Which statement about acetaminophen (paracetamol) is correct regarding its anti-inflammatory activity?
- A It lacks significant anti-inflammatory activity because it poorly inhibits peripheral COX in the presence of peroxides ✓
- B It has potent peripheral anti-inflammatory action comparable to ibuprofen
- C It inhibits COX-2 selectively, giving anti-inflammatory but not analgesic effect
- D It reduces inflammation by blocking leukotriene synthesis like zileuton
Correct answer: A. It lacks significant anti-inflammatory activity because it poorly inhibits peripheral COX in the presence of peroxides
Explanation
Paracetamol is a weak inhibitor of peripheral COX-1 and COX-2 because peroxides present at sites of inflammation reduce its efficacy. It acts centrally (likely on a COX variant or endocannabinoid system) for analgesia and antipyresis, but it has negligible peripheral anti-inflammatory activity. This is why it is classified as an analgesic-antipyretic, not an NSAID.
Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.
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