Anti-inflammatory agents – Naproxen MCQs With Answer

Anti-inflammatory agents – Naproxen MCQs With Answer

This concise, SEO-friendly introduction helps B.Pharm students master Naproxen and anti-inflammatory agents through focused topics like mechanism of action, pharmacokinetics, metabolism, adverse effects, drug interactions, clinical uses, dosing, and formulation differences. Emphasis on keywords—Naproxen, anti-inflammatory agents, NSAIDs, COX inhibition, pharmacology, adverse effects, and B.Pharm MCQs—makes this resource ideal for exam preparation and quick revision. The material balances clinical relevance and molecular details, including enterohepatic recycling, protein binding, renal and cardiovascular safety concerns, and comparison with other NSAIDs. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which enzyme is primarily inhibited by Naproxen to exert its anti-inflammatory effect?

• Cyclooxygenase-1 (COX-1)
• Cyclooxygenase-2 (COX-2)
• 5-Lipoxygenase (5-LOX)
• Phospholipase A2

Correct Answer: Cyclooxygenase-1 (COX-1)

Q2. What is the predominant mechanism responsible for Naproxen’s analgesic action?

• Inhibition of prostaglandin synthesis
• Blocking opioid receptors
• Activation of GABAergic pathways
• Stimulation of adrenergic receptors

Correct Answer: Inhibition of prostaglandin synthesis

Q3. Which pharmacokinetic property of Naproxen explains its twice-daily dosing in many patients?

• High first-pass metabolism
• Long elimination half-life (~12-17 hours)
• Rapid renal excretion
• Poor oral absorption

Correct Answer: Long elimination half-life (~12-17 hours)

Q4. Naproxen is classified chemically as which type of NSAID?

• Propionic acid derivative
• Acetic acid derivative
• Fenamate
• Oxicam

Correct Answer: Propionic acid derivative

Q5. Which route is the primary route of elimination for Naproxen and its metabolites?

• Renal excretion
• Fecal excretion via bile
• Pulmonary exhalation
• Salivary secretion

Correct Answer: Renal excretion

Q6. High plasma protein binding of Naproxen is clinically important because it can cause which interaction?

• Displacement of other highly protein-bound drugs
• Increased hepatic metabolism of other drugs
• Direct inhibition of renal tubular secretion of penicillin
• Enhanced absorption of coadministered drugs

Correct Answer: Displacement of other highly protein-bound drugs

Q7. Which adverse effect is most commonly associated with Naproxen use?

• Gastrointestinal ulceration and dyspepsia
• Severe hypoglycemia
• Significant hair loss
• Ototoxicity

Correct Answer: Gastrointestinal ulceration and dyspepsia

Q8. Which patient condition is a relative contraindication for Naproxen?

• Peptic ulcer disease
• Seasonal allergic rhinitis
• Mild intermittent asthma without NSAID sensitivity
• Vitamin B12 deficiency

Correct Answer: Peptic ulcer disease

Q9. Naproxen’s risk of cardiovascular events compared with some selective COX-2 inhibitors is generally considered to be:

• Lower than many COX-2 selective inhibitors
• Higher than all other NSAIDs
• Equivalent to aspirin at low doses
• Non-existent

Correct Answer: Lower than many COX-2 selective inhibitors

Q10. Which metabolizing organ and reaction play a major role in Naproxen clearance?

• Hepatic glucuronidation in the liver
• Pulmonary oxidation in the lungs
• Renal acetylation in the kidney
• Intestinal hydrolysis by gut flora

Correct Answer: Hepatic glucuronidation in the liver

Q11. Which laboratory parameter should be monitored in long-term Naproxen therapy?

• Serum creatinine and renal function
• Serum sodium concentration only
• Pulmonary function tests
• Fasting blood glucose exclusively

Correct Answer: Serum creatinine and renal function

Q12. Naproxen is often preferred over other NSAIDs for which condition due to its duration of action?

• Rheumatoid arthritis with chronic pain control
• Acute bacterial infection
• Parkinson’s disease tremor
• Hyperthyroidism

Correct Answer: Rheumatoid arthritis with chronic pain control

Q13. A major drug interaction concern when Naproxen is coadministered with ACE inhibitors is:

• Reduced antihypertensive efficacy and potential renal impairment
• Enhanced cough suppression
• Increased ACE inhibitor absorption
• Prolonged ACE inhibitor half-life causing toxicity

Correct Answer: Reduced antihypertensive efficacy and potential renal impairment

Q14. Which patient population requires caution or avoidance of Naproxen due to increased bleeding risk?

• Patients on chronic warfarin therapy
• Patients taking multivitamins
• Patients with controlled epilepsy
• Patients with hypothyroidism

Correct Answer: Patients on chronic warfarin therapy

Q15. Which of the following describes Naproxen’s effect on platelet function?

• Reversible inhibition of platelet aggregation
• Irreversible inhibition similar to aspirin
• No effect on platelets
• Enhancement of platelet aggregation

Correct Answer: Reversible inhibition of platelet aggregation

Q16. Which formulation strategy can improve Naproxen’s gastric tolerability?

• Enteric-coated or delayed-release formulation
• Intramuscular oily depot formulation
• Topical transdermal patch only
• Rapid-dissolve immediate release tablet

Correct Answer: Enteric-coated or delayed-release formulation

Q17. Which is a common therapeutic indication for Naproxen?

• Acute gout attacks and musculoskeletal pain
• Type 1 diabetes mellitus control
• Antiviral prophylaxis
• Anticoagulation therapy

Correct Answer: Acute gout attacks and musculoskeletal pain

Q18. Which statement about Naproxen’s COX selectivity is correct?

• Naproxen is relatively non-selective, inhibiting both COX-1 and COX-2
• Naproxen is highly selective for COX-2 only
• Naproxen selectively inhibits lipoxygenase enzymes
• Naproxen exclusively inhibits COX-3

Correct Answer: Naproxen is relatively non-selective, inhibiting both COX-1 and COX-2

Q19. Which adverse renal effect may occur with Naproxen, particularly in volume-depleted patients?

• Acute kidney injury due to reduced prostaglandin-mediated renal perfusion
• Nephrogenic diabetes insipidus
• Renal tubular acidosis type I only
• Immediate renal carcinoma

Correct Answer: Acute kidney injury due to reduced prostaglandin-mediated renal perfusion

Q20. Which pregnancy category or guidance is generally recommended for NSAID use like Naproxen in the third trimester?

• Avoid use due to risk of premature closure of ductus arteriosus
• Safe and recommended throughout pregnancy
• Indicated to prevent preeclampsia
• Only topical use is contraindicated

Correct Answer: Avoid use due to risk of premature closure of ductus arteriosus

Q21. Naproxen’s stereochemistry includes which characteristic relevant to activity?

• It is a single S-enantiomer active form
• It exists only as a racemic amine
• It is an achiral molecule
• It is active only as a cyclic dimer

Correct Answer: It is a single S-enantiomer active form

Q22. In overdose management of Naproxen, which supportive measure is most important?

• Activated charcoal if presented early
• Forced diuresis as first-line always
• Immediate hemodialysis for all patients
• Administration of naloxone

Correct Answer: Activated charcoal if presented early

Q23. Which drug interaction increases Naproxen concentration by inhibiting its metabolism?

• Cimetidine (via hepatic enzyme inhibition)
• Antacids neutralizing pH
• Laxatives increasing transit time
• Bisphosphonates reducing bone uptake

Correct Answer: Cimetidine (via hepatic enzyme inhibition)

Q24. The risk of NSAID-induced peptic ulcers can be reduced by co-prescribing which medication?

• Proton pump inhibitors (e.g., omeprazole)
• Alpha-glucosidase inhibitors
• Loop diuretics
• Beta-lactam antibiotics

Correct Answer: Proton pump inhibitors (e.g., omeprazole)

Q25. Naproxen’s bioavailability after oral administration is best described as:

• High and rapid with good absorption
• Negligible due to poor solubility
• Only bioavailable with food
• Zero because it is not orally active

Correct Answer: High and rapid with good absorption

Q26. In elderly patients, Naproxen dosing should be adjusted because of increased risk of:

• Gastrointestinal bleeding and renal impairment
• Increased muscle mass
• Enhanced cognitive function
• Higher metabolic clearance requiring higher doses

Correct Answer: Gastrointestinal bleeding and renal impairment

Q27. Which enzyme polymorphism might theoretically affect Naproxen metabolism?

• UGT polymorphisms affecting glucuronidation
• Monoamine oxidase polymorphisms
• Acetylcholinesterase variants
• Ribonuclease polymorphisms

Correct Answer: UGT polymorphisms affecting glucuronidation

Q28. Which statement describes Naproxen’s enterohepatic recycling relevance?

• Enterohepatic recycling may prolong drug exposure and half-life
• It prevents any biliary excretion of the drug
• It causes immediate renal clearance only
• It eliminates the need for hepatic metabolism

Correct Answer: Enterohepatic recycling may prolong drug exposure and half-life

Q29. For topical inflammatory conditions, which Naproxen formulation is sometimes used?

• Topical gel or cream containing Naproxen sodium
• Intravenous Naproxen solution for topical use
• Transmucosal Naproxen syrup
• Inhaled Naproxen aerosol

Correct Answer: Topical gel or cream containing Naproxen sodium

Q30. Which is an important counseling point when a patient starts Naproxen?

• Take with food or milk to reduce gastric irritation
• Always take on an empty stomach for best effect
• Stop all antihypertensive medications immediately
• There is no interaction with anticoagulants

Correct Answer: Take with food or milk to reduce gastric irritation

Q31. Naproxen sodium differs from Naproxen acid mainly in:

• Faster onset of action due to increased solubility
• Complete inactivity compared to Naproxen acid
• Different mechanism of action targeting COX-3
• Exclusive topical use only

Correct Answer: Faster onset of action due to increased solubility

Q32. Which condition may be exacerbated by Naproxen due to prostaglandin inhibition?

• Hypertension and fluid retention
• Hypotension requiring pressors
• Improved glycemic control in diabetes
• Reduced risk of pulmonary embolism

Correct Answer: Hypertension and fluid retention

Q33. Compared to ibuprofen, Naproxen is often considered to have:

• Longer duration of action and similar GI risk profile
• Much lower GI risk and no renal effects
• Shorter half-life requiring dosing every 2 hours
• Exclusive COX-2 selectivity

Correct Answer: Longer duration of action and similar GI risk profile

Q34. Which symptom suggests an allergic reaction to Naproxen?

• Urticaria, bronchospasm, or angioedema
• Improved joint mobility
• Mild thirst after dosing
• Enhanced appetite

Correct Answer: Urticaria, bronchospasm, or angioedema

Q35. Why is Naproxen use associated with caution in asthma patients with NSAID sensitivity?

• It can precipitate bronchospasm by shifting arachidonic acid to leukotriene pathway
• It directly blocks beta-2 receptors causing bronchoconstriction
• It increases blood glucose worsening asthma
• It sedates patients causing respiratory depression

Correct Answer: It can precipitate bronchospasm by shifting arachidonic acid to leukotriene pathway

Q36. Which co-administered drug class increases gastrointestinal bleeding risk with Naproxen?

• Antiplatelet agents like aspirin or clopidogrel
• Topical antifungals
• Oral hypoglycemics only
• Antacids in all cases

Correct Answer: Antiplatelet agents like aspirin or clopidogrel

Q37. Naproxen’s recommended initial adult oral dose for acute pain in many guidelines is approximately:

• 500 mg followed by 250 mg every 6–8 hours as needed
• 50 mg once daily only
• 2000 mg every hour
• 0.5 mg once monthly injection

Correct Answer: 500 mg followed by 250 mg every 6–8 hours as needed

Q38. Which hepatic effect is possible with chronic Naproxen use?

