Which one of the following analgesic drug lacks anti-inflammatory action? & x20; - RRB Nsg. Superintendent-21 July 2019 (Shift-2nd)

RRB Nsg. Superintendent-21 July 2019 (Shift-2nd)

Pharmacology

Easy

Appeared in: RRB Nsg. Superintendent-21 July 2019 (Shift-2nd)

Explanation

Paracetamol is an analgesic (pain reliever) and antipyretic (fever reducer) that possesses negligible or very weak anti-inflammatory properties.
Its mechanism of action is primarily central, inhibiting cyclooxygenase (COX) enzymes in the brain.
Unlike NSAIDs, it is a weak inhibitor of COX in peripheral tissues, where inflammatory mediators like prostaglandins are produced, making it ineffective for treating inflammation.

Option A: Piroxicam is a potent Non-Steroidal Anti-Inflammatory Drug (NSAID) of the oxicam class. It has strong anti-inflammatory, analgesic, and antipyretic properties.
Option B: Ibuprofen is a widely used NSAID of the propionic acid derivative class. It is well-known for its effective anti-inflammatory, analgesic, and antipyretic actions.
Option C: Diclofenac sodium is a potent NSAID (aryl-acetic acid derivative) that strongly inhibits prostaglandin synthesis, providing powerful anti-inflammatory effects.

Visual 1: Diagram: Illustrating the mechanism of action of Paracetamol versus NSAIDs. The diagram would show Paracetamol primarily inhibiting COX in the CNS, while NSAIDs inhibit COX in both the CNS and peripheral tissues at the site of inflammation.
Visual 2: Flowchart: A decision tree for selecting an analgesic, showing the initial choice between Paracetamol (for non-inflammatory pain/fever) and an NSAID (when inflammation is present).

Clinical Relevance

Nursing practice connection: Knowing Pharmacology of Analgesics and Anti-inflammatory Drugs helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
This distinction is critical for safe nursing practice. Paracetamol is the preferred analgesic/antipyretic for patients with contraindications to NSAIDs, such as those with peptic ulcer disease, bleeding disorders, asthma exacerbated by aspirin, or certain renal conditions.
Nurses must educate patients that while Paracetamol can relieve pain from an injury like a sprained ankle, it will not reduce the swelling; an NSAID would be needed for that.
What if? If a patient presents with acute inflammatory arthritis (e.g., a gout flare-up), administering only Paracetamol would be inappropriate as it would not address the underlying inflammation. The correct management would involve an NSAID like Diclofenac or Ibuprofen to control both pain and inflammation.

How to Approach the Question

First, analyze the question to identify the key requirement: the drug must be an analgesic but 'lack' anti-inflammatory action.
Second, recall the major classes of common, non-opioid analgesics: para-aminophenol derivatives (like Paracetamol) and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).
Third, remember the defining characteristic of each class. The name 'NSAID' itself tells you they are anti-inflammatory. Paracetamol is the primary analgesic that is not an NSAID.
Fourth, classify each option. Piroxicam, Ibuprofen, and Diclofenac are all classic NSAIDs. Paracetamol is the only option that does not fit this category.
Finally, conclude that Paracetamol is the correct answer as it is the only drug listed that is known for its analgesic and antipyretic effects without significant anti-inflammatory action.

Concept Tested & Keywords

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