García CI, Díaz FSD, Zorrilla MJG, Cortés CR

Language: Spanish
References: 14
Page: 324-331
PDF size: 282.23 Kb.

ABSTRACT

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most consumed drugs worldwide, with or without medical prescription, mostly for the symptomatic treatment of a widely range of diseases characterized by acute or chronic pain. NSAIDs have a heterogenous chemical structure that gives them antipyretic, anti-inflammatory and analgesic properties through their ability to inhibit proinflammatory prostaglandins. The variability in risk profiles among NSAIDs forces the medical community to individualize their use based on the personal characteristics of the patients as well as the expertise of the physician. NSAIDs should be used for short cycles of treatment with the lowest doses possible, using them in a range of clinical efficacy, with specific monitoring of gastrointestinal, cardiovascular, renal hepatic and hematologic complications. The objective of this work is to review the safety aspects of the treatment with NSAIDs in chronic analgesic management.

REFERENCES

1. Cazacu I, Mogosan C, Loghin F. Safety issues of current analgesics: an update. Clujul Med. 2015; 88 (2): 128-136.

2. Scheiman JM, Hindley CE. Strategies to optimize treatment with NSAIDs in patients at risk for gastrointestinal and cardiovascular adverse events. Clin Ther. 2010; 32 (4): 667-677.

3. Smith SR, Deshpande BR, Collins JE, Katz JN, Losina E. Comparative pain reduction of oral non-steroidal anti-inflammatory drugs and opioids for knee osteoarthritis; systematic analytic review. Osteoarthr. Cartil. 2016; 24 (6): 962-972.

4. Danelich IM, Wright SS, Lose JM, Tefft BJ, Cicci JD, Reed BN. Safety of nonsteroidal antiinflammatory drugs in patients with cardiovascular disease. Pharmacotherapy. 2015; 35 (5): 520-535.

5. Scarpignato C, Lanas A, Blandizzi C, Lems WF, Hermann M, Hunt RH. Safe prescribing of non-steroidal anti-inflammatory drugs in patients with osteoarthritis—an expert consensus addressing benefits as well as gastrointestinal and cardiovascular risks for the International NSAID Consensus Group. BMC Med. 2015; 13: 55.

6. Kongtharvonskul J, Anothaisintawee T, McEvoy M, Attia J, Woratanarat P, Kongtharvonskul AT. Efficacy and safety of glucosamine, diacerein, and NSAIDs in osteoarthritis knee: a systematic review and network meta-analysis. Eur J Med Res. 2015; 20: 24.

7. O’Neil CK, Hanlon JT, Marcum ZA. Adverse effects of analgesics commonly used by older adults with osteoarthritis: focus on non-opioid and opioid analgesics. Am J Geriatr Pharmacother. 2012; 10 (6): 331-342.

8. Enthoven WT, Roelofs PD, Deyo RA, van Tulder MW, Koes BW. Non-steroidal anti-inflammatory drugs for chronic low back pain. Cochrane Database of Syst Rev [Internet]. Disponible en: http://onlinelibrary.wiley.com.pbidi.unam.mx:8080/doi/10.1002/14651858.CD012087/pdf

9. Brune K, Patrignani P. New insights into the use of currently available non-steroidal anti-inflammatory drugs. J Pain Res. 2015; 8: 105-118.

10. Matthews ML. The role of dose reduction with NSAID use. Am J Manag Care. 2013; 19 (14): s273-277.

11. Chen YF, Jobanputra P, Barton P, Bryan S, Fry-Smith A, Harris G et al. Cyclooxygenase-2 selective non-steroidal anti-inflammatory drugs (etodolac, meloxicam, celecoxib, rofecoxib, etoricoxib, valdecoxib and lumiracoxib) for osteoarthritis and rheumatoid arthritis: a systematic review and economic evaluation. Health Technol Assess. 2008; 12 (11): 1-278.

12. Hunter TS, Robison C, Gerbino PP. Emerging evidence in NSAID pharmacology: important considerations for product selection. Am J Manag Care. 2015; 21 (7): S139-147.

13. Yeomans ND. Consensus about managing gastrointestinal and cardiovascular risk of nonesteroidal anti-inflammatory drugs? BMC Med. 2015; 13: 56.

14. White WB, Kloner RA, Angiolillo DJ, Davidson MH. Cardiorenal safety of OTC analgesics. J Cardiovasc Pharmacol Ther. 2018; 23 (2): 103-118.