In recent years, a class of drugs known as COX-2 inhibitors has

Question

In recent years, a class of drugs known as COX-2 inhibitors has gotten much publicity for the drugs' power to relieve inflammation and pain. These drugs are relatively new to the pharmaceutical industry, their mechanisms of action having been discovered only in 1971. That year, John Vane discovered the relationship between nonsteroidal anti-inflammatory drugs, such as aspirin, and a group of molecules, called prostaglandins, responsible for producing the sensation of pain in the human body, among other functions.

Prostaglandins were first discovered in the 1930s and are now known to be generated by most mammalian tissues in response to external stimuli. Unlike classical hormones that are synthesized in one tissue but act on a distant one, prostaglandins act on the cells that produce them or on cells located close to the prostaglandins’ cells of origin. Aspirin alleviates pain by inhibiting the function of an enzyme called cyclooxygenase or COX; this inhibition prevents the production of prostaglandins. The three forms of this enzyme, COX-1, COX-2, and COX-3, all stimulate the production of prostaglandins, but each serves a different purpose. COX-1 functions to protect the stomach from irritating gastric acids. COX-2 functions to induce inflammation in injured tissue and COX-3 functions to control the sensation of pain. Aspirin and other similar drugs, such as naproxen, inhibit both COX-1 and COX-2, sometimes producing or aggravating stomach ulcers in patients who take them.

In order to eliminate the side effects of aspirin and related drugs, several pharmaceutical companies in the 1990s developed drugs that inhibited only COX-2. However, side effects almost always cropped up, even after clinical trials that seemed to indicate none. This often occurs because trials are conducted within very limited parameters; once the drug has been approved for mass distribution, however, the number of people taking it and the length of time that it is taken increase dramatically. Several COX-2 drugs that have been popular in recent years fit this pattern: initially successful in clinical trials, subsequent studies showed them to have serious, potentially lethal side effects.

Though prostaglandin chemistry and enzymology have been studied for half a century, pinpointing the exact role of the molecules in physiological processes still remains a challenge for researchers. Hence it is not surprising that recent therapeutic attempts to interfere with the formation of certain prostaglandins have produced unexpected side effects. It now seems that the hype surrounding COX-2 drugs may have been premature.   1 
 1. The passage suggest which the following about COX- 2 inhibitors?

A. They fail to protect the stomach from gastric acids that can cause irritation, but protect the body from tissue inflammation.
B. They produce similar side effects as those caused by Naproxen.
C. They were introduced approximately 20 years after the relationship between aspirin and prostaglandins was discovered.
D. They stimulate production of prostaglandins that cause tissue inflammation.
E. They are generated by external stimuli and act on the cells that produce them.

2 
 2. According to the passage, all of the following are true of prostaglandins EXCEPT:

A. They were discovered in the 1930s.
B. They are generated by most mammalian tissues.
C. They produce the sensation of pain in the body, but are also responsible for other bodily functions.
D. They cause side effects that clinical trials failed to detect.
E. Their production is affected by enzymes COX-1, COX- 2, and COX-3.

3 
 3. The author mentions that prostaglandins are generated in response to external stimuli primarily in order to support the contention that

A. Prostaglandins can produce or aggravate stomach ulcers.
B. Prostaglandins act in the same tissue that produces them.
C. Prostaglandins prevent the enzyme cyclooxygenase from functioning.
D. Prostaglandins are significantly different from most mammalian hormones.
E. Prostaglandins are responsible for the human sensation of pain.

4 
 4. The primary purpose of this passage is to

A. explain the therapeutic benefits of a new type of pain reliever
B. initiate a debate concerning the benefits of COX-2 inhibitors
C. warn the public that clinical trials cannot ensure drug safety
D. describe the impetus for and result of COX-2 inhibitors’ introduction
E. introduce research findings to support COX-2 inhibitors over COX-1 inhibitors

BillyZ · Answer

3. The author mentions that prostaglandins are generated in response to external stimuli primarily in order to support the contention that

A. Prostaglandins can produce or aggravate stomach ulcers.
B. Prostaglandins act in the same tissue that produces them.
C. Prostaglandins prevent the enzyme cyclooxygenase from functioning.
D. Prostaglandins are significantly different from most mammalian hormones.
E. Prostaglandins are responsible for the human sensation of pain.

