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NSAID prescribing precautions.

Amanda Risser1, Deirdre Donovan, John Heintzman

  • 1School of Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239-3098, USA. rissera@ohsu.edu

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Summary

Nonsteroidal anti-inflammatory drugs (NSAIDs) carry risks like gastrointestinal bleeding and cardiovascular events. Careful patient selection and monitoring are crucial for safe NSAID use, especially in high-risk groups.

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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
06:59

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

Area of Science:

  • Pharmacology
  • Internal Medicine
  • Gastroenterology

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for pain and inflammation.
  • Their use is associated with significant risks, including upper gastrointestinal (GI) bleeding and cardiovascular complications.

Purpose of the Study:

  • To review the risks and benefits of NSAID use.
  • To highlight patient populations at increased risk for adverse events.
  • To provide guidance on safe prescribing practices.

Main Methods:

  • Literature review of NSAID pharmacology and clinical trial data.
  • Analysis of risk factors for NSAID-associated adverse events.
  • Synthesis of current clinical recommendations for NSAID use.

Main Results:

  • High-risk groups for GI bleeding include older adults, those on anticoagulants, and individuals with a history of NSAID-related bleeding.
  • NSAIDs can exacerbate heart failure, increase blood pressure, and are linked to cardiovascular events, though celecoxib may pose less risk.
  • Potential adverse effects include hepatic damage (rare), renal failure, CNS effects, and exacerbation of asthma. NSAIDs should be avoided in late pregnancy.

Conclusions:

  • NSAID prescribing requires careful consideration of patient-specific risks and benefits.
  • Vigilance is needed for potential GI, cardiovascular, renal, and hepatic complications.
  • Specific NSAIDs (ibuprofen, indomethacin, naproxen) are considered safe for breastfeeding women, but caution is advised in pregnancy and for children.