Lipid-lowering drugs: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Lipid-lowering drugs

Sample item

A patient started on nicotinic acid for dyslipidaemia complains of intense facial flushing and warmth. Which drug taken beforehand reduces this adverse effect, and why?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Aspirin, by inhibiting prostaglandin D2 synthesis

Niacin-induced flushing is mediated by prostaglandin D2 released from skin cells through a niacin receptor. Aspirin taken before the dose blunts the flush by cyclooxygenase inhibition. Flushing also lessens with continued use.

Option by option

  • A. Aspirin, by inhibiting prostaglandin D2 synthesis (correct)

    Correct. Cyclooxygenase inhibition reduces the prostaglandin mediator of flushing.

  • B. Propranolol, by blocking beta receptors

    Beta-blockers do not address the prostaglandin-mediated vasodilatation.

  • C. Atropine, by blocking muscarinic receptors

    Atropine would add anticholinergic effects and does not block the flush.

  • D. Cetirizine, by blocking H1 receptors fully

    The flush is not mainly histamine-mediated, so H1 blockade gives little benefit.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Aspirin, by inhibiting prostaglandin D2 synthesis. Niacin-induced flushing is mediated by prostaglandin D2 released from skin cells through a niacin receptor.

Why is "Propranolol, by blocking beta receptors" not the answer?

Beta-blockers do not address the prostaglandin-mediated vasodilatation.

Why is "Atropine, by blocking muscarinic receptors" not the answer?

Atropine would add anticholinergic effects and does not block the flush.

Why is "Cetirizine, by blocking H1 receptors fully" not the answer?

The flush is not mainly histamine-mediated, so H1 blockade gives little benefit.

What concept does this question test?

It tests Lipid-lowering drugs in Pharmacology. Aspirin taken before the dose blunts the flush by cyclooxygenase inhibition. Flushing also lessens with continued use.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Lipid-lowering drugs?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.