NSAIDs - Non steroidal anti-inflammatory drugs
Risk factors
for gastro-intestinal complications with NSAIDs
Patient related factors
- Age >60 years
- History of ulcer disease.
NSAID Protection Strategies
- Use lowest possible doses of NSAIDs
- Use safer NSAIDs (Ibuprofen)
- Alternatively
consider
- Cox-2
inhibitors such as Mesulid
- Made in Ireland, cheaper than diclofenac[Ref]
- Contra-indicated in severe heart failure
- Caution in hypertension and in patients with a ooedema for any other reasons
- Proton pump inhibitors
- Misoprostil.
- Cox-2
inhibitors such as Mesulid
Cautions / contraindications
Contra indications
- History of hypersensitivity to Aspirin or any other NSAID
- (asthma, angiooedema, urticaria or rhinitis precipitated by Aspirin or any other NSAID)
- Active peptic ulceration.
Cautions
- In the elderly
- Renal, cardiac or hepatic impairment (causing a deterioration of renal function)
- Coagulation defects
- During pregnancy (or breast feeding)
Prescribing in the elderly
All patients should be advised to seek
a review
of their analgesic requirements by their practice nurse
or
GP after two days
Please read sections above.
For soft tissue injuries consider
- Paracetamol in full dose
- Alternatively Ibuprofen at 400 mg tds
- Both Paracetamol and Ibuprofen as above.