If prostaglandins are a response to external stimuli, or stimuli outside of the body, then that external stimuli must be closely linked to at least one of the major functions of prostaglandin.

(A) Stomach ulcers are produced or aggravated by aspirin and similar drugs, not prostaglandins (and, in fact, these drugs inhibit prostaglandins).

(B) It is mentioned in the passage that “prostaglandins act on the cells that produce them,” but the author does not draw a connection between where prostaglandins act and what (i.e. external stimuli) generates their production.

(C) Paragraph 2 states that aspirin, not prostaglandin, prevents cyclooxygenase from functioning.

(D) Paragraph 2 states that most mammalian hormones "are synthesized in one tissue but act on a distant one" and contrasts prostaglandins, which "act on the cells that produce them" or on other nearby cells. This difference is based upon where the hormones act, not on what the hormones are responding to (whether external stimuli or something else).

(E) CORRECT. Paragraph 1 states that prostaglandins are " responsible for producing the sensation of pain in the human body, among other functions .” In the second paragraph the author mentions that  aspirin alleviates pain by preventing the production of prostaglandins . To bridge the two assertions, the author provides evidence that  prostaglandins are indeed responsible for the sensation of pain , an external stimuli.

BillyZ · Answer

2. According to the passage, all of the following are true of prostaglandins EXCEPT:

A. They were discovered in the 1930s.
B. They are generated by most mammalian tissues.
C. They produce the sensation of pain in the body, but are also responsible for other bodily functions.
D. They cause side effects that clinical trials failed to detect.
E. Their production is affected by enzymes COX-1, COX- 2, and COX-3.

The "True/False" technique is useful for EXCEPT questions. Four of the answer choices will contain information found in the passage; these will be labeled True. One answer choice will contain information not found in the passage; it will be labeled False.

(A) True. Paragraph 2 states “ prostaglandins were first discovered in the 1930s ."

(B) True. Paragraph 2 states prostaglandins are " generated by most mammalian tissues .”

(C) True. Paragraph 1 states that prostaglandins are " responsible for producing the sensation of pain in the human body, among other functions .”

(D) CORRECT. False. The author never claims that prostaglandins cause side effects. According to paragraph 4,  the COX inhibitor drugs, not prostaglandins, caused side effects that went undetected during clinical trials .

(E) True. Paragraph 2 states that “ aspirin alleviates pain by inhibiting... COX; this inhibition prevents the production of prostaglandins " and goes on to list the three forms of the enzyme, COX-1, COX-2, and COX-3.

rohitjha12 · Answer

Hi Experts,

Can you please explain why the answer to Q1 is 'C'? Nowhere in the passage is the mention of COX-2 inhibitor introduction year. For me , the answer should be 'B' as 'Naproxen' inhibits COX 2 also.

Please share your opinion.

Regards,
Rohit

lostin · Answer

These drugs are relatively new to the pharmaceutical industry,   their mechanisms of action having been discovered only in 1971.   That year, John Vane discovered the relationship between nonsteroidal anti-inflammatory drugs, such as aspirin, and a group of molecules, called prostaglandins, responsible for producing the sensation of pain in the human body, among other functions.

Prostaglandins were first discovered in the 1930s and are now known to be generated by most mammalian tissues in response to external stimuli. Unlike classical hormones that are synthesized in one tissue but act on a distant one, prostaglandins act on the cells that produce them or on cells located close to the prostaglandins’ cells of origin. Aspirin alleviates pain by inhibiting the function of an enzyme called cyclooxygenase or COX; this inhibition prevents the production of prostaglandins. The three forms of this enzyme, COX-1, COX-2, and COX-3, all stimulate the production of prostaglandins, but each serves a different purpose. COX-1 functions to protect the stomach from irritating gastric acids. COX-2 functions to induce inflammation in injured tissue and COX-3 functions to control the sensation of pain. Aspirin and other similar drugs, such as naproxen, inhibit both COX-1 and COX-2, sometimes producing or aggravating stomach ulcers in patients who take them.

