NSAID renal impairment — FRCA Primary MCQ

Correct answer: D — It inhibits prostaglandin synthesis

NSAIDs reduce prostaglandin-mediated afferent arteriolar vasodilation, risking renal hypoperfusion. It blocks voltage-gated sodium channels is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. It undergoes Hofmann elimination is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. It is hydrolysed by nonspecific esterases is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. It stimulates intracellular potassium uptake is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. In Primary FRCA pharmacology, link the clinical effect to the receptor, distribution or elimination mechanism rather than memorising isolated facts.

Reference: Peck, Hill & Williams Pharmacology for Anaesthesia and Intensive Care; BNF; Primary FRCA textbooks