Which medication does NOT inhibit phospholipase A2 as part of its mechanism of action?

Nepafenac (Nevanec) is primarily classified as a non-steroidal anti-inflammatory drug (NSAID) used topically in the treatment of inflammation and pain related to ocular surgery. Its mechanism of action involves the inhibition of cyclooxygenase (COX) enzymes, which subsequently reduces the production of inflammatory mediators such as prostaglandins. Unlike corticosteroids, which do inhibit phospholipase A2 (an enzyme responsible for the liberation of arachidonic acid from membrane phospholipids), nepafenac does not target this pathway.

In contrast, corticosteroids like loteprednol (Lotemax) exert their anti-inflammatory effects by inhibiting phospholipase A2, thereby reducing the formation of inflammatory mediators. Both hydroxychloroquine and chloroquine, while primarily known for their use in autoimmune conditions, also have mechanisms that involve the modulation of immune responses and inflammatory processes, and they do not primarily focus on inhibiting phospholipase A2 directly.

Therefore, the distinctive mechanism of action of nepafenac, which centers on COX inhibition rather than inhibition of phospholipase A2, makes it the correct choice regarding medications that do not inhibit this enzyme.