Which of the following medications should a patient with asthma and sensitivity to aspirin avoid?

Patients with asthma who have a sensitivity to aspirin, often referred to as aspirin-exacerbated respiratory disease (AERD), should avoid both aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) because these medications can provoke asthma symptoms.

In individuals with this sensitivity, the ingestion of aspirin can lead to bronchoconstriction and an increase in respiratory symptoms, which are potentially dangerous. NSAIDs, including ibuprofen and naproxen, can have a similar effect since they also inhibit the cyclooxygenase (COX) enzymes, leading to a reduced synthesis of prostaglandins that regulate various physiological functions, including bronchial tone.

While acetaminophen is generally considered a safer alternative for pain relief in these patients, it does not share the same risks associated with aspirin and NSAIDs. The other options, including combinations that involve antibiotics or metformin, do not apply directly to the sensitivity issues related to aspirin and NSAIDs for asthma patients. Therefore, the recommendation to avoid both aspirin and NSAIDs is crucial for managing asthma effectively in sensitive patients.