Use of Nonsteroidal Antiinflammatory Drugs

American‐Style Football and Cardiovascular Health

“…NSAID use patterns among ASF athletes vary and include short‐term use in the context of acute injury management, long‐term use for the management of chronic pain syndromes, and pregame use, often at high doses, including injectable formulations. At present, the cardiovascular54 and renal55 implications of each of these NSAID utilization strategies among ASF participants are unknown; however, associations linking NSAID use with increases in blood pressure,56 incident ischemic heart disease,57 and cerebrovascular disease58 in the general population underlie contemporary public health guidelines, which endorse only modest NSAID intake for short‐term medical conditions 59…”

“It looks after me”: How older patients make decisions about analgesics for osteoarthritis

“…However, whereas paracetamol at maximum dose (4 g/day) is relatively safe, NSAIDs (both nonselective and COX-2 selective agents) have a range of serious adverse effects, particularly affecting those aged 65 and above. These include gastrointestinal ulceration, myocardial infarction, stroke, hypertension, renal impairment and cardiac failure (4)(5)(6). Among patients over the age of 65, non-aspirin NSAID-related peptic ulcer disease contributes to a considerable number of hospitalizations each year (7).…”

“…Due to the different safety profiles of these treatments, most clinical practice guidelines recommend a stepped care approach to OA, with paracetamol being used as initial pharmacological therapy after trial of non-pharmacological interventions (5,(8)(9)(10). In patients whose symptoms are not controlled by paracetamol at the maximum recommended dose, then the guidelines suggest that an NSAID may be a suitable alternative to pharmacotherapy depending on the individual patient's risk profile (5,(8)(9)(10).…”

“…In patients whose symptoms are not controlled by paracetamol at the maximum recommended dose, then the guidelines suggest that an NSAID may be a suitable alternative to pharmacotherapy depending on the individual patient's risk profile (5,(8)(9)(10). The limited data that exist concerning adherence to these clinical practice guideline recommendations suggest that there is an under-utilization of paracetamol and an inappropriately high usage of NSAIDs (11)(12)(13).…”

ISFM and AAFP Consensus Guidelines: Long-Term use of NSAIDs in Cats

“…These are uncommon or rare, but include occasional exacerbation of congestive heart failure (CHF) and/or hypertension due to water and salt retention mediated by COX-1 and COX-2 suppression in the kidneys; reduced platelet aggregation and bleeding as a result of inhibition of COX-1 mediated platelet thromboxane production; and thromboembolic disease due to inhibition of COX-2 mediated endothelial prostacyclin production. 77,[96][97][98] While ex vivo inhibition of platelet thromboxane has been demonstrated for a number of NSAIDs in cats, studies have not been able to demonstrate a clinically ben eficial effect in preventing thromboembolic disease, or in promoting unwanted bleeding. 56,99 Currently, there are no data on the potential effects of NSAID therapy on blood pressure or CHF in cats, or on whether COX-2 selective agents may have a prothrombotic effect in certain individuals, such as those with a propensity to develop thromboembolism.…”