Drug commonly causing analgesic nephropathy is :
**Core Concept**
Analgesic nephropathy is a form of chronic kidney disease caused by long-term use of certain analgesic medications, leading to renal tubular damage and impaired renal function.
**Why the Correct Answer is Right**
The correct answer is **indomethacin**, a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX) enzymes, leading to decreased prostaglandin synthesis and vasoconstriction in the renal vasculature. This results in decreased renal blood flow and glomerular filtration rate, contributing to analgesic nephropathy.
**Why Each Wrong Option is Incorrect**
**Option A:** Aspirin is a non-selective COX inhibitor, but it is less likely to cause analgesic nephropathy compared to indomethacin due to its lower potency and shorter duration of action.
**Option B:** Ibuprofen is another NSAID that can cause renal impairment, but it is not as strongly associated with analgesic nephropathy as indomethacin.
**Option C:** Paracetamol (acetaminophen) is not typically associated with analgesic nephropathy, as it does not significantly affect renal prostaglandin synthesis.
**Clinical Pearl / High-Yield Fact**
Remember that NSAIDs, especially those with high potency and long duration of action (e.g., indomethacin), can cause renal impairment and increase the risk of analgesic nephropathy. This is particularly important in patients with pre-existing renal disease or those taking multiple NSAIDs.
**Correct Answer: C. Paracetamol (acetaminophen)**