NSAIDs: COX-2 selective inhibitors: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pharmacology · NSAIDs: COX-2 selective inhibitors

Sample item

A 62-year-old man with prior myocardial infarction and peptic ulcer history needs an NSAID. Which concern applies to a selective COX-2 inhibitor such as celecoxib?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Reduced gastric injury but increased cardiovascular thrombotic risk

COX-2 inhibitors spare gastric COX-1 derived prostaglandins but reduce vascular prostacyclin without blocking platelet thromboxane, tilting towards thrombosis. They are used cautiously or avoided in established cardiovascular disease.

Option by option

  • A. Bronchospasm in all patients

    Bronchospasm is not a universal effect.

  • B. Increased gastric bleeding compared with non-selective NSAIDs

    Gastric injury is less, not more, with COX-2 selective drugs.

  • C. Reduced gastric injury but increased cardiovascular thrombotic risk (correct)

    Correct. Better gastric safety but higher thrombotic risk.

  • D. Marked antiplatelet effect that reduces thrombosis

    Selective COX-2 inhibitors have little effect on platelet thromboxane.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Reduced gastric injury but increased cardiovascular thrombotic risk. COX-2 inhibitors spare gastric COX-1 derived prostaglandins but reduce vascular prostacyclin without blocking platelet thromboxane, tilting towards thrombosis.

Why is "Bronchospasm in all patients" not the answer?

Bronchospasm is not a universal effect.

Why is "Increased gastric bleeding compared with non-selective NSAIDs" not the answer?

Gastric injury is less, not more, with COX-2 selective drugs.

Why is "Marked antiplatelet effect that reduces thrombosis" not the answer?

Selective COX-2 inhibitors have little effect on platelet thromboxane.

What concept does this question test?

It tests NSAIDs: COX-2 selective inhibitors in Pharmacology. They are used cautiously or avoided in established cardiovascular disease.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study NSAIDs: COX-2 selective inhibitors?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.