Gastric and renal effects of COX-2 selective and non-selective NSAIDs in rats receiving low-dose aspirin therapy

Abstract

The consumption of low-dose aspirin (LDA) to prevent cardiovascular disease continues to increase worldwide. Consequently, the number of chronic LDA users seeking dental procedures that require complementary acute anti-inflammatory medication has also grown. Considering the lack of literature evaluating this interaction, we analyzed the gastric and renal effects caused by a selective COX-2 inhibitor (etoricoxib) and a non-selective COX-2 inhibitor (ibuprofen) nonsteroidal anti-inflammatory drug (NSAID) in rats receiving chronic LDA therapy. Male Wistar rats were divided into six experimental groups (carboxymethylcellulose (CMC) - vehicle; LDA; LDA + ibuprofen; ibuprofen; LDA + etoricoxib; and etoricoxib) and submitted to long-term LDA therapy with a subsequent NSAID administration for three days by gavage. After the experimental period, we analyzed gastric and renal tissues and quantified serum creatinine levels. The concomitant use of LDA with either NSAID induced the highest levels of gastric damage when compared to the CMC group (F = 20.26, p < 0.05). Treatment with either LDA or etoricoxib alone was not associated with gastric damage. No significant damage was observed on kidney morphology and function (F = 0.5418, p > 0.05). These results suggest that even the acute use of an NSAID (regardless of COX-2 selectivity) can induce gastric damage when combined with the long-term use of low-dose aspirin in an animal model. Additional studies, including clinical assessments, are thus needed to clarify this interaction, and clinicians should be careful of prescribing NSAIDs to patients using LDA.

Effects of early antiplatelet therapy after splenectomy with gastro‐oesophageal devascularization

“…Aspirin exerts its antiplatelet effect by inhibiting cyclooxygenase and reducing the synthesis of TXA2. 17 Dipyridamole and aspirin have a synergistic effect in inhibiting the formation of TXA2, but dipyridamole has a stronger antiplatelet aggregation effect, mainly through inhibition of phosphodiesterase activity, increase in adenosine cyclase activity and increase in the level of platelet endocyclic phosphate. In this study, we selected dipyridamole and aspirin as the regular PVT prevention regimen.…”

Perfil de segurança da analgesia pré-emptiva com dexametasona na exodontia em ratos tratados com baixas doses de aspirina / Safety profile of preemptive analgesia with dexamethasone in tooth extraction in rats treated with low doses of aspirin

“…O cálculo amostral foi realizado por meio do programa GPower 3.1, considerando pesquisas anteriores que possuem semelhança com o nosso trabalho (MELO et al, 2017;MORO et al, 2016) Experimento 1 (E1) -4 grupos -sacrifício 2 dias após a exodontia para a avaliação de lesões gástricas e infecção (GHALAYANI et al, 2014;MORO et al, 2016;SILVA et al, 2015). Experimento 2 (E2) -4 grupos -sacrifício 28 dias após a exodontia para a avaliação do reparo ósseo alveolar e infecção (ABUOHASHISH et al, 2018;SHAHABOOEI et al, 2015;SOUSA et al, 2017b).…”

“…Apesar dos grandes benefícios trazidos pela DEX, sua prescrição por dentistas gera controvérsias, havendo profissionais que contestam sua indicação devido à possibilidade de eventos adversos, destacando-se possíveis ações de retardo no processo de reparo ósseo e aumento do risco de infecções, além dos efeitos sobre o trato gastrointestinal (TGI) como gastrite, úlceras e hemorragia digestiva (BLOECHLIGER et al, 2018;BOUVARD et al, 2013;FALCI et al, 2017;FU et al, 2012;HANSEN et al, 2008;KIM et al, 2009;NGEOW;LIM, 2016;POLDERMAN et al, 2019;TOMIZAWA et al, 2017). Destaca-se, também, que tem sido cada vez mais frequente o atendimento em consultórios odontológicos de pacientes submetidos ao uso crônico de baixas doses de Aspirina (BDAAS -75-325 mg/dia), uma vez que este medicamento está entre os agentes mais prescritos no mundo, sobretudo na prevenção de doenças cardiovasculares e mais recentemente na quimioprofilaxia de alguns tipos de câncer, principalmente o câncer colorretal, havendo estimativas de que, somente nos EUA, mais de 30% da população adulta utilize BDAAS cronicamente (GHANTOUS;FERNEINI, 2016;MCNEIL et al, 2018;MONTINARI;MINELLI;CATERINA, 2019;MORO et al, 2016;ORNELAS et al, 2017;STUNTZ;BERNSTEIN, 2017;THE ASCEND STUDY COLLABORATIVE GROUP, 2018). Porém, ainda que em baixas doses, a utilização crônica do AAS (conhecido mundialmente como Aspirina) também aumenta os riscos de eventos Brazilian Journal of Health Review, Curitiba, v.4, n.1, p.957-977 Jan/Feb.…”

Masking the Taste of Fixed-Dose Combination Drugs: Particular NSAIDs Can Efficiently Mask the Bitterness of Famotidine

“…However, since prostaglandins protect against gastric acid, gastric mucosal damage has been reported as a side effect of long-term administration of NSAIDs. 1,2) Therefore, fixed-dose combinations (FDC) of NSAIDs with acid secretion inhibitors have been developed with the advantage of reduced side effects, reduced number of medications taken, and improved adherence. 3,4) Famotidine (FAM) is a histamine receptor antagonist that decreases gastric acid secretion, used widely for treating gastric ulcers.…”