Gastrointestinal bleeding NSAID-related

NSAIDs are one of the most widely used classes of medications in the United States, particularly in the elderly.4 More than 20,000 deaths occur in the United States per year as a direct result of adverse events related to NSAID use. Chronic NSAID ingestion leads to symptoms of nausea and dyspepsia in nearly half of patients. Peptic ulceration occurs in up to 30% of patients who use NSAIDs chronically, with gastrointestinal bleeding or perforation occurring in 1.5% of patients who develop an ulcer. NSAID-related peptic ulcers usually occur in the stomach duodenal ulcers are much less common. 

Older and still widely-used analgesic compounds can cause unacceptable side-effects. This is especially the case for the traditional non-steroidal anti-inflammatory drugs (NSAIDs) which are associated with serious gastrointestinal complications such as bleeding, lesions and ulcers. Every year it is estimated that 16,500 NSAID-related deaths occur in the US alone, with 75,000 patients hospitalized. 

Paracetamol at high doses (over 4 g/day), liver toxicity is possible, especially in patients with chronic liver disease (viral or alcohol related) NSAID increased risk of gastrointestinal bleeding oliguria/anuria due to sodium and water retention hyperkalemia worsening of renal function... 

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