[Update on current care guidelines. Safe use of non-steroidal anti-inflammatory drugs].
Pain medication should be based on patient's needs and risk profile. Age > 65 years, prior ulcer, co-morbidities, large daily dose, Helicobacter pylori infection, concurrent use of glucocorticoids, serotonin re-uptake inhibitors, or warfarin increase the risk of upper gastrointestinal bleeds. As a preventive strategy the use of concurrent proton pump inhibitors with non-selective NSAIDs is recommended. It is also possible to use COX-2 selective NSAIDs but they are contraindicated for persons with atherosclerotic diseases and special consideration is required for persons with risk factors of heart diseases. Paracetamol is the drug of choice for pain.
Karvonen
Anna-Liisa
AL
Hakala
Markku
M
Helin-Salmivaara
Arja
A
Kankaanranta
Hannu
H
Kivilaakso
Eero
E
Kunnamo
Ilkka
I
Lehtola
Juhani
J
Martio
Jukka
J
D000082:Acetaminophen / Q000627:therapeutic use; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D004347:Drug Interactions; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors; D000082:Acetaminophen