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Non-steroidal anti-inflammatory drugs
A G Johnson1, D I Quinn, R O Day
1Department of Medicine, University of Queensland, Brisbane.
The Medical Journal of Australia
|August 7, 1995
Summary
Elderly patients face increased risks from non-steroidal anti-inflammatory drugs (NSAIDs). Clinicians should consider topical options, minimize oral NSAID doses, and avoid high-toxicity drugs in older adults.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Drug Safety
Background:
- Elderly individuals exhibit a heightened susceptibility to adverse drug reactions.
- Non-steroidal anti-inflammatory drugs (NSAIDs) pose particular risks due to potential drug interactions in older populations.
Purpose of the Study:
- To outline critical considerations for prescribing NSAIDs to the elderly.
- To provide guidance on minimizing risks associated with NSAID use in geriatric patients.
Main Methods:
- Review of existing literature on NSAID pharmacology and geriatric pharmacokinetics.
- Analysis of adverse event data related to NSAID use in elderly populations.
- Clinical guideline development based on risk-benefit assessment.
Main Results:
- Elderly patients are at significantly higher risk for adverse NSAID reactions compared to younger individuals.
- Drug interactions represent a substantial contributor to NSAID-related toxicity in the elderly.
- Specific NSAIDs, including phenylbutazone, salicylates, piroxicam, and indomethacin, carry a high risk of toxicity and should be avoided.
Conclusions:
- Prescribing oral NSAIDs to the elderly necessitates careful consideration of alternative therapies, such as topical NSAIDs.
- Minimizing dosage and duration of oral NSAID therapy, coupled with periodic treatment reviews, is crucial for reducing risks.
- Avoiding high-toxicity NSAIDs is a key strategy for ensuring patient safety in this demographic.