Nonsteroidal anti-inflammatory drugs.
NSAID-associated dyspeptic symptoms are common and can be managed empirically with an H2-receptor antagonist or a proton-pump inhibitor. Treatment of established gastroduodenal ulcers is accomplished best by withholding the offending drugs. Proton-pump inhibitors appear to heal ulcers at the same rate whether or not NSAID therapy is continued. After the ulcer is healed and if NSAID therapy must be continued, prophylaxis is accomplished best by the concomitant use of proton-pump inhibitors, misoprostol (at least 200 micrograms 3 times a day), or a NSAID that preferentially inhibits COX-2. The future development of newer, safer NSAID preparations, including highly selective COX-2 inhibitors and nitric oxide-releasing NSAIDs, should provide better treatment options for the increasing number of individuals requiring anti-inflammatory agents.
Tseng
C C
CC
Section of Gastroenterology, Boston University School of Medicine, Massachusetts, USA.
Wolfe
M M
MM
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D004381:Duodenal Ulcer / Q000188:drug therapy; D004415:Dyspepsia / Q000139:chemically induced* / Q000188:drug therapy; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D007527:Isoenzymes; D008565:Membrane Proteins; D016595:Misoprostol / Q000008:administration & dosage / Q000627:therapeutic use; D020030:Nitric Oxide Donors / Q000627:therapeutic use; D010544:Peroxidases / Q000037:antagonists & inhibitors; D011451:Prostaglandin-Endoperoxide Synthases; D054328:Proton Pump Inhibitors; D013276:Stomach Ulcer / Q000188:drug therapy
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D004791:Enzyme Inhibitors; D006635:Histamine H2 Antagonists; D007527:Isoenzymes; D008565:Membrane Proteins; D020030:Nitric Oxide Donors; D054328:Proton Pump Inhibitors; D016595:Misoprostol; D010544:Peroxidases; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases