Anti-inflammatory agents – Aspirin MCQs With Answer

Anti-inflammatory agents – Aspirin MCQs With Answer

Aspirin (acetylsalicylic acid) is a foundational anti-inflammatory agent studied extensively in B. Pharm curricula for its unique pharmacology, clinical uses, and safety profile. This concise introduction covers mechanism of action (irreversible COX inhibition), pharmacokinetics, therapeutic doses (analgesic, anti-inflammatory, antiplatelet), major adverse effects (GI bleeding, Reye’s syndrome, salicylate toxicity), and significant drug interactions. Understanding aspirin’s role in prostaglandin and thromboxane pathways, metabolic fate to salicylic acid, and management of overdose is essential for pharmacists. These MCQs focus on depth and application to help B. Pharm students prepare for exams and clinical practice. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. What is the chemical name of aspirin?

• Acetylsalicylic acid
• Salicylic acid
• Acetaminophen
• Benzoyl peroxide

Correct Answer: Acetylsalicylic acid

Q2. What is the primary mechanism by which aspirin exerts its anti-inflammatory effect?

• Reversible inhibition of lipoxygenase
• Irreversible acetylation of cyclooxygenase (COX) enzymes
• Activation of phospholipase A2
• Blockade of nitric oxide synthase

Correct Answer: Irreversible acetylation of cyclooxygenase (COX) enzymes

Q3. Aspirin preferentially inhibits which COX isoforms?

• COX-3 only
• COX-2 only
• COX-1 and COX-2
• 5-Lipoxygenase

Correct Answer: COX-1 and COX-2

Q4. How does aspirin produce its antiplatelet effect?

• Enhances platelet ADP uptake
• Inhibits thromboxane A2 synthesis in platelets
• Stimulates prostacyclin release from platelets
• Blocks platelet glycoprotein IIb/IIIa receptors

Correct Answer: Inhibits thromboxane A2 synthesis in platelets

Q5. Which therapeutic class does aspirin belong to?

• Opioid analgesic
• Nonsteroidal anti-inflammatory drug (NSAID)
• Beta-lactam antibiotic
• Selective serotonin reuptake inhibitor

Correct Answer: Nonsteroidal anti-inflammatory drug (NSAID)

Q6. What is the primary active metabolite responsible for most of aspirin’s anti-inflammatory actions?

• Acetaminophen
• Salicylic acid
• Benzoic acid
• p-Aminophenol

Correct Answer: Salicylic acid

Q7. Which acid-base disturbance is characteristically seen in early salicylate overdose?

• Metabolic alkalosis only
• Respiratory alkalosis followed by metabolic acidosis
• Metabolic acidosis only
• Respiratory acidosis

Correct Answer: Respiratory alkalosis followed by metabolic acidosis

Q8. Aspirin use in children with viral infections is strongly associated with which serious complication?

• Stevens-Johnson syndrome
• Reye’s syndrome
• Anaphylactic shock
• Juvenile rheumatoid arthritis

Correct Answer: Reye’s syndrome

Q9. Which condition is a major contraindication for regular aspirin therapy?

• Controlled hypertension
• History of peptic ulcer bleeding
• Hyperlipidemia treated with statins
• Stable hypothyroidism

Correct Answer: History of peptic ulcer bleeding

Q10. Approximate time to peak plasma concentration of immediate-release aspirin after oral administration?

• 15 minutes
• 1 hour
• 4 hours
• 8 hours

Correct Answer: 1 hour

Q11. Aspirin acetylates which amino acid residue on the COX enzyme to inhibit it?

• Lysine
• Serine
• Cysteine
• Tyrosine

Correct Answer: Serine

Q12. How long does a single low dose of aspirin inhibit platelet function?

• 2–4 hours
• 24 hours
• 7–10 days (life span of platelets)
• 30 days

Correct Answer: 7–10 days (life span of platelets)

Q13. Gastrointestinal bleeding with aspirin is mainly due to inhibition of which protective mediators?

• Histamine
• Gastrin
• Prostaglandins (e.g., PGE2) produced by COX-1
• Somatostatin

Correct Answer: Prostaglandins (e.g., PGE2) produced by COX-1

Q14. What is the main effect of enteric-coated aspirin compared with plain aspirin?

• Increases systemic bioavailability dramatically
• Eliminates antiplatelet effect
• Delays absorption and may reduce gastric irritation
• Converts aspirin into salicylamide

Correct Answer: Delays absorption and may reduce gastric irritation

Q15. Which daily aspirin dose is commonly used for long-term antiplatelet therapy?

• 10 mg
• 75–100 mg
• 500–1000 mg
• 4 g

Correct Answer: 75–100 mg

Q16. Aspirin reduces formation of which intermediate prostaglandin metabolite?

