nsaids Flashcards
Q: What are the therapeutic effects of single doses of NSAIDs compared to paracetamol?
A: Single doses of NSAIDs have analgesic activity similar to paracetamol, but paracetamol is often preferred, especially in the elderly.
Q: What distinguishes the effects of regular full dosage NSAIDs?
A: Regular full dosage NSAIDs have both lasting analgesic and anti-inflammatory effects, making them particularly useful for continuous or regular pain associated with inflammation.
Q: What are the therapeutic effects of single doses of NSAIDs compared to paracetamol?
A: Single doses of NSAIDs have analgesic activity similar to paracetamol, but paracetamol is often preferred, especially in the elderly.
Q: What distinguishes the effects of regular full dosage NSAIDs?
A: Regular full dosage NSAIDs have both lasting analgesic and anti-inflammatory effects, making them particularly useful for continuous or regular pain associated with inflammation.
Q: What characterizes the differences in anti-inflammatory activity among NSAIDs?
A: NSAIDs show small differences in their anti-inflammatory activity, but individual response and tolerance to these drugs vary considerably.
Q: What proportion of patients respond to NSAIDs, and how do individuals typically respond to different NSAIDs?
A: Approximately 60% of patients respond to any NSAID. Among those who do not respond to one NSAID, many might respond to another.
Q: When does pain relief typically start after taking NSAIDs, and when can a full analgesic effect be expected?
A: Pain relief usually begins shortly after the first dose, and a full analgesic effect is generally achieved within a week. However, the anti-inflammatory effect may take up to 3 weeks to be evident or clinically assessable.
Q: What is the recommendation if appropriate responses to NSAIDs are not achieved within specific time frames?
A: If appropriate responses (pain relief or anti-inflammatory effect) are not obtained within a week for analgesia or three weeks for inflammation, trying another NSAID is recommended.
Q: How do NSAIDs reduce inflammation, and what impact does selective inhibition of cyclo-oxygenase-2 (COX-2) have?
A: NSAIDs reduce the production of prostaglandins by inhibiting the enzyme cyclo-oxygenase. Selective inhibition of COX-2 is linked to less gastrointestinal intolerance.
Q: Besides COX-2 selectivity, what other factors influence the susceptibility to gastrointestinal side effects, and how should an NSAID be chosen?
A: Various factors influence susceptibility to gastrointestinal effects. NSAIDs should be chosen based on the incidence of gastrointestinal and other side effects in individual cases.
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Q: What characterizes the differences in anti-inflammatory activity among NSAIDs?
A: NSAIDs show small differences in their anti-inflammatory activity, but individual response and tolerance to these drugs vary considerably.
Q: What proportion of patients respond to NSAIDs, and how do individuals typically respond to different NSAIDs?
A: Approximately 60% of patients respond to any NSAID. Among those who do not respond to one NSAID, many might respond to another.
Q: When does pain relief typically start after taking NSAIDs, and when can a full analgesic effect be expected?
A: Pain relief usually begins shortly after the first dose, and a full analgesic effect is generally achieved within a week. However, the anti-inflammatory effect may take up to 3 weeks to be evident or clinically assessable.
Q: What is the recommendation if appropriate responses to NSAIDs are not achieved within specific time frames?
A: If appropriate responses (pain relief or anti-inflammatory effect) are not obtained within a week for analgesia or three weeks for inflammation, trying another NSAID is recommended.
Q: How do NSAIDs reduce inflammation, and what impact does selective inhibition of cyclo-oxygenase-2 (COX-2) have?
A: NSAIDs reduce the production of prostaglandins by inhibiting the enzyme cyclo-oxygenase. Selective inhibition of COX-2 is linked to less gastrointestinal intolerance.
Q: Besides COX-2 selectivity, what other factors influence the susceptibility to gastrointestinal side effects, and how should an NSAID be chosen?
A: Various factors influence susceptibility to gastrointestinal effects. NSAIDs should be chosen based on the incidence of gastrointestinal and other side effects in individual cases.
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Q: What are the primary properties of Ibuprofen as a propionic acid derivative?
A: Ibuprofen exhibits anti-inflammatory, analgesic, and antipyretic properties. It stands out for having fewer side-effects than other non-selective NSAIDs, though its anti-inflammatory effects are comparatively weaker.
