Which of the following medications is least likely to cause gastrointestinal bleeding?

Acetaminophen is the medication least likely to cause gastrointestinal bleeding because it has a different mechanism of action compared to the nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. NSAIDs inhibit cyclooxygenase (COX) enzymes, which play a crucial role in the synthesis of prostaglandins. Prostaglandins are important for maintaining the gastric mucosal barrier and protecting the gastric lining. When this protective effect is diminished due to COX inhibition, the risk of ulcers and gastrointestinal bleeding increases.

In contrast, acetaminophen primarily acts as an analgesic and antipyretic without significantly affecting the COX enzymes in the gastrointestinal tract. Its safety profile makes it a preferred option for pain relief in individuals at risk for gastrointestinal complications. Methylprednisolone, a corticosteroid, can also contribute to gastrointestinal issues when combined with NSAIDs by increasing the risk of ulceration but is less directly related to bleeding compared to NSAIDs. Overall, acetaminophen is considered safer for the gastrointestinal tract, particularly in individuals who may require long-term pain management.