In order to eliminate the side effects of aspirin and related drugs,   several pharmaceutical companies in the 1990s developed drugs that inhibited only COX-2. 
 
I agree that unless we create a timeline of events and summary, it is easy to miss 20-year difference information.

HimanshuW11 · Answer

2. According to the passage, all of the following are true of prostaglandins EXCEPT:

A. They were discovered in the 1930s.
B. They are generated by most mammalian tissues.
C. They produce the sensation of pain in the body, but are also responsible for other bodily functions.
D. They cause side effects that clinical trials failed to detect.
E. Their production is affected by enzymes COX-1, COX- 2, and COX-3.

The first paragraph introduces COX-2 inhibitors and talks briefly about a 1971 discovery linking aspirin to prostaglandins. Paragraph 2 elaborates on the connections among aspirin, prostaglandins, and the three types of COX enzymes. Paragraph 3 discusses COX-2 inhibitors specifically, both the impetus for creating them and some negative effects. The final paragraph provides caution about the promise of COX-2 inhibitors.

(A) The passage explains the intended benefits behind the development of COX-2 inhibitors, but this is much too narrow to be the main purpose of the passage, particularly when a large part of the passage addresses the negative consequences.

(B) The author does not initiate a “debate.” For a debate, the author must introduce two clear opposing sides. The COX-2 inhibitors were developed to replace the earlier drugs that inhibited both COX-1 and COX-2, but then they were also found to have side effects.

(C) While paragraph 4 states that “Side effects almost always cropped up, even after clinical trials that seemed to indicate none," the author notes this only in the context of explaining the result of COX-2 inhibitors. This is too narrow to be the main purpose of the passage.

(D) CORRECT. This choice reflects the summary above: why COX-2 inhibitors were developed and the result of the drugs' introduction into the marketplace.

(E) This is incorrect because the passage never mentions a drug class of “COX-1 inhibitors.” COX-1 is introduced as an enzyme; it is not a class of drug.

HimanshuW11 · Answer

1. The passage suggest which the following about COX- 2 inhibitors?

A. They fail to protect the stomach from gastric acids that can cause irritation, but protect the body from tissue inflammation.
B. They produce similar side effects as those caused by Naproxen.
C. They were introduced approximately 20 years after the relationship between aspirin and prostaglandins was discovered.
D. They stimulate production of prostaglandins that cause tissue inflammation.
E. They are generated by external stimuli and act on the cells that produce them.

The word "suggests" in the question indicates that this is an inference question. The correct answer, therefore, will not be directly stated in the passage, but it will be based only on information found within the passage, with no outside speculation or assumptions necessary.

(A) Paragraph 2 states that COX-1 enzymes stimulate production of prostaglandins that "protect the stomach from irritating gastric acids.” As stated in paragraph 3, however, COX-2 inhibitors were designed to affect only COX-2; the specific impetus was not to interrupt the beneficial effects of COX-1.

(B) The author never describes the side effects caused by COX-2 and furthermore he states in paragraph 3 that the COX-2 drugs were designed “in order to eliminate the side effects of aspirin and related drugs.” Paragraph 2 states that Naproxen is one of those related drug.

(C) CORRECT. Paragraph 3 states that the drug class known as COX-2 inhibitors was introduced by “several pharmaceutical companies in the 1990s." Paragraph 1 states “their mechanisms of action having been discovered only in 1971." This suggests that approximately 20 years passed between the initial discovery and the introduction of COX-2 inhibitors.

(D) This choice is incorrect as it describes COX-2 enzymes, not COX-2 inhibitors; in addition, the information is directly stated in the passage rather than suggested. Paragraph 2 states that COX-2 appears to stimulate production of prostaglandins that "induce inflammation in injured tissues.”

(E) This choice is incorrect as it describes prostaglandins, not the drug class COX-2 inhibitors. Paragraph 2 states that prostaglandins are "generated by most mammalian tissues in response to external stimuli" and "prostaglandins act on the cells that produce them."

ballest127 · Answer

Hi Experts,

I have a question on Q3.

The passage states about the "Prostaglandins" in the second paragraph.

