Prescribing Safety Assessment (PSA) Practice Exam

Why are NSAIDs generally contraindicated for asthmatic patients?

1. They can cause respiratory depression

2. They increase airway inflammation

3. They can lead to bronchoconstriction

4. They aggravate heart conditions

The correct answer is: They can lead to bronchoconstriction

Nonsteroidal anti-inflammatory drugs (NSAIDs) can lead to bronchoconstriction in asthmatic patients due to their effects on the body's inflammatory pathways. In individuals with asthma, the respiratory system is already sensitive and reactive. NSAIDs, such as ibuprofen and aspirin, inhibit the enzyme cyclooxygenase (COX), which plays a role in the production of prostaglandins. Prostaglandins are involved in maintaining bronchial tone and modulating inflammation in the airways. For some asthmatic individuals, particularly those with a history of NSAID-induced bronchospasm, the inhibition of these prostaglandins can lead to an increase in leukotriene production. Leukotrienes are inflammatory mediators that can cause bronchoconstriction, leading to difficulty in breathing and exacerbation of asthma symptoms. Therefore, the potential for NSAIDs to induce bronchoconstriction is a significant concern, making them generally contraindicated for patients with asthma to avoid triggering an asthma attack.