Samter's Triad includes nasal polyps, asthma, and sensitivity to which drugs?

• A. Beta-blockers
• B. NSAIDs and aspirin
• C. Antibiotics
• D. Antihistamines

Answer: (B)

Samter's triad is aspirin-exacerbated respiratory disease, defined by the combination of nasal polyps, asthma, and sensitivity to nonsteroidal anti-inflammatory drugs, especially aspirin. The sensitivity arises because NSAIDs inhibit COX-1, which reduces protective prostaglandins and shunts arachidonic acid down the leukotriene pathway. The resulting surge in leukotrienes (C4, D4, E4) promotes bronchoconstriction, mucus production, and mucosal edema, worsening both asthma and nasal polyps. Clinically, this means many patients react to aspirin and many nonselective NSAIDs, while some COX-2 inhibitors may be tolerated but aren’t guaranteed. Understanding this mechanism helps explain why these patients have a distinct pattern of respiratory disease that requires avoiding trigger drugs and considering alternatives like leukotriene modifiers or aspirin desensitization in appropriate settings, alongside therapies targeting polyps and asthma.