Abstract:62-year-old female presents with hypertensive urgency while taking daily NSAIDs. This case demonstrates the effect of NSAIDs on BP, an often over-looked etiology of secondary hypertension. The detrimental effects of NSAIDs upon blood pressure have been well documented. The report reiterates and reviews the severity of the problem. We will review the existing literature and discuss the importance of small increases in blood pressure. This paper has not been submitted elsewhere, is not under review, or published… Show more
“…Berkurangnya kadar prostaglandin E2 dan prostasiklin yang bersifat vasodilator serta meningkatnya kadar tromboksan pada penggunaan OAINS yang non selektif akan menyebabkan timbulnya destabilisasi plak ateroma, aterogenesis, dan trombosis. Enzim siklooksigenase-2 diketahui merupakan sumber utama dalam produksi prostasiklin yang mempunyai efek kardioprotektif (Landefeld et al, 2016).…”
Hypertension causes atherosclerosis which can cause occlusion resulting in subchondral ischemia, which causes the exchange of nutrients and gases into the articular cartilage, which is disrupted and becomes the potential initiator of degradative changes or the so-called osteoarthritis. This review aims to evaluate the effect of antihypertensive drug interactions with NSAIDs on blood pressure. This article review was conducted using a narrative review study. The inclusion criteria in this article are the pharmacodynamic interaction of antihypertensives with NSAIDs in hypertensive patients with osteoarthritis. The results obtained seven articles that meet the inclusion criteria. Hypertensive patients with osteoarthritis receive medications that must be monitored because a drug-drug interaction can decrease the effectiveness of antihypertensives. One of the most widely used drugs in antihypertensive therapy is ACEi, but NSAIDs inhibit the antihypertensive effect on prostaglandin synthesis resulting from bradykinin production. The decrease in blood pressure stimulated by bradykinin plays an essential role in vasodilatation. The interaction of ACEi and NSAIDs can cause an increase in blood pressure with a minimum expansion of 1.1 mmHg. Still, when administering NSAIDs with CCBs, a decrease in blood pressure of 2.86 mmHg is obtained because the action is not dependent on prostaglandins. Based on the results, there were pharmacodynamic changes for both antihypertensive drugs and NSAIDs due to drug interactions that affected the patient's clinical outcome in the form of blood pressure.
“…Berkurangnya kadar prostaglandin E2 dan prostasiklin yang bersifat vasodilator serta meningkatnya kadar tromboksan pada penggunaan OAINS yang non selektif akan menyebabkan timbulnya destabilisasi plak ateroma, aterogenesis, dan trombosis. Enzim siklooksigenase-2 diketahui merupakan sumber utama dalam produksi prostasiklin yang mempunyai efek kardioprotektif (Landefeld et al, 2016).…”
Hypertension causes atherosclerosis which can cause occlusion resulting in subchondral ischemia, which causes the exchange of nutrients and gases into the articular cartilage, which is disrupted and becomes the potential initiator of degradative changes or the so-called osteoarthritis. This review aims to evaluate the effect of antihypertensive drug interactions with NSAIDs on blood pressure. This article review was conducted using a narrative review study. The inclusion criteria in this article are the pharmacodynamic interaction of antihypertensives with NSAIDs in hypertensive patients with osteoarthritis. The results obtained seven articles that meet the inclusion criteria. Hypertensive patients with osteoarthritis receive medications that must be monitored because a drug-drug interaction can decrease the effectiveness of antihypertensives. One of the most widely used drugs in antihypertensive therapy is ACEi, but NSAIDs inhibit the antihypertensive effect on prostaglandin synthesis resulting from bradykinin production. The decrease in blood pressure stimulated by bradykinin plays an essential role in vasodilatation. The interaction of ACEi and NSAIDs can cause an increase in blood pressure with a minimum expansion of 1.1 mmHg. Still, when administering NSAIDs with CCBs, a decrease in blood pressure of 2.86 mmHg is obtained because the action is not dependent on prostaglandins. Based on the results, there were pharmacodynamic changes for both antihypertensive drugs and NSAIDs due to drug interactions that affected the patient's clinical outcome in the form of blood pressure.
“…Different NSAIDs vary significantly in their effect on blood pressure with indomethacin, naproxen, and piroxicam resulting in the highest elevations in blood pressure [5]. Modest elevations in blood pressure are usually seen, with significant rises causing hypertensive crises rarely being reported in the literature [6].…”
Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed drugs to treat pain, and are easily available over the counter in lower dosages. NSAID use is associated with various side effects and elevated blood pressure is one of them. NSAIDs vary considerably in their effect on blood pressure with indomethacin being one of the NSAIDs associated with a significant increase in blood pressure. We present a case of a 58-year-old woman who developed a hypertensive crisis after a single dose of prescription indomethacin.
Pendahuluan: Stroke merupakan penyakit serebrovaskular yang menjadi penyebab utama kematian yang sering terjadi di Indonesia. Jumlah penderita stroke di seluruh dunia yang berusia dibawah 45 tahun terus meningkat. Adanya penyakit penyerta serta berbagai faktor resiko pasien stroke mengakibatkan pasien akan sering mengkonsumsi lebih dari dua macam obat dan dapat berisiko pada ketidakefektifan pengobatan dan memungkinkan terjadi drug related problems (DRPs). Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran kejadian DRPs pada pasien stroke yang menjalani pengobatan di poli saraf RSUD Dr M Yunus Bengkulu. Metode: Penelitian ini dilakukan dengan metode cross sectional secara prospektif pada pasien rawat jalan di poli saraf selama 2 bulan. Subjek yang memenuhi kriteria inklusi sejumlah 89 pasien. Kriteria eksklusi adalah pasien yang tidak bersedia terlibat hingga akhir penelitian dan tuli. Pengumpulan data dilakukan dengan melakukan wawancara dan pengisian kuesioner kualitas hidup menggunakan Short Form 36 (SF-36). Hasil: Dari 89 pasien stroke sebanyak 85 pasien (95,5%) menderita stroke non hemoragik, kejadian drug related problems (DRP’s) pada pasien stroke di poliklinik rawat jalan RSUD Dr M Yunus Bengkulu meliputi: ada indikasi yang tidak diterapi sebanyak 20 kasus (22,5%), obat yang tidak diperlukan sebanyak 3 kasus (3,4%), efek samping obat sebanyak 4 kasus (4,5%), dan pemilihan obat yang tidak tepat sebanyak 4 kasus (4,5%). Tidak ada hubungan antara faktor risiko umur dan jumlah obat yang diterima pasien dengan kejadian drug related problems (DRP’s), ada hubungan antara kualitas hidup pasien stroke dengan drug related problems (DRP’s) pada domain keadaan fisik. Kesimpulan: Jenis stroke yang paling banyak terjadi di RSUD Dr M Yunus Bengkulu adalah stroke non hemoragik sebanyak 85 pasien (95,5%). Kejadian drug related problems (DRP’s) pada pasien stroke di poliklinik rawat jalan RSUD Dr M Yunus Bengkulu terjadi sebesar 31 kasus. Jenis drug related problems (DRP’s) yang terjadi meliputi ada indikasi yang tidak diterapi sebanyak 20 kasus (22,5%), ada obat yang tidak perlu sebanyak 3 kasus (3,4%), efek samping obat sebanyak 4 kasus (4,5%), dan pemilihan obat yang tidak tepat sebanyak 4 kasus (4,5%). Tidak ada hubungan antara faktor risiko umur dan jumlah obat yang diterima pasien dengan kejadian drug related problems (DRP’s). Terdapat hubungan antara kualitas hidup pasien stroke dengan drug related problems (DRP’s) pada domain keadaan fisik.
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