Prolonged use of aspirin causes:
**Core Concept**
Aspirin, a nonsteroidal anti-inflammatory drug (NSAID), is known for its analgesic, antipyretic, and anti-inflammatory properties. However, its long-term use can lead to several adverse effects, particularly on the gastrointestinal and renal systems.
**Why the Correct Answer is Right**
Prolonged use of aspirin can cause **renal papillary necrosis** due to its effect on prostaglandin synthesis. Aspirin inhibits cyclooxygenase (COX) enzymes, which are responsible for converting arachidonic acid into prostaglandins. Prostaglandins play a crucial role in maintaining renal blood flow and medullary oxygenation. By inhibiting prostaglandin synthesis, aspirin can lead to decreased renal blood flow and oxygen delivery, resulting in renal papillary necrosis.
**Why Each Wrong Option is Incorrect**
**Option A:** **Gastric ulcers** - While aspirin can cause gastrointestinal irritation and ulcers, renal papillary necrosis is a more specific and severe consequence of prolonged aspirin use.
**Option B:** **Hypertension** - Aspirin has a mild antihypertensive effect, but it is not a direct consequence of its prolonged use.
**Option C:** **Liver damage** - Aspirin can cause hepatotoxicity, but this is not the primary concern with prolonged use.
**Clinical Pearl / High-Yield Fact**
When prescribing aspirin for long-term use, consider the patient's renal function and monitor for signs of renal impairment, such as hematuria, proteinuria, or decreased urine output.
**Correct Answer:** C.