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Nonsteroidal anti-inflammatory drugs.
Carin E Dugowson1, Priya Gnanashanmugam
1Division of Rheumatology, University of Washington, Box 356428, Seattle, WA 98195-3414, USA. carind@u.washington.edu
Summary
Nonsteroidal anti-inflammatory drugs effectively manage musculoskeletal pain but carry risks. Chronic use, especially of COX-2 inhibitors, can cause gastrointestinal and cardiovascular issues, necessitating careful patient monitoring.
Area of Science:
- Pharmacology
- Rheumatology
- Internal Medicine
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), including COX-2 selective agents, are widely prescribed for musculoskeletal pain conditions.
- While generally safe for short-term use in healthy individuals, chronic NSAID administration is associated with significant adverse effects.
Purpose of the Study:
- To review the risks and benefits of NSAIDs, particularly COX-2 inhibitors, in managing chronic musculoskeletal pain.
- To highlight the gastrointestinal and cardiovascular adverse effects associated with NSAID use.
Main Methods:
- Literature review of studies on NSAID efficacy and safety.
- Analysis of reported adverse events, focusing on gastrointestinal and cardiovascular complications.
- Discussion of patient monitoring and risk stratification strategies.
Main Results:
- NSAIDs are effective for various pain conditions like osteoarthritis and trauma.
- Chronic use frequently leads to gastrointestinal complications.
- Cardiovascular adverse effects are a growing concern, especially with COX-2 selective NSAIDs.
Conclusions:
- NSAID therapy requires careful consideration of patient comorbidities and risk factors.
- Regular monitoring of blood counts and renal/hepatic function is crucial for patients on long-term NSAIDs.
- Dosing and duration should be individualized to minimize adverse events.