Which statement is true about acetaminophen when compared with aspirin?

• A. Greater anti-inflammatory action
• B. Less gastric irritation
• C. No appreciable effect on uric acid excretion
• D. No alteration of bleeding time

Answer: (D)

The key idea here is how these drugs affect platelets and bleeding. Aspirin irreversibly inhibits COX-1 in platelets, which stops production of thromboxane A2 and prevents platelets from clumping together. Since platelets don’t make new COX-1, this effect lasts for the platelets’ lifetime, so bleeding time is prolonged with aspirin.

Acetaminophen, in contrast, does not have a meaningful effect on platelet function or the COX-1 pathway in platelets. It provides analgesia and fever relief mainly through central mechanisms and has little to no impact on platelet aggregation. Because of that, taking acetaminophen does not change bleeding time.

So the statement that acetaminophen does not alter bleeding time is true, and it reflects a fundamental difference in how these two drugs affect hemostasis.