This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Autacoids, Subject name: Pharmacology
[{'content': 'Most specific drug used for NSAID induced peptic ulcer \nSelect and explain. \nA. Misoprostol, B. Proton pump inhibitors, C. H2 blockers, D. Mucaine gel', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Gastric mucosal damage:- Gastric pain, mucosal erosion/ulceration and blood loss are produced by all NSAIDs to varying extents. Mech of peptic ulcer formation:- Inhibition of COX-1 mediated synthesis of gastroprotective PGs (PGE2, PGI2) is clearly involved. Deficiency of PGs reduces mucus and HCO3- secrection, tends to enhance acid secretion and may promote mucosal ischaemia. Thus, NSAIDs enhance aggressive factors and contain defensive factors in gastric mucosa--are ulcerogenic. Paracetamol, a very weak inhibitor of COX is practically free of gastric toxicity and selective COX-2 inhibitors are relatively safer. Treatment:- PGE2 analogue (misoprostol) administered concurrently with NSAIDs counteract their gastric toxicity. DOC for NSAID induced peptic ulcer is PPI. Ref:- kd tripathi;pg num:-194', 'role': 'assistant'}]