Pain: selective COX-2 inhibitors: practice question

A Anaesthesia 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.

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Anaesthesia · Pain: selective COX-2 inhibitors

Sample item

What is an advantage and a concern of celecoxib compared with non-selective NSAIDs?

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

The answer and the reasoning

D. Less gastrointestinal toxicity and no platelet inhibition, but a cardiovascular thrombotic risk

Selective COX-2 inhibitors spare COX-1, so they cause less gastric injury and do not impair platelet aggregation, which is useful perioperatively. They still impair renal function and have been associated with increased risk of thrombotic cardiovascular events. They should be avoided in established ischaemic heart disease.

Option by option

  • A. No renal effects and no cardiovascular risk

    Renal effects and cardiovascular risk are present with COX-2 inhibitors.

  • B. Acts as an opioid receptor agonist

    Celecoxib has no opioid receptor activity.

  • C. More gastrointestinal bleeding and more platelet inhibition

    These are features of non-selective NSAIDs.

  • D. Less gastrointestinal toxicity and no platelet inhibition, but a cardiovascular thrombotic risk (correct)

    Correct. COX-1 sparing reduces GI and bleeding effects, while cardiovascular risk remains.

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.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Less gastrointestinal toxicity and no platelet inhibition, but a cardiovascular thrombotic risk. Selective COX-2 inhibitors spare COX-1, so they cause less gastric injury and do not impair platelet aggregation, which is useful perioperatively.

Why is "No renal effects and no cardiovascular risk" not the answer?

Renal effects and cardiovascular risk are present with COX-2 inhibitors.

Why is "Acts as an opioid receptor agonist" not the answer?

Celecoxib has no opioid receptor activity.

Why is "More gastrointestinal bleeding and more platelet inhibition" not the answer?

These are features of non-selective NSAIDs.

What concept does this question test?

It tests Pain: selective COX-2 inhibitors in Anaesthesia. They still impair renal function and have been associated with increased risk of thrombotic cardiovascular events. They should be avoided in established ischaemic heart 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 Pain: selective COX-2 inhibitors?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.