Musuq
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A 54-year-old woman with type 2 diabetes mellitus well controlled with oral hypoglycemic agents comes to the physician because of a 2-week history of swelling in her left knee. She tells the physician that her knee is very stiff when she awakens in the morning and at bedtime. The pain and stiffness worsen with exertion. Low-dose ibuprofen results in incomplete relief. Which of the following best explains why a larger dose of ibuprofen is more appropriate?
A. The anti-inflammatory dose is nearly twice the analgesic dose
B. The drug is excreted at a fast rate because of renal complications of diabetes mellitus
C. Increasing the dose extends the half-life of the drug
D. Menopausal women metabolize the drug at a faster rate than premenopausal women
E. Oral hypoglycemic agents interfere with protein binding of ibuprofen
Edited by Musuq on 10/21/06 - 05:44 AM
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| sattar
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The answer is A. the anti-inflammatory dose is nearly twice the analgesic dose.
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| Musuq
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NSAIDs
Acetylsalicylic Acid (ASA; Aspirin) Irrev inhib COX. AT moderate dose it's analgesiic and antipyretic and it's antiinflammatory at high doses.
Ibuprofen and Naproxen have similar antiinflammatory and analgesic properties
Indomethacin, has more antiinflamatory property
Ketorolac, has more analgesic property
Selected inducers, inhibitors and substrates of CYP2C91
Type Agent
Inducers: rifampicin, secobarbital, hyperforin (constituent of St Johns Wort)
Inhibitors: amiodarone, fenofibrate, fluconazole, fluvastatin, fluvoxamine, isoniazid, lovastatin, probenecid, sertraline, sulfamethoxazole, teniposide, voriconazole, zafirlukast
Substrates: amitriptyline, certain angiotensin II receptor antagonists (losartan, irbesartan), fluoxetine, fluvastatin, NSAIDs (incl. celecoxib, diclofenac, ibuprofen, meloxicam, naproxen, piroxicam), pitavastatin, phenytoin, rosiglitazone, sulfonylureas (incl. glibenclamide, glipizide, glimepiride, tolbutamide), tamoxifen, warfarin
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| Musuq
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What about E? because that is a fact, Sulfonilureas and ibuprofen also compete for binding proteins, ibuprofen increase the Sulfonilureas free-fraction cause it is placed instead.
HELP!
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| dreamer
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Oral hypoglycemic agents interfere with protein binding of ibuprofen
from what i understand, it seems that hypoglycemic agents will replace the protein binding ibuprofen which will increase free ibuprofen , so it might need to decrease the dose of ibuprofen instead of increase it
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| dreamer
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so i go with a
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| drfax
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A.
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