Prescribing Safety Assessment (PSA) Practice Exam

When are NSAIDs contraindicated?

1. In cases of headache

2. With renal failure

3. During pregnancy

4. With a family history of diabetes

The correct answer is: With renal failure

Nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in cases of renal failure due to their effects on kidney function. NSAIDs can lead to renal impairment because they inhibit the production of prostaglandins, which are vital for maintaining blood flow in the kidneys, especially in states of reduced blood volume or renal perfusion. When prostaglandin synthesis is inhibited, it can result in renal vasoconstriction, decreased glomerular filtration rate, and worsening of existing kidney injury. In contrast, while headaches can often be treated with NSAIDs, they are not a contraindication in and of themselves. During pregnancy, the use of NSAIDs is typically avoided, especially in the third trimester, due to potential risks to the fetus, but they are not universally contraindicated in all stages. A family history of diabetes does not directly contraindicate the use of NSAIDs, though caution may be warranted in managing patients with diabetes who may have kidney issues.