This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pharmacology
Anaphylactic reaction caused by NSAIDs, all are true, except ? 
Select and explain. 
A. Caused by All NSAIDs, B. COX-2 inhibitors are safe, C. Related to hypersensitivity reaction, D. Not related to inhibition of COX
B: COX-2 inhibitors are safe
Answer: B: COX-2 inhibitors are safe 
Explanation: Ans. is 'b' i.e., COX-2 inhibitors are safe(Ref: Clinical pharmacology 3d/e p.786)Anaphylactic reaction (anaphylaxis)It is dre to immediate (type-L) hypersensitivity involving cross linking of drug-specific IgE.Regardless of COX selectivity pattern, NSAIDs may function as haptens capable of inducing allergic sensitization.Thus, all COX inhibitors (nonselective or selective) can cause this reaction.