• Leukotriene B4
• Prostaglandin H2 (PGH2)
• Histamine
• Thrombin

Correct Answer: Prostaglandin H2 (PGH2)

Q17. How do low doses of aspirin affect uric acid excretion?

• Increase uric acid excretion (uricosuric)
• No change in uric acid handling
• Decrease uric acid excretion (reduces renal clearance)
• Lower serum uric acid by promoting degradation

Correct Answer: Decrease uric acid excretion (reduces renal clearance)

Q18. What is the most definitive treatment for severe salicylate poisoning with life-threatening acid-base disturbance?

• Activated charcoal only
• Intravenous bicarbonate and supportive care; hemodialysis if severe
• Gastric lavage only
• Oral antidote to salicylate

Correct Answer: Intravenous bicarbonate and supportive care; hemodialysis if severe

Q19. Why is aspirin generally avoided in late pregnancy?

• Causes maternal hypertension
• May cause premature closure of the fetal ductus arteriosus
• Induces labor early in all cases
• Leads to fetal hyperglycemia

Correct Answer: May cause premature closure of the fetal ductus arteriosus

Q20. Aspirin increases bleeding risk when combined with which anticoagulant?

• Metformin
• Warfarin
• Propranolol
• Omeprazole

Correct Answer: Warfarin

Q21. Aspirin is hydrolyzed to salicylic acid primarily by which mechanism?

• Cytochrome P450 oxidation
• Plasma and hepatic esterases (non-enzymatic hydrolysis also contributes)
• Glutathione conjugation
• Beta-lactamase activity

Correct Answer: Plasma and hepatic esterases (non-enzymatic hydrolysis also contributes)

Q22. Is aspirin’s inhibition of platelet COX reversible or irreversible?

• Reversible competitive inhibition
• Irreversible acetylation
• Allosteric activation
• No effect on platelets

Correct Answer: Irreversible acetylation

Q23. What is the approximate pKa of aspirin (acetylsalicylic acid)?

• 1.0
• 3.5
• 7.4
• 10.5

Correct Answer: 3.5

Q24. Aspirin-acetylated COX-2 can generate which anti-inflammatory lipid mediator?

• Leukotriene B4
• 15-epi-lipoxin (aspirin-triggered lipoxin)
• Prostaglandin E2
• Thromboxane A3

Correct Answer: 15-epi-lipoxin (aspirin-triggered lipoxin)

Q25. Which laboratory test is used to monitor salicylate toxicity?

• Serum acetaminophen level
• Serum salicylate level
• Blood ethanol level
• Serum alkaline phosphatase only

Correct Answer: Serum salicylate level

Q26. Concurrent use of which NSAID can interfere with aspirin’s antiplatelet action?

• Ibuprofen
• Naproxen sodium (one-time dosing never affects aspirin)
• Acetaminophen
• Allopurinol

Correct Answer: Ibuprofen

Q27. Which of the following hemostatic tests is most likely to be prolonged by aspirin?

• Prothrombin time (PT)
• Activated partial thromboplastin time (aPTT)
• Bleeding time
• Serum fibrinogen level

Correct Answer: Bleeding time

Q28. Which analgesic is NOT classified as an NSAID?

• Ibuprofen
• Diclofenac
• Acetaminophen (paracetamol)
• Aspirin

Correct Answer: Acetaminophen (paracetamol)

Q29. Analgesic action of aspirin is primarily due to inhibition of prostaglandin synthesis that normally does what at nociceptors?

• Directly blocks sodium channels
• Sensitizes nociceptors to inflammatory mediators
• Destroys nociceptor neurons
• Stimulates opioid receptors

Correct Answer: Sensitizes nociceptors to inflammatory mediators

Q30. Aspirin reduces fever by acting on which central mechanism?

• Stimulating heat production in muscles
• Resetting the hypothalamic set point via decreased prostaglandin E2
• Blocking cholinergic receptors in sweat glands
• Inhibiting thyroid hormone release

Correct Answer: Resetting the hypothalamic set point via decreased prostaglandin E2

Q31. What is an approximate daily dose range used for anti-inflammatory effects of aspirin in adults?

• 50–100 mg/day
• 300–1000 mg/day
• 3–4 g/day
• 10 g/day

Correct Answer: 3–4 g/day

Q32. Which statement best describes salicylate pharmacokinetics?

• Always follows zero-order kinetics at therapeutic doses
• First-order elimination at low doses and mixed/zero-order at high toxic doses
• Eliminated solely by pulmonary excretion
• Not metabolized in the liver

Correct Answer: First-order elimination at low doses and mixed/zero-order at high toxic doses

Q33. How many days before elective surgery is aspirin usually discontinued to reduce bleeding risk?

