Adverse Effects of Nonsteroidal Antiinflammatory Drugs: An Update of Gastrointestinal, Cardiovascular and Renal Complications

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are used chronically to reduce pain and inflammation in patients with arthritic conditions, and also acutely as analgesics by many patients. Both therapeutic and adverse effects of NSAIDs are due to inhibition of cyclooxygenase (COX) enzyme. NSAIDs are classified as non-selective and COX-2-selective inhibitors (COXIBS) based on their extent of selectivity for COX inhibition. However, regardless of their COX selectivity, reports are still appearing on the GI side effect of NSAIDs particularly on the lower gastrointestinal (GI) tract and the harmful role of their controlled release formulations. In addition, previously unpublished data stored in the sponsor's files, question the GI sparing properties of rofecoxib, a COXIB that has been withdrawn due to cardiovascular (CV) side effects. Presently, the major side effects of NSAIDs are the GI complications, renal disturbances and CV events. There is a tendency to believe that all NSAIDs are associated with renal and CV side effects, a belief that is not supported by solid evidence. Indeed, lower but still therapeutics doses of some NSAIDs may be cardioprotective. In this review, we briefly discuss the GI toxicity of the NSAIDs and assess their renal and CV adverse effects in more detail.

Anti-inflammatory and anti-proliferative activities of the wild edible cruciferous:Diplotaxis simplex

“…To treat acute inflammatory disorders, steroidal anti-inflammatory drugs were used. However, the use of these medicines is frequently related with disorders on gastric mucosa, as well as on the renal and cardiovascular systems (Harirforoosh et al 2013). Non-steroidal anti-inflammatory drugs are also an important group of drugs largely utilized in the treatment of inflammatory diseases, acting by inhibition of the cyclooxygenase and then prevent the conversion of arachidonic acid to prostaglandins (Blackler et al 2014).…”

Can perioperative haemodynamics and opioid requirement in Abdominal Hysterectomy be influenced by a premedication drug?

“…Since NSAIDs have adverse renal, gastrointestinal and haemostatic effects in some patients, their role is limited in some situations. 23,24 Gabapentin is a less well known drug. To make use of gabapentin widely, we have to prove several things about gabapentin.…”

A narrative review of non-operative treatment, especially traditional Chinese medicine therapy, for lumbar intervertebral disc herniation

“…However, a systematic review conducted by Vroomen et al indicated that compared with placebo, NSAIDs might be no more effective at improving global pain at 5 to 30 days in people with sciatic pain caused by LIDH (low-quality evidence) (71). In addition, NSAIDs also have undesirable side effects including ulcers, bleeding, kidney failure, and increased risk of heart attack and stroke (72). Therefore, although NSAIDs might be more effective in the acute stage of LIDH, it should be cautious for patients welfare to choose NSAIDs in the treatment of pain especially sciatic pain caused by LIDH.…”