While at the end of the first paragraph the passage talks about prostaglandins, which are responsible for producing the sensation of pain in the human body
, the second paragraph starts by stating that "Prostaglandins .... and are now known to be generated by most mammalian tissues in response to external stimuli. Unlike classical hormones that are synthesized in one tissue but act on a distant one, prostaglandins act on the cells that produce them or on cells located close to the prostaglandins??? cells of origin"

The two statements are the contexts on which "Prostaglandins" is based.

However, why answer choice B is incorrect, even though it is also based on one of the mentioned context.

Please explain.

Thank you.

CrackverbalGMAT · Answer

Hi

You have identified perfectly the context for the mention of prostaglandin - that it is responsible for the sensation of pain, and how they are different from other hormones.

However, this question deals with the role that "external stimuli" plays. Now, option (B) can be ruled out for 2 reasons:

1) It is not entirely accurate - prostaglandins also act in nearby tissues.
2) More importantly, it is hard to fathom a connection between "acting in the same tissue" and "external stimuli".

On the other hand, pain in the human body is almost always caused by some sort of external stimuli (external, not necessarily to the body, but to the specific cells). It is the body signalling that something is not right ie; "external stimuli". Therefore, this statement better supports the context for prostaglandins being responsible for pain.

Hope this helps.

Hoozan · Answer

EducationAisle  please explain how (C) wins over (A) in question 1?

EducationAisle · Answer

Yeah tricky one. C is relatively easy to conclude. Notice the following sentences:

- their mechanisms of action having been discovered only in 1971. That year, John Vane discovered the relationship between nonsteroidal anti-inflammatory drugs, such as aspirin, and a group of molecules, called prostaglandins

- several pharmaceutical companies in the 1990s developed drugs that inhibited only COX-2

So, COX-2 inhibitors were introduced approximately 20 years after the relationship between aspirin and prostaglandins was discovered. Hence, C.

The one reason why A is perhaps not the best answer is because while I agree that COX-1 functions to protect the stomach from irritating gastric acids, it is just irrelevant to the discussion that COX- 2 inhibitors  fail to protect  the stomach from irritating gastric acids.

It would be interesting however, to also see what OE states.

samarpan.g28 · Answer

In question 4, are we not talking about potential harms and hype about COX-2? In my opinion, option B is correct. Kindly someone explain why D is correct.

Sajjad1994 · Answer

The passage provides information about the introduction of COX-2 inhibitors, starting with the discovery of the relationship between nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and prostaglandins by John Vane in 1971. It explains the role of prostaglandins and the three forms of the enzyme cyclooxygenase (COX-1, COX-2, and COX-3) in the human body. The passage then discusses the development of COX-2 inhibitors in the 1990s as an attempt to eliminate the side effects associated with drugs like aspirin, which inhibit both COX-1 and COX-2. The subsequent revelation of serious side effects in some COX-2 inhibitors, despite initially successful clinical trials, is also discussed. Overall, the passage aims to describe the reasons behind the introduction of COX-2 inhibitors and the outcomes that followed.

Option B  is incorrect because the passage does not aim to initiate a debate. Instead, it primarily provides information and presents facts regarding COX-2 inhibitors, their development, and the challenges associated with their use. The passage doesn't present conflicting viewpoints or actively engage in a debate about the benefits of COX-2 inhibitors.

The passage is more focused on delivering information about the discovery of prostaglandins, the role of COX enzymes, the development of COX-2 inhibitors, and the challenges and side effects associated with these drugs. The tone is informative rather than argumentative or debatable. Therefore,  option D  better captures the main purpose of the passage.

KHannigan · Answer

Poor question design on #3.

There is a mismatch between the detail in the text and the logical link required by the question. The question asks about the author’s purpose in mentioning a specific fact — the responsiveness of prostaglandins to external stimuli. This kind of inference question hinges on identifying why that detail was included within the flow of the argument.

But in this case, the information about prostaglandins being generated in response to external stimuli is a  standalone fact  within a paragraph providing background about prostaglandins. It is not explicitly or implicitly marshaled in service of or otherwise linked to any larger argument or conclusion in the text.

Thus, none of the answer options logically follow as the primary reason for the inclusion of that fact.

In recent years, a class of drugs known as COX-2 inhibitors has

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In recent years, a class of drugs known as COX-2 inhibitors has

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