Q: How does Dexibuprofen relate to Ibuprofen, and what is its specific use?
A: Dexibuprofen, the active enantiomer of ibuprofen, shares similar properties and is specifically licensed for relieving mild to moderate pain and inflammation.
Q: What are the primary properties of Ibuprofen as a propionic acid derivative?
A: Ibuprofen exhibits anti-inflammatory, analgesic, and antipyretic properties. It stands out for having fewer side-effects than other non-selective NSAIDs, though its anti-inflammatory effects are comparatively weaker.
Q: How does Dexibuprofen relate to Ibuprofen, and what is its specific use?
A: Dexibuprofen, the active enantiomer of ibuprofen, shares similar properties and is specifically licensed for relieving mild to moderate pain and inflammation.
Q: What makes Naproxen a preferred choice among NSAIDs?
A: Naproxen is favored due to its combination of good efficacy and a relatively low incidence of side-effects, although slightly more than ibuprofen.
Q: How does Flurbiprofen compare to Naproxen in terms of effectiveness and side-effects?
A: Flurbiprofen might be slightly more effective than naproxen but is associated with slightly more gastrointestinal side-effects than ibuprofen.
Q: What characterizes Ketoprofen in comparison to Ibuprofen, and what is Dexketoprofen used for?
A: Ketoprofen possesses anti-inflammatory properties similar to ibuprofen but tends to induce more side-effects. Dexketoprofen, an isomer of ketoprofen, is introduced for short-term relief of mild to moderate pain.
Q: How does Tiaprofenic acid’s effectiveness compare to Naproxen, and what distinguishes it from Ibuprofen in terms of side-effects?
A: Tiaprofenic acid is as effective as naproxen but tends to have more side-effects compared to ibuprofen.
Let me know if you need more flashcards or details about these specific NSAIDs!
Q: What makes Naproxen a preferred choice among NSAIDs?
A: Naproxen is favored due to its combination of good efficacy and a relatively low incidence of side-effects, although slightly more than ibuprofen.
Q: How does Flurbiprofen compare to Naproxen in terms of effectiveness and side-effects?
A: Flurbiprofen might be slightly more effective than naproxen but is associated with slightly more gastrointestinal side-effects than ibuprofen.
Q: What characterizes Ketoprofen in comparison to Ibuprofen, and what is Dexketoprofen used for?
A: Ketoprofen possesses anti-inflammatory properties similar to ibuprofen but tends to induce more side-effects. Dexketoprofen, an isomer of ketoprofen, is introduced for short-term relief of mild to moderate pain.
Q: How does Tiaprofenic acid’s effectiveness compare to Naproxen, and what distinguishes it from Ibuprofen in terms of side-effects?
A: Tiaprofenic acid is as effective as naproxen but tends to have more side-effects compared to ibuprofen.
Let me know if you need more flashcards or details about these specific NSAIDs!
Q: How do Diclofenac sodium and aceclofenac compare in efficacy to Naproxen?
A: Both Diclofenac sodium and aceclofenac demonstrate similar efficacy to naproxen.
Q: What characterizes Etodolac concerning its efficacy and licensed use?
A: Etodolac is comparable in efficacy to naproxen and holds a license for symptomatic relief in osteoarthritis and rheumatoid arthritis.
Q: How does Indometacin’s action compare to Naproxen, and what are notable side-effects associated with Indometacin?
A: Indometacin’s action is equal to or sometimes superior to naproxen but is accompanied by a high incidence of side-effects, including headache, dizziness, and gastrointestinal disturbances.
Q: What are the primary characteristics of Mefenamic acid in terms of its anti-inflammatory properties and associated risks?
A: Mefenamic acid possesses minor anti-inflammatory properties and has occasionally been linked to diarrhea and hemolytic anemia, necessitating treatment discontinuation.
Q: How is Meloxicam licensed for use, and in what conditions is it beneficial?
A: Meloxicam is licensed for short-term pain relief in osteoarthritis and for long-term treatment in rheumatoid arthritis and ankylosing spondylitis.
Q: In what way does Nabumetone compare in effect to Naproxen?
A: Nabumetone demonstrates a comparable effect to naproxen.
If you need more flashcards or details on these drugs, feel free to ask!
Q: How do Diclofenac sodium and aceclofenac compare in efficacy to Naproxen?
A: Both Diclofenac sodium and aceclofenac demonstrate similar efficacy to naproxen.
Q: What characterizes Etodolac concerning its efficacy and licensed use?
A: Etodolac is comparable in efficacy to naproxen and holds a license for symptomatic relief in osteoarthritis and rheumatoid arthritis.
Q: How does Indometacin’s action compare to Naproxen, and what are notable side-effects associated with Indometacin?
A: Indometacin’s action is equal to or sometimes superior to naproxen but is accompanied by a high incidence of side-effects, including headache, dizziness, and gastrointestinal disturbances.
Q: What are the primary characteristics of Mefenamic acid in terms of its anti-inflammatory properties and associated risks?
A: Mefenamic acid possesses minor anti-inflammatory properties and has occasionally been linked to diarrhea and hemolytic anemia, necessitating treatment discontinuation.
Q: How is Meloxicam licensed for use, and in what conditions is it beneficial?
A: Meloxicam is licensed for short-term pain relief in osteoarthritis and for long-term treatment in rheumatoid arthritis and ankylosing spondylitis.
Q: In what way does Nabumetone compare in effect to Naproxen?
A: Nabumetone demonstrates a comparable effect to naproxen.
If you need more flashcards or details on these drugs, feel free to ask!
Q: What are the primary concerns associated with Phenylbutazone despite its licensing for ankylosing spondylitis?
A: Phenylbutazone is associated with serious side-effects, particularly hematological reactions. Its use is recommended only by specialists in severe cases where other treatments are deemed unsuitable.
Q: What distinguishes Piroxicam’s effectiveness and administration frequency compared to Naproxen, and what are its notable side-effects?
A: Piroxicam is as effective as naproxen and permits once-daily administration due to its long duration of action. However, it’s associated with more gastrointestinal side-effects and frequent serious skin reactions.
Q: How does Sulindac compare in tolerance to Naproxen?
A: Sulindac demonstrates similar tolerance to naproxen.
Q: What characterizes Tenoxicam in terms of its activity, tolerance, and administration frequency compared to Naproxen?
A: Tenoxicam is similar in activity and tolerance to naproxen. Its long duration of action allows once-daily administration.
Q: For what condition is Tolfenamic acid licensed?
A: Tolfenamic acid is licensed for the treatment of migraine.
Q: Which NSAIDs are specifically licensed for short-term management of postoperative pain?
A: Ketorolac trometamol and the selective COX-2 inhibitor, parecoxib, are licensed for short-term management of postoperative pain.
Q: What advantages do selective COX-2 inhibitors like etoricoxib and celecoxib possess compared to non-selective NSAIDs, and for what conditions are they licensed?
A: Etoricoxib and celecoxib are as effective as non-selective NSAIDs but have a lower risk of serious upper gastrointestinal events. They are licensed for pain relief in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis; etoricoxib is also for relief in acute gout.
Q: What historical use did Aspirin have in rheumatoid arthritis, and what are the preferences today?
A: Aspirin was previously used in high doses for rheumatoid arthritis, but other NSAIDs are now preferred.
If you need further details or additional flashcards on these NSAIDs or related topics, feel free to ask!
Q: What are the primary concerns associated with Phenylbutazone despite its licensing for ankylosing spondylitis?
A: Phenylbutazone is associated with serious side-effects, particularly hematological reactions. Its use is recommended only by specialists in severe cases where other treatments are deemed unsuitable.
Q: What distinguishes Piroxicam’s effectiveness and administration frequency compared to Naproxen, and what are its notable side-effects?
A: Piroxicam is as effective as naproxen and permits once-daily administration due to its long duration of action. However, it’s associated with more gastrointestinal side-effects and frequent serious skin reactions.
Q: How does Sulindac compare in tolerance to Naproxen?
A: Sulindac demonstrates similar tolerance to naproxen.
Q: What characterizes Tenoxicam in terms of its activity, tolerance, and administration frequency compared to Naproxen?
A: Tenoxicam is similar in activity and tolerance to naproxen. Its long duration of action allows once-daily administration.
Q: For what condition is Tolfenamic acid licensed?
A: Tolfenamic acid is licensed for the treatment of migraine.
Q: Which NSAIDs are specifically licensed for short-term management of postoperative pain?
A: Ketorolac trometamol and the selective COX-2 inhibitor, parecoxib, are licensed for short-term management of postoperative pain.
Q: What advantages do selective COX-2 inhibitors like etoricoxib and celecoxib possess compared to non-selective NSAIDs, and for what conditions are they licensed?
A: Etoricoxib and celecoxib are as effective as non-selective NSAIDs but have a lower risk of serious upper gastrointestinal events. They are licensed for pain relief in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis; etoricoxib is also for relief in acute gout.
Q: What historical use did Aspirin have in rheumatoid arthritis, and what are the preferences today?
A: Aspirin was previously used in high doses for rheumatoid arthritis, but other NSAIDs are now preferred.
If you need further details or additional flashcards on these NSAIDs or related topics, feel free to ask!
When is the use of NSAIDs considered potentially inappropriate in the elderly according to STOPP criteria?
NSAIDs might be considered inappropriate if prescribed:
With certain blood thinners like vitamin K antagonists, direct thrombin inhibitors, or factor Xa inhibitors in combination (increased risk of major gastrointestinal bleeding).
With concurrent antiplatelet agents without proton pump inhibitor (PPI) prophylaxis (raising the risk of peptic ulcer disease).
In a history of peptic ulcer disease or gastrointestinal bleeding, unless accompanied by concurrent PPI or H2-receptor antagonist (risk of peptic ulcer relapse), excluding COX-2 selective NSAIDs.
Alongside corticosteroids without PPI prophylaxis (heightened risk of peptic ulcer disease).
When the patient has an estimated glomerular filtration rate (eGFR) less than 50 mL/minute/1.73 m² (risk of renal function decline).
In cases of severe hypertension or severe heart failure (risk of exacerbation).
For chronic treatment of gout without a contraindication to a xanthine-oxidase inhibitor (xanthine-oxidase inhibitors are the primary choice prophylactic drugs in gout).
Using a COX-2 selective NSAID in concurrent cardiovascular disease (increased risk of myocardial infarction and stroke).
When is the use of NSAIDs considered potentially inappropriate in the elderly according to STOPP criteria?
NSAIDs might be considered inappropriate if prescribed:
With certain blood thinners like vitamin K antagonists, direct thrombin inhibitors, or factor Xa inhibitors in combination (increased risk of major gastrointestinal bleeding).
With concurrent antiplatelet agents without proton pump inhibitor (PPI) prophylaxis (raising the risk of peptic ulcer disease).
In a history of peptic ulcer disease or gastrointestinal bleeding, unless accompanied by concurrent PPI or H2-receptor antagonist (risk of peptic ulcer relapse), excluding COX-2 selective NSAIDs.
Alongside corticosteroids without PPI prophylaxis (heightened risk of peptic ulcer disease).
When the patient has an estimated glomerular filtration rate (eGFR) less than 50 mL/minute/1.73 m² (risk of renal function decline).
In cases of severe hypertension or severe heart failure (risk of exacerbation).
For chronic treatment of gout without a contraindication to a xanthine-oxidase inhibitor (xanthine-oxidase inhibitors are the primary choice prophylactic drugs in gout).
Using a COX-2 selective NSAID in concurrent cardiovascular disease (increased risk of myocardial infarction and stroke).
Q: What potential risks are associated with prolonged NSAID use after 20 weeks of pregnancy according to MHRA/CHM advice (June 2023)?
A: Prolonged NSAID use after week 20 of pregnancy may be associated with an increased risk of:
Oligohydramnios due to fetal renal dysfunction, usually reversible upon discontinuation.
Constriction of the ductus arteriosus, often resolving after treatment cessation.
Q: What serious outcomes can result from these risks during pregnancy?
A: These risks can lead to restriction of fetal growth and cardiac dysfunction, impacting the fetus significantly.
Q: According to healthcare professional advice, what measures should be taken regarding NSAID use in pregnancy after 20 weeks?
A: Healthcare professionals are advised to:
Avoid prescribing systemic NSAIDs after week 20 of pregnancy unless clinically required, opting for the lowest effective dose for the shortest duration.
Consider antenatal monitoring for oligohydramnios if NSAIDs have been used for several days after week 20; discontinue NSAIDs if oligohydramnios is detected or if no longer necessary.
