Knowledge Of Non-steroidal Anti-inflammatory Drugs Research Articles

Knowledge of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and their Adverse Effects among Medical and Non-Medical Students

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are the common analgesics, antipyretics, and anti-inflammatory drugs. Though, their frequent consumption cause peptic ulcer disease (PUD) and other unfavorable side effects. This study aimed to compare the knowledge and attitude of Karachi medical and non-medical students about NSAIDs and their adverse effects. Methods: A comparative cross-sectional study was conducted from June 2021-2022, including 344 students from four universities in Karachi, with an equal ratio of medical (n=172) and non-medical (n=172). The study participants were requested to fill out the questionnaire based on the usage of NSAIDs, over-the-counter availability, side effects, etc. The knowledge of adverse drug reactions, reasons for self-medication, and NSAID prescriptions were compared using the Chi-square/Fisher Test. Results: The results showed that about 88.4% of students had some previous knowledge of NSAIDs, of which 98.2% were from the medical sector and 78.4% were from the non-medical sector. 68.6% of students were familiar with the NSAIDs’ adverse effects, 90.1% were medical students, and 47.1% were non-medics. Only 47.7% of the total population was aware of PUD, with 80.2% attending medical universities. While most of the self-medicating students were non-medical 84.7%. Conclusion: Medical students of Karachi possessed more knowledge about NSAID use and its adverse effects. The most known prevalent adverse was PUD, which indicates GI bleeding. It is recommended that there is a dire need for awareness concerning the usage, safety and adverse effects of NSAIDs. Keywords: NSAIDs; Peptic Ulcer Disease; Medical Students; Non-medical Students.

Regulation of Autophagy by Non-Steroidal Anti-Inflammatory Drugs in Cancer.

Cancer is the leading cause of death, placing a substantial global health burden. The development of the most effective treatment regimen is the unmet clinical need for cancer. Inflammation plays a role in tumorigenesis and progression, and anti-inflammation may be a promising option for cancer management and prevention. Emerging studies have shown that non-steroidal anti-inflammatory drugs (NSAIDs) display anticarcinogenic and chemopreventive properties through the regulation of autophagy in certain types of cancer. In this review, we summarize the pharmacological functions and side effects of NSAIDs as chemotherapeutic agents, and focus on its mode of action on autophagy regulation, which increases our knowledge of NSAIDs and cancer-related inflammation, and contributes to a putative addition of NSAIDs in the chemoprevention and treatment of cancer.

Enfermedad ulcerosa péptica

Peptic ulcer is a mucosal break of diameter 5mm or larger, reaching submucosal layer. H. pylori and non-steroidal anti-inflammatory drugs (NSAID) intake, are the main causes. Their incidence has fallen during last years, in parallel with the incidence of H. pylori and the improvement in the knowledge of NSAID's effects. Symptoms are unspecific. Predominant symptom is epigastric pain, however asymptomatic cases are possible and may appear like a complication of another disorder. Nowadays, diagnosis is mainly endoscopic, allowing both ulcer visualization and to take biopsy samples in order to discard H. pylori and malignancy. Digestive hemorrhage is the most frequent complication, its treatment requires: adequate staging, fluid management, proton pump inhibitors (PPIs) use and endoscopic therapy in ulcer recurrence in high-risk patients. Gastric-wall perforation and obstruction are other possible complications. The two pillars of peptic ulcer treatment are H. pylori eradication therapy and PPI treatment when necessary, according with ulcer location and etiology.

Basic Knowledge of Non-steroidal Anti-inflammatory Drugs among Saudi Community

Pharmacology, Toxicology and Biomedical Reports,2019,5,2,93-96.DOI:10.5530/PTB.2019.5.17Published:July 2019Type:Research ArticleAuthors:Amani Abdullah Bahdailah Author(s) affiliations:Amani Abdullah Bahdailah*, Pharmaceutical Care Services, King Abdullah Bin Abdulaziz University Hospital, Riyadh, SAUDI ARABIA. Abstract:Objectives: The use of non-steroidal anti-inflammatory drugs (NSAIDs) is a rising problem in the modern medical world. NSAIDs are easily available over the counter and accessible to the public. As such, we have seen a need to assess the knowledge and perception of public use of NSAIDs. In this study, we aimed to explore the knowledge of public use of NSAIDs among the participants from major metropolitan areas in the Kingdom of Saudi Arabia. Methodology: This is a cross-sectional study conducted for a period of 6 months using a questionnaire, which was developed to evaluate the use of NSAIDs in several major metropolitan areas among the Kingdom of Saudi Arabia. This questionnaire was randomly distributed digitally using the Survey Monkey system to individuals in the Kingdom of Saudi Arabia via social networking sites. The survey collected demographic data, age, education, socioeconomic status. The patient knowledge about the administration of NSAIDs status with meals, side effects, expiry date, resource information and related knowledge issues. The data were tabulated and analyzed by using SPSS version 13. Results: In this study, a total of 3000 patients received the questionnaire and of them, 500 responded, which means the response rate was 16.6%. The highest percentage of responders were in the age group of 40 years and above (52.63% n=263). Majority of the responders were those who had a university degree (66.20% (n=329)). According to our results, 63.31% (n=316) of the participants they knew how to take NSAIDs, i.e. with or without food is essential. Approximately 45% (n=224) of the participants knew about the possible side effects of NSAIDs. Half of the study population thought that expiry date is the time by which drugs become ineffective, whereas 33.81% (n=169) of the participants thought that drugs become toxic after this time. Around 61.87% (n=309) of the participants obtained information about NSAIDs from the package insert, whereas 32.45% (n=162) of the participants obtained information from the internet. Conclusion: The primary knowledge regarding NSAIDs is inadequate in the Kingdom of Saudi Arabia. Patient education about NSAIDs is highly recommended at healthcare institutions to prevent drug-related mistake, reduce economic burden on the healthcare system in Saudi Arabia. Keywords:Knowledge, Non-steroidal Anti-inflammatory Drugs, Patient, Saudi ArabiaView:PDF (180.31 KB) PDF PDF Images Sociodemographic characteristic of the respondents.

Knowledge of patients on safe medication use in relation to nonsteroidal anti-inflammatory drugs.

Introduction:Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed and used medications that are used as analgesic, antipyretic, or anti-inflammatory agents, but have a high risk of adverse effects.Objective:The main purpose of this study is to evaluate the knowledge of patients toward the risks and safe usage of NSAIDs.Methods:A descriptive cross-sectional study was conducted among patients who attended orthopedic clinics at King Khalid University Hospital in Riyadh, Saudi Arabia, during December 2017 to February 2018. A self-administered questionnaire comprising three sections [sociodemographic information, patients’ knowledge of NSAIDs, and the attitude toward receiving information about NSAIDs’ adverse drug reactions (ADRs)] was used. The attitude was measured with a 5-point Likert scale.Results:The mean duration of NSAIDs usage was 7.3 ± 6.9 years. Only 45% of the respondents used NSAIDs daily, while 38% said they only used NSAIDs as needed. Nearly one-quarter of patients (25.5%) were counseled by a healthcare provider on the risks of NSAIDs. Almost 94% and 90.5% of the study subjects agreed that physicians and pharmacists, respectively, should play an essential role in providing information regarding ADRs to their patients. More than half of the respondents claimed that information about ADRs might lead them to discontinue their medicines. More than one-third of respondents stated that their healthcare setting provided them with insufficient knowledge of ADRs.Conclusion:Counseling of patients may diminish potentially inappropriate use and increase risk awareness. Healthcare providers can improve their role in identifying and counseling patients on NSAIDs.

Non-Steroidal Anti-Inflammatory Drugs Prescription in Elderly Ambulatory Patients

Non-steroidal antiinflammatory drugs (NSAID) are widely used medications in elderly ambulatory patients despite their numerous side effects. The NSAID prescription by 6 general practitioners (GPs) working in a single center to ambulatory patients aged 65 years or older was retrospectively evaluated. Individual interviews of the 6 GPs were performed by means of qualitative questionnaires to determine NSAID prescription habits, knowledge of NSAID by doctors, knowledge of Good Clinical Practice (GCP) recommendations. We then conducted a retrospective observational study in 154 patients aged 65 years or older who received at least one NSAID given orally between October 1st and December 31st of 2014, by means of a questionnaire including 34 validated evaluation criteria according to the current guidelines. The 6 GPs did not frequently prescribe NSAID in their patients aged 65 years or older, due to the high number of co-prescribed drugs, renal or liver insufficiency, and the high risk of side effects in these patients. Their knowledge regarding the side effects, contra-indications and warnings of the various available NSAIDs are heterogeneous and none of the interviewed GPs were aware of available GCP recommendations regarding NSAIDs prescription and side effects prevention in older patients. 10.5% of the 154 patients had a prescription of at least one NSAID. However, this prescription was in agreement with the market authorization recommendation in only 72% of cases. Numerous gaps were identified between daily practice of these GPs and the available GCP recommendations, except for the recommendations regarding gastrointestinal side effects and contra-indications of the NSAID, which were highly respected. GCP recommendations for NSAIDs prescription are unknown from prescribers and respect of these recommendations should be improved by means of a patient-dedicated follow-up file designed to optimize the management and prevention of NSAID-related side effects in daily practice.

À l’ère de l’automédication, que savent les femmes enceintes des anti-inflammatoires ?

Non-steroidal anti-inflammatory drugs (NSAIDs) are contraindicated in pregnancy because of the many foetalmaternal complications they can induce. Yet, NSAIDs can be massively found in family medicine cabinets and they are over the-counter drugs for most of them. Because of the actual trend of empowerment and public authorities encouraging self-medication, NSAIDs might be used. Our aim was to assess pregnant women's knowledge of NSAIDs. A descriptive study, through the distribution of 330 questionnaires to all pregnant women consulting at the Teaching hospital of Saint-Etienne, during a week, from February 11(th), 2014 to 19(th), 2014. The answering rate was 96.4%. Around 46% of pregnant women declared self-medicating. More than 1 in 3 women considered NSAIDs without danger starting from their 6th month of pregnancy. Eighty-six percent of women recognized ibuprofen as belonging to NSAISs. However, 1 in 2 women didn't consider Rhinadvil® (ibuprofene/pseudoephedrine) as such and approximately 40% for Aspegic® (lysine acetylsalicylate) and Aspirin® (acetylsalicylic acid). Danger's perception varied according to the galenic and the trade name: 60% of them thought that Rhinadvil® was without risks and around 1 in 2 women thought the same for Aspirin® and Aspegic®. Eighty-six per cent of women recognized ibuprofen as belonging to NSAIDs. However, 1 in 2 women didn't consider Rhinadvil® as such and approximately 40% for Apegic® and Aspirin®. Pregnant women's knowledge of NSAIDs is not satisfactory. They are not aware of their danger and do not know how to recognize them. Yet, self-medication is rising and its accessibility is made easier. A work on prevention and information is therefore essential.

NESTEROIDINIŲ VAISTŲ NUO UŽDEGIMO VARTOJIMO YPATUMAI: VISUOMENĖS ŽINIŲ, ELGESIO IR POŽIŪRIO ĮVERTINIMAS

Iki šiol Lietuvoje nebuvo atlikta tyrimų, kurie vertintų visuomenės žinias apie NVNU. Šio tyrimo tikslas buvo įvertinti nesteroidinių vaistų nuo uždegimo vartojimo ypatumus, visuomenės žinias apie šiuos vaistus bei elgesį juos vartojant. Atliktas perspektyvinis momentinis stebėjimo tyrimas, jam atlikti pasirinktas anoniminės apklausos metodas. Tyrimo insturmentas – originalus klausimynas, sudarytas iš 5 dalių, 22 klausimų. Aprašomoji ir lyginamoji statistinė duomenų analizė atlikta statistiniu paketu SPSS Statistics 17.0. Rezultatai laikyti statistiškai patikimais, kai patikimumo koeficientas p<0,05. Nors tyrimo rezultatai parodė, kad NVNU yra labai dažnai vartojami vaistiniai preparatai, tačiau visuomenės žinios apie šiuos vaistus nėra pakankamos. Daugiau nei pusės apklaustųjų žinios apie NVNU buvo vidutinės arba silpnos (55.7 proc.). Dažniausiai vartojami NVNU yra ibuprofenas, diklofenakas ir nimesulidas. Savigyda NVNU yra plačiai paplitęs reiškinys, galintis nulemti neracionalų NVNU vartojimą ir grėsmę pacientų saugumui. Gydytojai ir vaistininkai turėtų skirti daugiau laiko konsultuodami pacientus apie NVNU racionalų vartojimą, saugumą bei galimas nepageidaujamas reakcijas, skirdami ar išduodami šiuos vaistinius preparatus.

Side Effects of Non-Steroidal Anti-Inflammatory Drugs: The Experience of Patients with Musculoskeletal Disorders

