Uses of nonsteroidal anti-inflammatory drugs in pediatrics

Nonsteroidal anti-inflammatory drugs have an expanding role in pediatrics. The indications include (1) treatment of childhood rheumatic disease and other chronic inflammatory conditions; (2) symptomatic treatment of clinical problems such as fever, musculoskeletal pain, or dysmenorrhea; and (3) induction of closure of patent ductus arteriosus. Nonsteroidal anti-inflammatory drugs are generally well tolerated with a low incidence of serious side effects. However, potentially serious gastrointestinal, hepatic, central nervous system, and renal adverse effects have occurred. The pediatrician should be familiar with the pharmacokinetics and dosages of the various nonsteroidal anti-inflammatory drugs as well as laboratory tests necessary to monitor their use. Guidelines are suggested.