title: [Nonsteroidal anti-inflammatory agents--choice between disturbances of gastrointestinal tract and cardiovascular toxicity].
abstract: Nonsteroidal anti-inflammatory agents are used more than 100 years. Most of them can cause undesirable effects on gastrointestinal tract: ulceration, bleeding and perforation of stomach and duodenum. Gastrointestinal toxicity is diminished when selective cyclooxygenase-2 inhibitors are used. However, recent clinical trials have showed that the use of cyclooxygenase-2 inhibitors increases the risk of cardiovascular event and cerebrovascular accident. According to the data such risk may be high using also nonselective nonsteroidal anti-inflammatory agents, however, it is lesser. Incidence rates of the cardiovascular events and cerebrovascular accidents increase due to activated thrombotic activity. Nonsteroidal anti-inflammatory agents are very useful in the management of rheumatic diseases and as pain relievers. Choosing appropriate nonsteroidal anti-inflammatory agent it is essential to consider the risk of gastrointestinal as well cardiovascular damage.
authors.affiliation: Department of Theoretical and Clinical Pharmacology, Kaunas University of Medicine, Kaunas, Lithuania. gingum@takas.lt
authors.forename: Gintautas
authors.initials: G
authors.lastname: Gumbrevicius
authors.forename: Arvydas
authors.initials: A
authors.lastname: Milasius
authors.forename: Audrius
authors.initials: A
authors.lastname: Sveikata
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000925:Anticoagulants / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000401:mortality; D002561:Cerebrovascular Disorders / Q000139:chemically induced / Q000401:mortality; D018849:Controlled Clinical Trials as Topic; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects; D004347:Drug Interactions; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D005938:Glucocorticoids / Q000009:adverse effects; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy; D010437:Peptic Ulcer / Q000139:chemically induced / Q000150:complications; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced; D010439:Peptic Ulcer Perforation / Q000139:chemically induced; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D052246:Cyclooxygenase 2 Inhibitors; D005938:Glucocorticoids