Implications of NSAID therapy in elderly patients

Elderly patients receiving nonsteroidal antiinflammatory drugs (NSAID) require special consideration. Specific areas of concern include such physiologic changes as reduced viability of gastrointestinal transport systems, increased toxicity of water-soluble drugs, reduced plasma clearance of some agents and impaired renal and hepatic function. Since elderly patients frequently receive several medications concomitantly, awareness of potential drug interactions is critical. Further, adverse effects of NSAID may pose unique management challenges in elderly patients, particularly in those with impaired renal function. Lastly, of primary concern is the lack of clinical studies addressing the specific needs of this patient population. Further investigation is needed to better define the multifactorial aspects of management of elderly patients receiving NSAID.