Nongastrointestinal adverse reactions to NSAID

The use of nonsteroidal antiinflammatory drugs (NSAID) has been associated with numerous adverse reactions other than gastrointestinal (GI) damage, the most widely recognized and extensively studied of the deleterious effects of these agents. Those of particular importance include inhibition of blood clotting, impairment of renal and hepatic function, dermatologic and respiratory intolerance reactions, such hematologic disorders as agranulocytosis and aplastic anemia, and untoward effects on pregnancy; in addition, the use of aspirin or salicylates in children has been associated with the occurrence of Reye's syndrome. NSAID inhibition of prostaglandin biosynthesis, the mechanism responsible for GI adverse reactions, is known or suspected to play a role in many of the non-GI adverse reactions. However, the precise mechanisms underlying most of these effects have not been fully elucidated.