Start practicing

Pharmacology · patient case question

All of the following are true of NSAIDs EXCEPT:

Patient case: Choosing and stopping drugs

demo: Series of prescribing decisions

chief: Several patients seen in one session raise questions about antibiotic choice, analgesia and anticoagulation.

history: One patient has a spreading odontogenic infection unresponsive to five days of empirical antibiotics. Another takes rivaroxaban for atrial fibrillation. A third developed a widespread blistering rash and mucosal ulceration a week after starting a new medication.

meds: Varies by patient.

findings: Not applicable.

  1. They are the first choice for severe chronic pain requiring escalating doses
  2. They inhibit cyclo-oxygenase and reduce prostaglandin synthesis
  3. They are effective for mild to moderate inflammatory pain
  4. They have a ceiling effect above which no further analgesia occurs
Show answer and explanation

Correct answer: A. They are the first choice for severe chronic pain requiring escalating doses

  • A. Correct, and this is the exception. NSAIDs are not the answer to severe pain requiring dose escalation, precisely because of the ceiling effect. Raising the dose past that point adds gastrointestinal, renal and bleeding risk without adding analgesia.
  • B. This is true. They inhibit COX-1 and COX-2, reducing prostaglandin synthesis, which produces both the therapeutic effect and the gastric and renal adverse effects.
  • C. This is true. NSAIDs are the first-line analgesic for odontogenic pain because the pain is prostaglandin-mediated, and they outperform opioids for it.
  • D. This is true and is the defining pharmacological limitation of the class. Opioids, by contrast, have no analgesic ceiling.

Practice Pharmacology questions Pharmacology study notes

More Pharmacology practice questions