In Samter's triad, which medication class should be avoided?

In Samter's triad, which medication class should be avoided?

• A. NSAIDs and aspirin
• B. Intranasal corticosteroids
• C. Montelukast
• D. Antihistamines

Answer: (A)

Samter's triad is aspirin-exacerbated respiratory disease, where NSAIDs and aspirin trigger symptoms by inhibiting COX-1 and shunting arachidonic acid toward the 5-lipoxygenase pathway, leading to increased leukotriene production that promotes bronchospasm and worsens nasal polyps. Because of this mechanism, avoiding NSAIDs and aspirin is essential. Other options aren’t inherently contraindicated: intranasal corticosteroids help reduce nasal inflammation and polyps, montelukast blocks leukotriene receptors and can aid control of airway reactivity, and antihistamines address histamine-related allergy symptoms but don’t drive the problem in Samter’s triad.

Samter's triad is aspirin-exacerbated respiratory disease, where NSAIDs and aspirin trigger symptoms by inhibiting COX-1 and shunting arachidonic acid toward the 5-lipoxygenase pathway, leading to increased leukotriene production that promotes bronchospasm and worsens nasal polyps. Because of this mechanism, avoiding NSAIDs and aspirin is essential. Other options aren’t inherently contraindicated: intranasal corticosteroids help reduce nasal inflammation and polyps, montelukast blocks leukotriene receptors and can aid control of airway reactivity, and antihistamines address histamine-related allergy symptoms but don’t drive the problem in Samter’s triad.