Answer 18

18.  Choice B is the correct answer.  The pathogenesis behind dysmenorrhea is excessive prostaglandins.  NSAIDS are first line because they inhibit prostaglandins.  Norco would not do anything for the underlying problem.  Metformin would be appropriated for someone with polycystic ovarian syndrome (PCOS).  Glyburide would not be appropriate and would likely cause hypoglycemia in a non diabetic patient.