Hypersensitivities to non-steroidal anti-inflammatory drugs

Abstract

NSAIDs are the most commonly used medications worldwide and are responsible for almost 25% of adverse drug reactions. Such reactions can have different manifestations and can be immunologic or non-immunologic. The diagnosis is primarily based on the medical history, which can be difficult in patients receiving multiple medications. Because skin testing and blood tests are not valid for NSAIDs reactions, confirmation requires an appropriately-designed challenge. The latter could be avoided when the history is obvious and the reaction is life-threatening. The challenge route can be oral, nasal, or bronchial. Avoidance of the causative NSAID, often associated with the avoidance of the cross-reacting preparations, is the cornerstone of management. In most cases, a safe substitute can be used. When treatment with the causative NSAID is necessary, titrated desensitization can be performed. This review discusses the classes of NSAIDs, mechanisms of their adverse reactions, manifestations, diagnosis, and management.

Clinical benefits of aspirin desensitization in patients with nonsteroidal anti-inflammatory drug exacerbated respiratory disease are not related to urinary eicosanoid release and are accompanied with decreased urine creatinine

“…[1][2][3][4][5] The clinical symptoms of rhinosinusitis and bronchial asthma can be exacerbated by ingestion of aspirin (acetylsalicylic acid) (ASA) or other NSAIDs. A history of NSAID hypersensitivity is a risk factor for severe chronic asthma 6 -9 and is associated with nearfatal asthma phenotype.…”

Beneficial effect of Ageratum conyzoides Linn (Asteraceae) upon inflammatory response induced by carrageenan into the mice pleural cavity

“…Moreover, if the factor that triggers the inflammation persists, the inflammation can become relentless, leading to an intensification of the lesion (Headland and Norling, 2015). Many of the commonly used anti-inflammatory agents are becoming less acceptable due to serious adverse reactions, such as gastric intolerance, bone marrow depression and water and salt retention (Mourad and Bahna, 2014;Pretorius et al, 2013).…”

Rational Use of Nonsteroidal Anti-Inflammatory Drugs. Clinical Guidelines

“…При использовании НПВП могут возникать гематологические осложнения (наиболее часто -при приеме метамизола и индометацина) [208,209], тяжелые кожные аллергические реакции [207,210,211] и бронхоспазм (у страдающих бронхиальной астмой) [212,213].…”