A 70-year-old woman with a history of chronic pain is prescribed ibuprofen. Which of the following adverse effects is most commonly associated with prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs)? A) Gastric ulcers B) Hypoglycemia C) Renal failure D) Hyperkalemia E) Hyperlipidemia Correct Answer: A) Gastric ulcers Explanation: NSAIDs like ibuprofen inhibit COX-1 and COX-2 enzymes, leading to reduced prostaglandin synthesis. Prostaglandins protect the gastric mucosa, so inhibition increases the risk of gastric ulcers and GI bleeding. Hypoglycemia (B) is not typically associated with NSAID use. Renal failure (C) can occur with prolonged NSAID use, but gastric ulcers are more common. Hyperkalemia (D) is more associated with ACE inhibitors or potassium-sparing diuretics. Hyperlipidemia (E) is not a common side effect of NSAIDs. Key Tips for PLAB 1: ✅ NSAIDs = Risk of gastric ulcers, renal toxicity, and GI bleeding ✅ Co-treatment = Consider using PPI (proton pump inhibitors) for ulcer prevention in long-term use ✅ Contraindications = Active peptic ulcer disease, renal insufficiency
