<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 45-year-old man comes to the physician because of intermittent lower back pain for 1 week. His symptoms began shortly after lifting heavy boxes at work. He has not had any fever, chills, or weight loss. He has a history of peptic ulcer disease. He does not smoke or drink alcohol. His vital signs are within normal limits. Examination shows mild paraspinal lumbar tenderness. Neurologic examination shows no focal findings. An x-ray of the spine shows no abnormalities. Which of the following is the most appropriate initial pharmacotherapy?? A: Aspirin, B: Acetaminophen, C: Oxycodone, D: Naproxen, E: Ibuprofen,  <response>: This is a clinical case of a 45-year-old man with lower back pain after lifting heavy boxes at work. The key findings are intermittent lower back pain for 1 week, no feverchillsweight loss, history of peptic ulcer disease, no smokingalcohol use, normal vital signs, mild paraspinal lumbar tenderness on exam, and normal spine x-ray. The question asks about the most appropriate initial pharmacotherapy. Since this appears to be uncomplicated mechanical low back pain, NSAIDs are typically first-line. However, this patient has a history of peptic ulcer disease, which is a relative contraindication for NSAIDs due to their gastrointestinal side effects. Acetaminophen would be safer in this patient. Aspirin also carries a gastrointestinal bleeding risk and is not preferred. Oxycodone is a narcotic and too strong for initial therapy. B: Acetaminophen 