Continuously record current and recent medicines, including over-the-counter drugs, at each antenatal appointment.
Q: Why are systemic NSAIDs contraindicated during the third trimester (after 28 weeks) of pregnancy?
A: During the third trimester, systemic NSAIDs are contraindicated due to the risks of premature closure of the ductus arteriosus, fetal renal dysfunction, prolonged maternal bleeding time, and inhibition of uterine contractions during labor.
These guidelines aim to mitigate potential risks associated with NSAID use in pregnant individuals, particularly after 20 weeks and during the third trimester.
Q: What potential risks are associated with prolonged NSAID use after 20 weeks of pregnancy according to MHRA/CHM advice (June 2023)?
A: Prolonged NSAID use after week 20 of pregnancy may be associated with an increased risk of:
Oligohydramnios due to fetal renal dysfunction, usually reversible upon discontinuation.
Constriction of the ductus arteriosus, often resolving after treatment cessation.
Q: What serious outcomes can result from these risks during pregnancy?
A: These risks can lead to restriction of fetal growth and cardiac dysfunction, impacting the fetus significantly.
Q: According to healthcare professional advice, what measures should be taken regarding NSAID use in pregnancy after 20 weeks?
A: Healthcare professionals are advised to:
Avoid prescribing systemic NSAIDs after week 20 of pregnancy unless clinically required, opting for the lowest effective dose for the shortest duration.
Consider antenatal monitoring for oligohydramnios if NSAIDs have been used for several days after week 20; discontinue NSAIDs if oligohydramnios is detected or if no longer necessary.
Continuously record current and recent medicines, including over-the-counter drugs, at each antenatal appointment.
Q: Why are systemic NSAIDs contraindicated during the third trimester (after 28 weeks) of pregnancy?
A: During the third trimester, systemic NSAIDs are contraindicated due to the risks of premature closure of the ductus arteriosus, fetal renal dysfunction, prolonged maternal bleeding time, and inhibition of uterine contractions during labor.
These guidelines aim to mitigate potential risks associated with NSAID use in pregnant individuals, particularly after 20 weeks and during the third trimester.
Q: What advice should patients or their carers be given regarding systemic NSAID use in pregnancy?
A: Patients or their carers should be advised that:
Systemic NSAIDs should be avoided entirely during the third trimester of pregnancy.
Systemic NSAIDs should also be avoided from week 20 of pregnancy onwards unless specifically advised by a doctor.
If a systemic NSAID is used for more than a few days during later pregnancy, additional monitoring, such as ultrasound scans, may be required.
Non-prescription pain relief preparations containing multiple active drugs should be used cautiously, seeking advice from a healthcare professional to ensure the lowest effective dose for the shortest time.
Seeking medical advice is crucial if pain persists for longer than 3 days or if there is repeated pain during pregnancy.
Q: Which NSAIDs do these recommendations not apply to, and what advice should be sought for their use during pregnancy?
A: This advice doesn’t apply to aspirin, COX-2 selective inhibitors, and topical NSAIDs. Separate advice regarding the use of these during pregnancy should be followed.
These recommendations aim to provide clear guidance for patients or their caregivers regarding the cautious use of NSAIDs during pregnancy, emphasizing avoidance during specific trimesters and the importance of seeking medical advice for persistent or recurring pain.
Q: What advice should patients or their carers be given regarding systemic NSAID use in pregnancy?
A: Patients or their carers should be advised that:
Systemic NSAIDs should be avoided entirely during the third trimester of pregnancy.
Systemic NSAIDs should also be avoided from week 20 of pregnancy onwards unless specifically advised by a doctor.
If a systemic NSAID is used for more than a few days during later pregnancy, additional monitoring, such as ultrasound scans, may be required.
Non-prescription pain relief preparations containing multiple active drugs should be used cautiously, seeking advice from a healthcare professional to ensure the lowest effective dose for the shortest time.
Seeking medical advice is crucial if pain persists for longer than 3 days or if there is repeated pain during pregnancy.
Q: Which NSAIDs do these recommendations not apply to, and what advice should be sought for their use during pregnancy?
A: This advice doesn’t apply to aspirin, COX-2 selective inhibitors, and topical NSAIDs. Separate advice regarding the use of these during pregnancy should be followed.