• 1 day
• 3 days
• 7 days
• 30 days

Correct Answer: 7 days

Q34. Aspirin can impair renal function by inhibiting which protective mechanism in the kidney?

• Angiotensin II production
• Prostaglandin-mediated vasodilation of the afferent arteriole
• ADH secretion
• Renin release solely in the brain

Correct Answer: Prostaglandin-mediated vasodilation of the afferent arteriole

Q35. Which early symptom is a classic sign of salicylate toxicity?

• Jaundice
• Tinnitus
• Bradycardia
• Hypothermia

Correct Answer: Tinnitus

Q36. Aspirin is converted to salicylic acid which is primarily responsible for which effects?

• Antiplatelet action exclusively
• Most anti-inflammatory and analgesic effects
• Selective beta-adrenergic blockade
• Antibiotic activity

Correct Answer: Most anti-inflammatory and analgesic effects

Q37. Aspirin shows greater inhibitory potency for which COX isoform at low doses?

• COX-3
• COX-2
• COX-1
• 5-Lipoxygenase

Correct Answer: COX-1

Q38. In Kawasaki disease, aspirin is used primarily to:

• Treat bacterial infection
• Reduce inflammation and prevent coronary thrombosis
• Increase platelet production
• Lower blood glucose

Correct Answer: Reduce inflammation and prevent coronary thrombosis

Q39. Aspirin-exacerbated respiratory disease (AERD) is thought to result from:

• IgE-mediated allergy to salicylates
• Shunting of arachidonic acid to leukotriene production causing bronchospasm
• Direct histamine release from mast cells only
• Excess prostacyclin formation

Correct Answer: Shunting of arachidonic acid to leukotriene production causing bronchospasm

Q40. Which co-therapy is commonly used to reduce the risk of aspirin-induced gastric ulcers?

• Loop diuretic
• Proton pump inhibitor (PPI)
• Beta blocker
• Statin

Correct Answer: Proton pump inhibitor (PPI)

Q41. Aspirin specifically impairs platelet aggregation response to which agonist?

• Thrombin only
• Arachidonic acid
• Collagen but not arachidonic acid
• ADP exclusively

Correct Answer: Arachidonic acid

Q42. Which organ is the major site for conjugation and metabolism of salicylates?

• Kidney
• Liver
• Lung
• Spleen

Correct Answer: Liver

Q43. Which form of salicylate is more water-soluble and often used when higher solubility is required?

• Acetylsalicylic acid (aspirin)
• Sodium salicylate
• Methyl salicylate
• Salicylamide

Correct Answer: Sodium salicylate

Q44. Which laboratory parameter is least likely to be significantly altered by aspirin at therapeutic doses?

• Bleeding time
• Platelet aggregation to arachidonic acid
• Serum salicylate concentration
• Prothrombin time (PT)

Correct Answer: Prothrombin time (PT)

Q45. Why does low-dose aspirin preferentially inhibit thromboxane A2 over endothelial prostacyclin (PGI2)?

• Platelets lack nuclei and cannot resynthesize COX, while endothelial cells can
• Platelets do not contain COX enzymes
• Endothelial COX has a different active site that aspirin cannot acetylate
• Aspirin is actively transported into platelets only

Correct Answer: Platelets lack nuclei and cannot resynthesize COX, while endothelial cells can

Q46. Maternal use of aspirin near term can cause which fetal complication?

• Neural tube defects
• Premature closure of the ductus arteriosus
• Fetal hyperthyroidism
• Excessive fetal growth

Correct Answer: Premature closure of the ductus arteriosus

Q47. The triad characteristic of aspirin-exacerbated respiratory disease includes:

• Hypertension, tachycardia, urticaria
• Asthma, nasal polyps, aspirin sensitivity
• Renal failure, anemia, thrombocytopenia
• Migraine, photophobia, nausea

Correct Answer: Asthma, nasal polyps, aspirin sensitivity

Q48. Inhibition of COX enzymes by aspirin diverts arachidonic acid metabolism toward which pathway?

• CYP450 hydroxylation
• 5-Lipoxygenase pathway leading to leukotrienes
• Sphingolipid synthesis
• Cholesterol biosynthesis

Correct Answer: 5-Lipoxygenase pathway leading to leukotrienes

Q49. Aspirin’s chemical precursor in traditional medicine was derived from which natural source?

• Willow bark (salicin)
• Tea leaves
• Coal tar
• Fermented soy

Correct Answer: Willow bark (salicin)

Q50. Which drug can be co-prescribed to replace protective prostaglandins and help prevent aspirin-induced gastric ulcers?

• Misoprostol
• Metoclopramide
• Amoxicillin
• Spironolactone

Correct Answer: Misoprostol

G S Sachin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.

Mail- Sachin@pharmacyfreak.com