title: Minimizing risks of NSAIDs: cardiovascular, gastrointestinal and renal.
abstract: Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in treating inflammation, pain and fever, but their cardiovascular, renal and gastrointestinal toxicity can result in significant morbidity and mortality to patients. Techniques for minimizing the adverse risks of NSAIDs include avoiding use of NSAIDs where possible, particularly in high-risk patients; keeping NSAID dosages low; prescribing modified-release and enteric-coated NSAIDs; prescribing cyclooxygenase-2-selective inhibitors where appropriate; monitoring for early signs of side effects; prescribing treatments designed to minimize NSAID side effects; and developing new therapeutic strategies beyond the inhibition of cyclooxygenase. All of the above strategies can be useful in reducing the risk of NSAID complications. The optimal use and management of NSAIDs involves an individualized paradigm approach to establish efficacy with optimal tolerability given the patient risk factors for adverse events.
authors.affiliation: College of Pharmacy Department of Pharmaceutical Sciences and Pharmacotherapy Washington State University, Pullman/Spokane, WA 99164-6534, USA. ndavies@wsu.edu
authors.forename: Neal M
authors.initials: NM
authors.lastname: Davies
authors.forename: Jonathon K
authors.initials: JK
authors.lastname: Reynolds
authors.forename: Megan R
authors.initials: MR
authors.lastname: Undeberg
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Gates
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ohgami
authors.forename: Karina R
authors.initials: KR
authors.lastname: Vega-Villa
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal