Which of the following drug aggravate bronchial asthma cotrimoxazole , co amoxiclav ,chloramphenicol , aspirin
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The answer is confirmed. Here is the full explanation:
Answer: Aspirin
Among the four options - cotrimoxazole, co-amoxiclav, chloramphenicol, and aspirin - aspirin is the drug that aggravates bronchial asthma.
Why Aspirin Causes Asthma Exacerbation
Aspirin inhibits cyclooxygenase (COX-1), which blocks prostaglandin synthesis. This has two consequences:
- Loss of bronchodilatory prostaglandins (e.g., PGE2) - these normally help keep airways open.
- Shunting of arachidonic acid to the lipoxygenase (5-LOX) pathway, producing excess leukotrienes (LTC4, LTD4, LTE4) - potent bronchoconstrictors and pro-inflammatory mediators.
This leads to the clinical syndrome called Aspirin-Exacerbated Respiratory Disease (AERD), also known as Samter's Triad, consisting of:
- Bronchial asthma
- Recurrent rhinitis / nasal polyps
- Aspirin/NSAID hypersensitivity with urticaria and bronchospasm
As stated in Robbins & Kumar Basic Pathology: "Several pharmacologic agents provoke asthma, aspirin being the most striking example... likely to involve some abnormality in prostaglandin metabolism stemming from inhibition of cyclo-oxygenase by aspirin."
Why the Others Do NOT Aggravate Asthma
| Drug | Class | Asthma effect |
|---|---|---|
| Cotrimoxazole (sulfamethoxazole + trimethoprim) | Antibiotic (sulfonamide + DHFR inhibitor) | No COX inhibition; does not aggravate asthma |
| Co-amoxiclav (amoxicillin + clavulanate) | Beta-lactam antibiotic | No bronchospasm mechanism |
| Chloramphenicol | Bacteriostatic antibiotic (50S ribosome inhibitor) | No bronchospasm mechanism |
| Aspirin | NSAID / COX inhibitor | Aggravates asthma via leukotriene overproduction |
Note: Beta-blockers are the other major drug class that aggravates asthma (by blocking beta-2 adrenoceptors), but none of those are in this question.
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