Which of the following statements is accurate regarding anti-inflammatory drugs that are cyclooxygenase-2 (COX-2) selective?
COX-2 inhibitors include Celecoxib.
COX-2 inhibitors belong to first generation NSAIDs.
COX-2 inhibitors are associated with peptic ulcers.
COX-2 inhibitors work by promoting inflammation.
The Correct Answer is A
Choice A rationale
Celecoxib is a highly selective inhibitor of the COX-2 enzyme, which is primarily induced at sites of inflammation and mediates the synthesis of pro-inflammatory prostaglandins. By specifically blocking COX-2, Celecoxib aims to reduce inflammation and pain with a lower risk of gastrointestinal adverse effects compared to non-selective nonsteroidal anti-inflammatory drugs (NSAIDs) that also inhibit constitutive COX-1.
Choice B rationale
COX-2 selective inhibitors, such as celecoxib, are considered second-generation NSAIDs, developed after the initial non-selective NSAIDs (like aspirin, ibuprofen), which are classified as first-generation. This newer class was designed to minimize the adverse effects, particularly gastrointestinal, associated with the non-selective inhibition of the constitutive COX-1 enzyme.
Choice C rationale
The primary advantage and design feature of COX-2 selective inhibitors are their reduced risk of gastrointestinal adverse effects, including peptic ulcers, compared to non-selective NSAIDs. Non-selective NSAIDs inhibit COX-1, which produces protective prostaglandins necessary for maintaining the gastric mucosal barrier, making their inhibition the main cause of ulcers.
Choice D rationale
COX-2 selective inhibitors work by reducing inflammation. The COX-2 enzyme catalyzes the conversion of arachidonic acid into pro-inflammatory prostaglandins. By inhibiting this enzyme, these drugs decrease the synthesis of these inflammatory mediators, thereby lessening the signs and symptoms of inflammation, pain, and fever.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
The Beers Criteria specifically focuses on drugs with potential risks outweighing benefits in older adults due to age-related physiological changes like decreased renal clearance and altered drug distribution, not a list of universally appropriate medications.
Choice B rationale
The Beers Criteria primarily addresses prescription medications that are commonly used and potentially harmful to older adults, not a comprehensive list of over-the-counter drugs or herbal supplements, which also carry risks.
Choice C rationale
The Beers Criteria is a guide for healthcare professionals listing specific medications or medication classes that should generally be avoided or used with caution in older adults, aiming to reduce adverse drug events.
Choice D rationale
While medication management is crucial, the Beers Criteria is a list of potentially inappropriate medications, not an outline of patient characteristics or strategies for older patients to self-manage their medications effectively.
Correct Answer is B
Explanation
Choice A rationale
Exudate accumulation, which is fluid and cells leaking from blood vessels, certainly contributes to the swelling (tumor) associated with a sprained ankle and inflammation. However, the feeling of heat (calor) is primarily a direct result of vasodilation and the subsequent increase in the volume of warm blood flowing into the injured area, raising the local tissue temperature.
Choice B rationale
The cardinal sign of inflammation described as heat (calor) is a direct physiological consequence of arteriolar vasodilation at the site of injury. This increased vascular permeability and localized hyperemia results in a greater volume of warm, oxygenated blood entering the capillary beds of the sprained ankle, which raises the local skin and tissue temperature.
Choice C rationale
An infection is a potential cause of inflammation but is not the mechanism that explains the localized heat. The process of an infection would still trigger the inflammatory response, including vasodilation and increased blood flow, which is the direct cause of the elevated local temperature observed on palpation.
Choice D rationale
A thermal injury, such as a burn, is a type of injury that causes inflammation and heat, but a sprained ankle is a mechanical injury (ligament tear/stretch). In a sprain, the heat is a result of the body's inflammatory response to the tissue damage, not a direct application of external heat or thermal damage itself.
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