BOF 43

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BOF: 43

A 36-year-old female is known to have migraine. She is usually able to get relief by using paracetamol. She had given up smoking for years but has begun to smoke 20 cigarettes a day and now complains that paracetamol no longer relieves her headaches.

This is because:

a)      Smoking reduces cerebral blood flow

b)      Nicotine is a competitive inhibitor of paracetamol

c)      Smoking induces liver enzymes

d)      Smoking reduces blood flow to the intestine and thereby reduces absorption of paracetamol

e)      Smoking increases renal clearance of paracetamol

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