Nonsteroidal anti-inflammatory drugs gastrointestinal effects

Ibuprofen This is a commonly used nonsteroidal anti-inflammatory drug. Side effects and overdose can result in gastrointestinal bleeding or a metabolic acidosis. 

Chutkan R, Toubia N Effect of nonsteroidal anti-inflammatory drugs on the gastrointestinal tract Diagnosis by wireless capsule endoscopy. Gastrointest Endosc Clin N Am 2004 14 67-85. 

Mobic is the proprietary preparation of meloxicam, a non-steroidal antiinflammatory drug, which is also a selective inhibitor of cyclo-oxygenase-2. It is therefore less likely to cause gastrointestinal side-effects than other nonsteroidal anti-inflammatory drugs. However, it is still best to administer meloxicam after food. 

Nonsteroidal anti-inflammatory drugs (NSAlDs) nonselectively inhibit the activities of both COX-1 and COX-2. Out of concern for the gastrointestinal side effects of NSAID, scientists have discovered and developed many specific COX-2 inhibitors that facilitate a safer choice for controlling inflammatory diseases (73). Eor example, NS-398, a selective COX-2 inhibitor, has been shown to reduce tension (mechanical stress)-induced PGE2 production from periodontal ligament cell cultures (74). 

A third of all general practice consultations are for musculoskeletal complaints. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, and their gastrointestinal effects account for an estimated 1200 deaths per year in the UK. A hitherto unsuspected inflammatory component is now known to accompany conditions such as atherosclerosis. As understanding of the complex mechanisms underlying the inflammatory process increases, new ways of influencing it are developed, as witness therapies directed against specific cytokines, and COX-2 specific NSAIDs (COXIBs). 

Lapane KL, Spooner JJ, Mucha L, Straus WL. Effect of nonsteroidal anti-inflammatory drug use on the rate of gastrointestinal hospitalizations among people hving in long-term care. J Am Geriatr Soc 2001 49(5) 577-84. 

Nonsteroidal Anti-Inflammatory Drugs NSAIDs have now become the drugs of choice over colchicine because of the severe gastrointestinal side effects associated with colchicine and its lack of efficacy to resolve the gouty pain unless used within 24 hours after the occurrence of the initial attack. NSAIDs such as indomethacin, naproxen, and ibuprofen are effective because they have a short r/2, a rapid onset of action, and are better tolerated by patients. 

Despite the rigorous process for drug approval and regulation, several important medications have been removed from the market because of serious ADEs over the past 30 years. Examples of serious but uncommon effects include acute flank syndrome associated with suprofen," the gastrointestinal effects associated with nonsteroidal anti-inflammatory drugs (NSAIDs) in the elderly," troglitazone and the risk of hepatotoxicity," and the adverse effects of cisapride... 

Laine L. Review article The effect of Helicobacter pylori iirfection on nonsteroidal anti-inflammatory drug-induced upper gastrointestinal tract injury. Aliment Phamacol Ther 2002 16(Suppl l) 34-39. 

Maetzel A, Eerraz MB, Bombardier C. The cost-effectiveness of misoprostol in preventing serious gastrointestinal events associated with the use of nonsteroidal anti-inflammatory drugs. Arthritis Rheum 1998 41 16-25. 

A 45-year-old surgeon has developed symmetric early morning stiffness in her hands. She wishes to take a nonsteroidal anti-inflammatory drug to relieve these S3mptoms and wants to avoid gastrointestinal side effects. Which one of the following drugs is most appropriate ... 

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