Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

What medication can enhance the effectiveness of nonsteroidal anti-inflammatory drugs in a patient with fibromyalgia?

1. Corticosteroid

2. Antimalarial agent

3. Salicylate

4. Tricyclic antidepressant

The correct answer is: Tricyclic antidepressant

Tricyclic antidepressants can play a significant role in enhancing the effectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs) for patients with fibromyalgia. This condition is characterized by widespread pain and often accompanied by other symptoms such as fatigue, sleep disturbances, and cognitive difficulties. The underlying mechanisms of fibromyalgia involve both central and peripheral sensitization to pain, and tricyclic antidepressants, such as amitriptyline, have analgesic properties that address these mechanisms. They work by inhibiting the reuptake of neurotransmitters like serotonin and norepinephrine, which helps modulate pain perception and improve sleep quality. When used in conjunction with NSAIDs, tricyclic antidepressants can provide a synergistic effect, enhancing pain relief and overall management of fibromyalgia symptoms. This combined approach allows for potentially lower doses of each medication, minimizing side effects while maximizing therapeutic benefits. Additionally, the improved sleep quality due to tricyclic antidepressants can contribute to better pain control, as sleep disturbances often exacerbate fibromyalgia symptoms. Other medications listed, such as corticosteroids, antimalarial agents, and salicylates, do not have the same supportive role in the management of fibromyalgia and do not necessarily enhance the effectiveness