Which one of the following NSAIDs has adverse effects on liver?
**Core Concept**
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) are a class of medications that have analgesic, antipyretic, and anti-inflammatory properties. They work by inhibiting the enzyme cyclooxygenase (COX), which is involved in the synthesis of prostaglandins. Prostaglandins play a key role in inflammation and pain. However, not all NSAIDs are created equal, and some have a higher propensity to cause liver damage.
**Why the Correct Answer is Right**
Ibuprofen is a commonly used NSAID that is generally well-tolerated, but it can cause liver damage in rare cases. The mechanism behind ibuprofen-induced liver injury is thought to involve the formation of reactive metabolites that cause liver cell damage. The risk of liver damage is higher in patients who take high doses of ibuprofen or have pre-existing liver disease. Ibuprofen can also cause a condition called cholestatic hepatitis, which is characterized by a decrease in bile flow and inflammation of the liver.
**Why Each Wrong Option is Incorrect**
* **Option A:** Aspirin is another NSAID, but it is less likely to cause liver damage compared to ibuprofen. Aspirin is more commonly associated with gastrointestinal side effects, such as bleeding and ulcers.
* **Option B:** Naproxen is a NSAID that is often used to treat arthritis and other inflammatory conditions. While it can cause liver damage, the risk is lower compared to ibuprofen. Naproxen is also more likely to cause gastrointestinal side effects.
* **Option D:** No option was provided, so this section is skipped.
**Clinical Pearl / High-Yield Fact**
Remember that NSAIDs can cause liver damage, but the risk is higher with certain medications like ibuprofen. Always monitor patients for signs of liver injury, such as jaundice, fatigue, and abdominal pain, especially when starting new NSAIDs.
**Correct Answer:** C.