• Elevated liver enzymes and rarely hepatotoxicity
• Definitive prevention of hepatitis
• Complete hepatic regeneration
• Immediate hepatic necrosis in all users

Correct Answer: Elevated liver enzymes and rarely hepatotoxicity

Q39. In pediatric dosing considerations, Naproxen is commonly dosed based on:

• Weight (mg/kg) with age-appropriate formulations
• Fixed adult dose regardless of weight
• Only by surface area without regard to age
• Height in centimeters exclusively

Correct Answer: Weight (mg/kg) with age-appropriate formulations

Q40. Which monitoring advice is important for long-term Naproxen therapy in patients with cardiovascular disease?

• Monitor blood pressure and signs of fluid retention
• No monitoring needed as it is CV-safe
• Only monitor for hearing loss
• Discontinue all antihypertensives immediately

Correct Answer: Monitor blood pressure and signs of fluid retention

Q41. Which lab test may be prolonged if Naproxen displaces anticoagulants from plasma proteins?

• Prothrombin time (PT/INR) when on warfarin
• Thyroid stimulating hormone only
• Random blood glucose exclusively
• Serum magnesium concentration

Correct Answer: Prothrombin time (PT/INR) when on warfarin

Q42. Which metabolic product is formed during hepatic metabolism of Naproxen?

• Naproxen glucuronide conjugate
• Naproxen sulfate exclusively
• Unchanged Naproxen only, without metabolites
• Oxidized nitro-naproxen radical

Correct Answer: Naproxen glucuronide conjugate

Q43. Which factor enhances the risk of NSAID-induced renal complications when using Naproxen?

• Concomitant use of diuretics and ACE inhibitors
• High dietary fiber intake
• Daily multivitamin supplementation
• Regular aerobic exercise

Correct Answer: Concomitant use of diuretics and ACE inhibitors

Q44. Naproxen’s analgesic and antipyretic efficacy is due to reduction in which mediators?

• Prostaglandins (e.g., PGE2)
• Insulin and glucagon
• Serotonin only
• Endorphins

Correct Answer: Prostaglandins (e.g., PGE2)

Q45. A patient with a history of aspirin-exacerbated respiratory disease should:

• Avoid Naproxen and other NSAIDs that inhibit COX-1
• Prefer Naproxen because it is safe
• Double the dose for desensitization
• Use Naproxen to prevent asthma attacks

Correct Answer: Avoid Naproxen and other NSAIDs that inhibit COX-1

Q46. For management of acute gout pain, Naproxen therapy is typically started at:

• A moderate to high initial dose to rapidly reduce inflammation
• Microgram doses due to potency
• Only topical application with no oral dosing
• Once monthly intramuscular injection

Correct Answer: A moderate to high initial dose to rapidly reduce inflammation

Q47. Which clinical sign indicates potential serious GI bleeding in a patient taking Naproxen?

• Black tarry stools (melena) or hematemesis
• Mild hiccups after meals
• Improved appetite and weight gain
• Clear urine without changes

Correct Answer: Black tarry stools (melena) or hematemesis

Q48. Which statement about Naproxen and aspirin coadministration is correct?

• Naproxen can interfere with aspirin’s antiplatelet effect if taken concurrently
• Naproxen enhances aspirin’s irreversible platelet inhibition
• They have no pharmacodynamic interaction
• Coadministration eliminates GI risk entirely

Correct Answer: Naproxen can interfere with aspirin’s antiplatelet effect if taken concurrently

Q49. Which is a safe practice when initiating Naproxen in a patient with mild renal impairment?

• Use lowest effective dose and monitor renal function
• Prescribe maximum dose without monitoring
• Avoid all monitoring and continue indefinitely
• Switch to nephrotoxic antibiotics concurrently

Correct Answer: Use lowest effective dose and monitor renal function

Q50. In terms of pharmacology education for B.Pharm students, MCQs on Naproxen should emphasize:

• Mechanism, PK/PD, adverse effects, interactions, and clinical use
• Only brand names without pharmacology
• Superficial facts unrelated to patient safety
• Exclusively dosage forms ignoring mechanism

Correct Answer: Mechanism, PK/PD, adverse effects, interactions, and clinical use

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