non steroidal anti-inflammatory drugs...

hi all, i am sure that all of us know the importance of NSAIDs in our life, so i chose the following valuable informations from davidson cuz they are so interesting...for more information see pages 989,990 and 991 in davidson....


recommendations for the use of NSAIDs:

* current use of anticoagulants is a contraindication to NSAIDs use.
* try to avoid the use of NSAIDs in the elderly and in those with important comorbidity.
* start with the lowest dose of one of the safer established NSAIDs (eg. ibuprofen) and only increase the dose if required.
* if unsatisfactoy result is obtained with one NSAID, a trial of another NSAID may still be warranted.
* never prescribe more than NSAID at a time.
* allow a 2-3 week trial to assess efficacy of any particular NSAID or dose.
for a patient with recognised risk factors for GI ulceration (see below) consider co-prescribtion with omprazole or misoprostol or use of coxib (highly selective COX-2 inhibitors).


Risk factors for NSAIDs-induced ulcers:

1- age more than 60 years.
2- past history of peptic ulcer.
3- past history of adverse event with NSAIDs.
4- concomitant steroid use.
5- high dose or multiple NSAIDs.
6- idividual NSAID-highest with azapropazone, piroxicam, ketoprofen; lower with ibuprufen.

best regards.......