NSAID
Introduction
NSAID are drugs used to treat pain and inflammation.
Scope
20 on market. Selective vs non-selective. 5-10% of all prescriptions a year. 70 million annual rx in US. Second most common over the counter medicine second to APAP. [3]
Prostaglandins
1992, Nobel prize was given for discovering how aspirin works. Dr. Bergstrom said, "PG synthesized in all cells in the body."[3]
If using a less GI toxic NSAID, is PPI indicated to prevent NSAID-induced ulcer disease?NSAIDs and Prostoglandins
The effect of NSAIDs on prostoglandins
NSAIDs and the inhibition of cyclooxygenase (COX) isoenzymesProstoglandins are hormone like molecules that are derived from arachidonic acid. They function to sustain homeostasis and mediate pathogenic mechanisms such as the inflammatory response. Prostoglandins are derived from arachidonate by cyclooxygenase (COX) isoenzymes. NSAIDs (nonsteroidal anti-inflammatory drugs) are used to block prostoglandin synthesis by inhibiting COX-1 and COX-2 which decreases inflammation in the body. [1,2]
Preventing GI toxicity from NSAID
PPI drugs
H2 Blockers
Can a dialysis patient take NSAID?
NSAID can cause or worsen kidney disease but since a patient considered end stae (ESRD) does not have potential for recovery, it might be safe to use and NSAID.