Term
| How do NSAIDs cause gastrointestinal (GI) ulcers? |
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Definition
High doses NSAIDs, used chornically, greatly increase ones risk for gastrointestinal (GI) ulcers.
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Term
In patients who are not candidates for celecoxib (those with _____ risk), use ibuprofen or ______ over agents with higher - GI risk (such as piroxicam, etc). |
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Definition
| cardiovascular; diclofenac |
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Term
| PPIs do what to ulcer risk? |
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Definition
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Term
| What are some high risk ulcer patients? |
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Definition
those > 65 years, patients taking ASA, steroids or warfarin daily and these patients should receive a PPI with chronic use of non-selective NSAIDs regardless of previous history of GI ulcers. |
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Term
Celecoxib can be used in patients using steroids or warfarin or patients > 65 years if they do NOT have cardiovascular risk factors. |
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Definition
| Statement. Not a question. |
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Term
Use caution with NSAIDs in any person with ______ or renal disease for other reasons as well, including blood pressure elevation and decreased renal blood flow. If possible, avoid NSAIDs and celecoxib in patients with both ______ and _____ and those at high risk of chronic kidney disease. |
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Definition
| cardiovascular; high GI; CV risk |
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Term
| Ther risk factors for NSAID - Induced Ulcers? |
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Definition
Age (>65 years)
Use of steroids, anticoagulants or antiplatelets (aspirin, clopidogrel, prasugrel)
Previous ulcer
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Term
| Best treatment for NSAID induced ulcer? |
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Definition
Discontinue (if possible) or lower the dose of the NSAID. If NSAIDs are continued, the ulcer will take longer to heal. PPIs are the drugs of choice and should be used for ~8 weeks of therapy. Misoprostol is also an option, but diarrhea and cramping along with its four times per day dosing regimen contribute to poor patient compliance. |
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