These recommendations aim to provide clear guidance for patients or their caregivers regarding the cautious use of NSAIDs during pregnancy, emphasizing avoidance during specific trimesters and the importance of seeking medical advice for persistent or recurring pain.
Q: What is the general association between NSAID use and cardiovascular events, regardless of baseline risk factors or duration of use?
A: All NSAID use, including COX-2 selective inhibitors, can be associated with a small increased risk of thrombotic events (e.g., myocardial infarction and stroke), albeit to varying degrees. The highest risk might be observed in those receiving high doses for extended periods.
Q: Which specific NSAIDs are associated with an increased risk of thrombotic events?
A: COX-2 selective inhibitors, diclofenac (at 150 mg daily), and high-dose ibuprofen (at 2.4 g daily) are linked to increased thrombotic risk. Aceclofenac’s treatment advice has been updated, aligning with diclofenac due to its structural similarity and metabolism to diclofenac. Etoricoxib at licensed doses shares a similar increased risk as diclofenac. However, low doses of ibuprofen (1.2 g daily or less) and naproxen (at 1 g daily) are associated with lower thrombotic risks.
Q: What prescribing advice is suggested regarding NSAIDs to mitigate cardiovascular risks?
A: Prescribing advice recommends using the lowest effective NSAID dose for the shortest possible duration to manage symptoms. Long-term treatment necessity should be periodically reviewed.
These findings underscore the importance of judiciously prescribing NSAIDs, emphasizing the need for the lowest effective dose for the shortest duration to mitigate potential risks of cardiovascular events.
Q: What is the general association between NSAID use and cardiovascular events, regardless of baseline risk factors or duration of use?
A: All NSAID use, including COX-2 selective inhibitors, can be associated with a small increased risk of thrombotic events (e.g., myocardial infarction and stroke), albeit to varying degrees. The highest risk might be observed in those receiving high doses for extended periods.
Q: Which specific NSAIDs are associated with an increased risk of thrombotic events?
A: COX-2 selective inhibitors, diclofenac (at 150 mg daily), and high-dose ibuprofen (at 2.4 g daily) are linked to increased thrombotic risk. Aceclofenac’s treatment advice has been updated, aligning with diclofenac due to its structural similarity and metabolism to diclofenac. Etoricoxib at licensed doses shares a similar increased risk as diclofenac. However, low doses of ibuprofen (1.2 g daily or less) and naproxen (at 1 g daily) are associated with lower thrombotic risks.
Q: What prescribing advice is suggested regarding NSAIDs to mitigate cardiovascular risks?
A: Prescribing advice recommends using the lowest effective NSAID dose for the shortest possible duration to manage symptoms. Long-term treatment necessity should be periodically reviewed.
These findings underscore the importance of judiciously prescribing NSAIDs, emphasizing the need for the lowest effective dose for the shortest duration to mitigate potential risks of cardiovascular events.
Q: What is the association between NSAIDs and gastrointestinal (GI) toxicity?
A: All NSAIDs pose a risk of serious gastrointestinal toxicity, with a higher risk observed in the elderly population. Variation exists among non-selective NSAIDs in terms of the risks of serious upper gastrointestinal side-effects, ranging from piroxicam, ketoprofen, and ketorolac trometamol (high risk) to indometacin, diclofenac, and naproxen (intermediate risk) and ibuprofen (lowest risk, though high doses associate with intermediate risk). COX-2 selective inhibitors generally exhibit a lower risk of serious upper gastrointestinal side-effects compared to non-selective NSAIDs.
Q: What recommendations are provided to mitigate gastrointestinal risks associated with NSAIDs?
A: Recommendations include preferring NSAIDs associated with low risks (e.g., ibuprofen), commencing at the lowest recommended dose, avoiding concurrent use of multiple oral NSAIDs, and using the combination of NSAIDs and low-dose aspirin cautiously, monitoring patients closely if necessary.
Q: In what scenarios should NSAID use be approached cautiously or with specific considerations regarding gastrointestinal events?
A: It’s preferable to avoid NSAIDs in patients with active or prior gastrointestinal ulceration or bleeding. However, in cases of serious rheumatic diseases necessitating NSAIDs for effective pain relief, careful usage might be required. Patients at risk of gastrointestinal ulceration, especially the elderly, needing NSAID treatment, should also receive gastroprotective treatment.
Q: How do various administration methods or strategies partially mitigate NSAID-induced gastrointestinal symptoms?
A: Despite efforts like taking NSAIDs with milk or food, using enteric-coated formulations, or changing the route of administration, these measures only partially reduce symptoms like dyspepsia, as systemic and local effects of NSAIDs contribute to gastrointestinal damage.
These recommendations aim to guide the cautious use of NSAIDs, particularly in populations vulnerable to gastrointestinal complications, and suggest strategies to minimize associated risks.
Q: What is the association between NSAIDs and gastrointestinal (GI) toxicity?
A: All NSAIDs pose a risk of serious gastrointestinal toxicity, with a higher risk observed in the elderly population. Variation exists among non-selective NSAIDs in terms of the risks of serious upper gastrointestinal side-effects, ranging from piroxicam, ketoprofen, and ketorolac trometamol (high risk) to indometacin, diclofenac, and naproxen (intermediate risk) and ibuprofen (lowest risk, though high doses associate with intermediate risk). COX-2 selective inhibitors generally exhibit a lower risk of serious upper gastrointestinal side-effects compared to non-selective NSAIDs.
Q: What recommendations are provided to mitigate gastrointestinal risks associated with NSAIDs?
A: Recommendations include preferring NSAIDs associated with low risks (e.g., ibuprofen), commencing at the lowest recommended dose, avoiding concurrent use of multiple oral NSAIDs, and using the combination of NSAIDs and low-dose aspirin cautiously, monitoring patients closely if necessary.
Q: In what scenarios should NSAID use be approached cautiously or with specific considerations regarding gastrointestinal events?
A: It’s preferable to avoid NSAIDs in patients with active or prior gastrointestinal ulceration or bleeding. However, in cases of serious rheumatic diseases necessitating NSAIDs for effective pain relief, careful usage might be required. Patients at risk of gastrointestinal ulceration, especially the elderly, needing NSAID treatment, should also receive gastroprotective treatment.
Q: How do various administration methods or strategies partially mitigate NSAID-induced gastrointestinal symptoms?
A: Despite efforts like taking NSAIDs with milk or food, using enteric-coated formulations, or changing the route of administration, these measures only partially reduce symptoms like dyspepsia, as systemic and local effects of NSAIDs contribute to gastrointestinal damage.
These recommendations aim to guide the cautious use of NSAIDs, particularly in populations vulnerable to gastrointestinal complications, and suggest strategies to minimize associated risks.
Q: How does alcohol consumption affect the risk associated with NSAIDs in terms of gastrointestinal hemorrhage?
A: Alcohol consumption increases the risk of gastrointestinal hemorrhage when used alongside NSAIDs. Specialist sources suggest that concurrent use may not need to be entirely avoided with moderate alcohol intake. However, greater caution is advised for individuals exceeding the recommended daily limits for alcohol consumption.
Q: What cautionary advice is provided concerning acute kidney injury in relation to NSAIDs and alcohol?
A: Acute kidney injury cases have been associated with the combined use of NSAIDs and acute excessive alcohol consumption.
These points underline the importance of understanding the potential risks of combining NSAIDs with alcohol consumption, especially in terms of gastrointestinal hemorrhage and acute kidney injury. Moderation and adherence to recommended limits are advised to mitigate associated risks.
Q: How does alcohol consumption affect the risk associated with NSAIDs in terms of gastrointestinal hemorrhage?
A: Alcohol consumption increases the risk of gastrointestinal hemorrhage when used alongside NSAIDs. Specialist sources suggest that concurrent use may not need to be entirely avoided with moderate alcohol intake. However, greater caution is advised for individuals exceeding the recommended daily limits for alcohol consumption.
Q: What cautionary advice is provided concerning acute kidney injury in relation to NSAIDs and alcohol?
A: Acute kidney injury cases have been associated with the combined use of NSAIDs and acute excessive alcohol consumption.
These points underline the importance of understanding the potential risks of combining NSAIDs with alcohol consumption, especially in terms of gastrointestinal hemorrhage and acute kidney injury. Moderation and adherence to recommended limits are advised to mitigate associated risks.
