Italian survey on non-steroidal anti-inflammatory drugs and gastrointestinal bleeding in children

Cardile, Sabrina; Martinelli, Massimo; Barabino, A.; Gandullia, Paolo; Oliva, Salvatore; Nardo, Giovanni Di; Dall’Oglio, Luigi; Rea, Francesca; Angelis, G.L. De; Bizzarri, Barbara; Guariso, Graziella; Masci, E.; Staiano, Annamaria; Miele, Erasmo; Romano, Claudio

doi:10.3748/wjg.v22.i5.1877

Cited by 43 publications

(39 citation statements)

References 20 publications

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“…Emerging research has shown that the main side effects of ibuprofen involve the gastrointestinal system [7] and the kidneys [8], especially in feverish dehydrated individuals.…”

Section: Introductionmentioning

confidence: 99%

Working Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal

Martino

Chiarugi

Boner

et al. 2017

Drugs

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Ibuprofen is the most widely used non-steroidal anti-inflammatory drug (NSAID) for the treatment of inflammation, mild-to-moderate pain and fever in children, and is the only NSAID approved for use in children aged ≥3 months. Its efficacy and safety profile have led to its increasing use in paediatric care, even without medical prescription. However, an increase of suspected adverse reactions to ibuprofen has been noted in concomitance with the raised, often medically unsupervised, consumption of the drug. The purpose of this work was a critical review of the paediatric literature over the last 15 years on side effects and adverse events associated with ibuprofen, in order to highlight circumstances associated with higher risks and to promote safe and appropriate use of this drug. The literature from 2000 to date demonstrates that gastrointestinal events are rare, but (when they occur) include both upper and lower digestive tract lesions. Dehydration plays an important role in triggering renal damage, so ibuprofen should not be given to patients with diarrhoea and vomiting, with or without fever. Likewise, ibuprofen should never be administered to patients who are sensitive to it or to other NSAIDs. It is contraindicated in neonates and in children with wheezing and persistent asthma and/or during varicella. Most of the analysed studies reported adverse events when ibuprofen was being used for fever symptoms or flu-like syndrome. Ibuprofen should not be used as an antipyretic, except in rare cases. Ibuprofen remains the drug of first choice in the treatment of inflammatory pain in children.

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“…Emerging research has shown that the main side effects of ibuprofen involve the gastrointestinal system [7] and the kidneys [8], especially in feverish dehydrated individuals.…”

Section: Introductionmentioning

confidence: 99%

Working Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal

Martino

Chiarugi

Boner

et al. 2017

Drugs

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“…La automedicación con antinflamatorios no esteroideos y opioides se ha asociado con efectos adversos renales, cardiovasculares y gastrointestinales, además del potencial de mal uso, abuso y dependencia que encierra esta práctica [9][10][11][12] .…”

Section: Introductionunclassified

Automedicación de analgésicos y antibióticos en estudiantes de pregrado de medicina

Mejía

Restrepo²,

Restrepo³

2017

MedUPB

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RESUMENObjetivo: automedicación es el uso de productos medicinales sin prescripción médica. En estudiantes de medicina es una práctica común y puede asociarse con efectos adversos. El objetivo del presente trabajo fue determinar la prevalencia de automedicación con antibióticos y analgésicos en estudiantes de pregrado de medicina y caracterizar las actitudes, los conocimientos y las prácticas frente a este comportamiento. Metodología: estudio transversal que contó con 625 estudiantes de pregrado de medicina de una universidad privada de Medellín-Colombia. Se diseñó una encuesta con 45 preguntas. La variable dependiente fue la automedicación de antibióticos y analgésicos. Se obtuvieron proporciones y promedios con sus medidas de dispersión. Se exploraron posibles asociaciones entre la práctica de la automedicación, el sexo y el semestre de formación. Se tomó como valor significativo p <0.05. Resultados: se incluyeron 625 estudiantes que aceptaron responder la encuesta, lo cual equivale al 58% de la totalidad de estudiantes matriculados. El 67% está conformado por mujeres. La razón mujer: hombre fue 2:1. La mediana para la edad fue 20 años (rango intercuartil: 3). La prevalencia de automedicación con analgésicos fue de 84% para las mujeres y 81% para los hombres y la de antibióticos de 28% para mujeres y 21% para hombres. El 90.1% de los estudiantes considera la automedicación como una práctica insegura; el 93% afirma que automedicarse con antibióticos produce resistencia antimicrobiana; sin embargo, el 78.6% afirma que continuará automedicándose. Discusión: la automedicación de analgésicos y antibióticos es un comportamiento común y complejo en estudiantes de pregrado de medicina. A pesar de tener el conocimiento de los riesgos que asumen por esta práctica, la mayoría no está dispuesta a cambiarla. Palabras clave: automedicación; conocimientos, actitudes y práctica en salud; educación de pregrado en medicina.ABSTRACT Objective: Self-medication is a common practice among university students worldwide. It is also common among medical students and has been associated, in the case of nonsteroid, antiinflamatory drugs, with renal, cardiovascular, and gastrointestinal adverse effects and multidrug-resistance in the case of antibiotics. The objective of this study was to determine the prevalence of self-medication with antibiotics and analgesics in undergraduate medical students and to characterize the attitudes, knowledge, and practices related to this behavior. Methodology: Cross-sectional study. 625 undergraduate medical students from a private university in Medellín, Colombia participated. A 45-question survey was designed. The dependent variable was self-medication of antibiotics and analgesics. Proportions and means with their dispersion measurements were obtained. We explored possible

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“…In a study of 51 patients in Italy regarding NSAID use, the rate of associated pain was 56.9%, PUs was 13.7%, hematemesis was 33.3%, and erosive lesions was 62%. 6 In addition to its direct effects, NSAIDs can cause pyloric edema by decreasing the prostaglandin E2 levels and increasing the gastric secretions by increasing the histamine levels indirectly.…”

Section: Discussionmentioning

confidence: 99%

Management of NSAID-related pyloric obstruction in a child using endoscopic balloon dilatation: A case report

Öztan¹,

Güngör-Takeş²,

Çağan-Appak³

et al. 2018

Turk J Pediatr

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Öztan MO, Güngör-Takeş G, Çağan-Appak Y, Yıldız C, Karakoyun M, Baran M. Management of NSAID-related pyloric obstruction in a child using endoscopic balloon dilatation: A case report. Turk J Pediatr 2018; 60: 765-768.A gastric outlet obstruction (GOO) is a major complication of peptic ulcers (PUs) and corrosive ingestion in children; however, the optimal management of a patient with a GOO after a PU remains controversial. Although surgical correction is the most common treatment option, endoscopic balloon dilatation and simultaneous dilatation with a steroid injection are used more frequently as first-line treatments for PU-related GOOs. These patients require operative interventions when the obstruction cannot be managed using endoscopic approaches or in cases of relapsing after the procedure. Here, we present a case to create awareness that endoscopic balloon dilatation is a simple, effective, and safe therapy for a PU-related GOO.

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Italian survey on non-steroidal anti-inflammatory drugs and gastrointestinal bleeding in children

Abstract: The data collected in this study confirms that adverse events with the involvement of the gastrointestinal tract secondary to NSAID use are also common in children.

Cited by 43 publications

References 20 publications

Working Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal

Working Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal

Automedicación de analgésicos y antibióticos en estudiantes de pregrado de medicina

Management of NSAID-related pyloric obstruction in a child using endoscopic balloon dilatation: A case report

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