Drug injury in the upper gastrointestinal tract: nonsteroidal anti-inflammatory drugs.
It is well established that nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin confer significant morbidity and mortality. The widespread use of these drugs has increased the absolute numbers of cases of NSAID- or aspirin-related upper gastrointestinal complications. Emerging data indicate that antidepressants, such as selective serotonin reuptake inhibitors and tricyclic antidepressants, may also increase risk for gastrointestinal bleeding. Multiple factors have been identified that increase risk for NSAID- and aspirin-related upper gastrointestinal complications. The highest risks are related to age (>60 years) and prior complicated peptic ulcer; additional risk factors include use of multiple NSAIDs and high doses of NSAIDS. Recent studies have demonstrated enhanced healing and prevention of NSAID- and aspirin-related gastrointestinal lesions with proton pump inhibitors.
Veterans Administration Salt Lake City Health Care System, UT 84106, USA. mae.go@med.va.gov
Mae F
MF
Go
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects; D005260:Female; D041981:Gastrointestinal Tract / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D009853:Omeprazole / Q000494:pharmacology; D010437:Peptic Ulcer / Q000453:epidemiology; D054328:Proton Pump Inhibitors; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology; D012737:Sex Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin; D009853:Omeprazole; D054328:Proton Pump Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors