Which pair correctly matches COX isoform and physiologic role? *

A. COX-1 — inducible; produces “bad prostaglandins”

B. COX-2 — constitutive; platelet aggregation

C. COX-3 — central; regulates pain and temperature

D. COX-1 — cerebral; fever control

14. Which NSAID should be strictly limited to ≤5 days due to GI/renal toxicity despite very high analgesic potency? *

A. Diclofenac

B. Ketorolac

C. Piroxicam

D. Naproxen

15. In a cardiovascular patient with peptic ulcer disease needing anti-inflammatory therapy, which choice offers best safety balance? *

A. Diclofenac with PPI

B. Paracetamol

C. Celecoxib

D. Naproxen

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Pain & Fever Management (Outpatient) - Exam 1

Best Regards,
Dr. Ahmed Khaled

Pain & Fever Management (Outpatient) - Exam 1

Best Regards,Dr. Ahmed Khaled

Best Regards,
Dr. Ahmed Khaled