Non-steroidal anti-inflammatory drugs (NSAIDs) are of choice for acute pain management in musculoskeletal disorders (MSDs) but they are not without side effects. The primary aim of this study was to investigate user’s experience of side effects of oral NSAIDs among patients with MSDs. Multi-stage sampling technique was used to select 296 patients with MSDs from physiotherapy out-patient clinics of five selected hospitals. A structured and close ended questionnaire was administered to investigate the side effects experienced by respondents. Descriptive statistics (mean, standard deviation, frequency and percentages) and Chi-square were used to compare the mean percentage difference in the knowledge of NSAIDs and their side effects. Only 15% of the respondents were able to recognize the listed side effects. A significant number of the respondents (58.7%) were not informed of the side effects of the NSAIDs at the time of prescription (Ӽ2 = 8.82, p = 0.003). About 33.4% and 31% of respondents identified dizziness and abdominal pain respectively as side effects. Sixty two (22.3%) respondents had experienced dizziness while 15.9% experienced abdominal pains. Diclofenac was the most frequently prescribed NSAID (153 [51.7%]). Only 2.0% and 2.7% of respondents were aware of phonophoresis and iontophoresis respectively as alternative means of administering NSAIDs where applicable. The Chi-square test revealed that the number of respondents that preferred alternative means of administration (where applicable) was significantly higher than those who preferred the oral routes (x2 = 74.5, p = 0.001). We concluded that this sample of Nigerian patients was not informed of the side effects of NSAIDs by the prescribers. Dizziness and abdominal pains were the most experienced side effects. The role of alternative methods to administer NSAIDs need to be made available to patients where applicable to increase their health care choices.

Pain Management by the Family Physician: The Family Practice Pain Education Project

Pain is a common complaint of patients who visit a family physician, and its appropriate management is a medical mandate. The fundamental principles for pain management are: placing the patient at the center of care; adequately assessing and quantifying pain; treating pain adequately; maximizing function; accounting for culture and gender differences; identifying red and yellow flags early; understanding and differentiating tolerance, dependence and addiction; minimizing side effects; and being familiar with and using CAM therapies when good evidence of efficacy exists. The pharmacologic management of pain requires thorough knowledge of nonsteroidal anti-inflammatory drugs, cyclo-oxygenase-2-specific inhibitors, and opioids. A table of equianalgesic dosages is useful because patients may need to move from one opioid to another. Accompanying this article are papers discussing 5 common pain disorders seen by family physicians, including: neck pain, low back pain, joint pain, pelvic pain, and cancer/end of life pain. The family physician who learns these principles of pain management and the algorithms for these common pain disorders can serve patients well.

Cyclo-oxygenase isoenzymes. How recent findings affect thinking about nonsteroidal anti-inflammatory drugs.

The discovery of at least 2 cyclo-oxygenase (COX) isoenzymes, referred to as COX-1 and COX-2, has updated our knowledge of nonsteroidal anti-inflammatory drugs (NSAIDs). This has lead investigators to reconsider what can be awaited from this class of drugs. The 2 COX isoenzymes share structural and enzymatic similarities, but are specifically regulated at the molecular level and may be distinguished apart in their functions, although some physiological overlap between them does occur. The major goal in developing selective COX inhibitors is to improve NSAID tolerability. Classic NSAIDs preferentially inhibit COX-1 in vitro, but it appears hazardous to judge their gastrointestinal (GI) safety profile from these data. New compounds with a high selectivity for COX-2, especially those that are non-acidic, may be better tolerated in the GI tract. While these compounds also might have a potential use in various diseases such as colorectal cancer and neurodegenerative diseases of the Alzheimer type, the possible appearance of adverse effects, perhaps renally-related, must be taken into consideration. Finally, well-designed large clinical trials are required to adequately estimate both the promising therapeutic advantages that may be offered by highly selective NSAIDs, and the potential drawbacks that may be inherent with prolonged COX-2 inhibition.

Repeat prescribing of non-steroidal anti-inflammatory drugs excluding aspirin: how careful are we?

About 5% of all National Health Service prescriptions in Britain and a quarter of reports of suspected adverse reactions are accounted for by non-steroidal anti-inflammatory drugs. Their prescription was investigated in two computerised group practices serving 11850 patients. Altogether 198 patients receiving repeat prescriptions of non-steroidal anti-inflammatory drugs were identified and relevant clinical details extracted from their notes. Of these patients, 119 were over 65 years old; 172 were receiving one of six different non-steroidal anti-inflammatory drugs; and 76 were taking drugs that can interact with non-steroidal anti-inflammatory drugs. Ninety one patients had one or more medical conditions that may be aggravated by non-steroidal anti-inflammatory drugs, and 36 had experienced side effects important enough for their treatment to be changed. A questionnaire to assess opinions and knowledge of non-steroidal anti-inflammatory drugs was given to 42 general practitioners and 26 rheumatologists. Although the two groups showed a comparable knowledge of the properties and costs of non-steroidal anti-inflammatory drugs, they differed significantly in their views on the circumstances under which these drugs should be used. Clear guidelines on the prescription of these drugs would indicate when careful monitoring is essential for patients to benefit from them safely.