NSAIDs In Patients Research Articles

The Effects of Topical Sesame (Sesamum indicum) Oil on Pain Severity and Amount of Received Non-Steroid Anti-Inflammatory Drugs in Patients With Upper or Lower Extremities Trauma.

Background:Most patients with trauma experience different levels of pain. Due to side effects as well as economic burden of drugs used for pain relief after trauma commonly, it is important to use low-cost methods independently or combined with drugs to alleviate pain.Objectives:Therefore, this study aimed to investigate the effects of topical sesame oil on pain severity and frequency of received NSAIDs of patients with trauma.Patients and Methods:This randomized clinical trial study was conducted on 150 patients with upper or lower extremities trauma in Dezful Ganjavian Hospital, Ahvaz, Iran, in 2014. Data was collected by a researcher-made questionnaire and Visual Analogue Scale (VAS). Patients were divided into two groups of control (n = 75) and intervention (n = 75) randomly. In the intervention group, patients applied topical sesame oil beside the routine cares, while in the control group patients just received routine cares. Severity of pain and frequency of received NSAIDs was assessed in the first, third, seventh and tenth days after the intervention in the both groups. Data was analyzed by SPSS19 software using descriptive and analytic (Chi-square and independent sample t-test) statistical methods.Results:Based on student sample t-test, there was a significant difference between intervention and control groups regarding the pain severity in the first (P = 0.06), third (P = 0.001), seventh (P = 0.001) and tenth (P = 0.001) days after the intervention. Besides, the frequency of received NSAIDs in the intervention group and the control group showed significant difference in four days after the intervention (for four days P = 0.001).Conclusions:Topical application of sesame oil could reduce pain severity and frequency of received NSAIDs in patients with upper or lower extremities trauma. Therefore, it is recommended to use this oil in complementary medicine for pain relief due to low cost, easy usage and lack of adverse effects.

The functional state of the stomach when taking nsaid in patients with chronic gastritis combined with osteoarthritis

The functional state of the stomach when taking nsaid in patients with chronic gastritis combined with osteoarthritis

NSAIDs Linked to Bleeding, Thromboembolism in AF Patients

NSAIDs Linked to Bleeding, Thromboembolism in AF Patients

Costo Utilidad de Colágena Polivinil-Pirrolidona en el Tratamiento de Osteartrosis de Rodilla en México

ObjectiveTo assess the cost-utility of collagen-polyvinyl pyrrolidone (collagen-PVP), a new drug developed and manufactured in Mexico, compared to non-steroidal anti-inflammatory drugs in the treatment of patients with knee osteoarthritis (OA) in Mexico. MethodsA probabilistic Markov model with a lifetime horizon was designed to evaluate the costs and outcomes (QALYs) of collagen-PVP compared to NSAIDs in patients with OA. Data from randomized clinical trials conducted in México were obtained as input for probabilities. Utility values ​​were elicited from international publications and costs information and service utilization was obtained from official publications of the Instituto Mexicano de Seguro Social - IMSS. Cost per quality-adjusted life-years was calculated by using the Mexican Healthcare payer perspective. A discount rate of 5% for both cost and outcomes was used. Sensitivity analyzes were performed with variations in the parameters of gender, age, and price of collagen-PVP. ResultsPatients treated with collagen-PVP showed a gain of 6.62 QALYs compared with 5.36 in patients with NSAIDs. The cost-utility ratio was higher in the NSAID group (MEX$ 170,010.76/QALY) compared to collagen-PVP (MEX $ 130,953.63/QALY). The incremental cost-utility ratio was MEX $ 35,194.16. ConclusionsThis is the first economic evaluation of a new medication developed in Mexico and conducted partially with local data. The results of this study allow concluding that collagen-PVP is deemed as the dominant alternative compared with NSAIDs in the treatment of knee osteoarthritis.

AB0830 Hypertension during the Treatment of Gouty Arthritis with Nsaids

BackgroundCardiovascular diseases are common in gout, with the hypertension (HTN) being the most frequent. Taking NSAIDs in patients with gout can result in destabilization of pre-existing HTN or the development...

Transient paraplegia after epidural catheter removal during low molecular heparin prophylaxis

Transient paraplegia after epidural catheter removal during low molecular heparin prophylaxis

SAT0359 The Number of Episodes of Acute Inflammation are Associated to Both Acute Gastrointestinal and Renal Complications Attributed to Nsaids in Patients with Gout

BackgroundUntreated or undertreated gout is characterized by recurrent episodes of acute inflammation (EAIs) of joint structures, called gout flares, and flares are commonly treated with non-steroidal anti-inflammatory drugs (NSAIDs). Proper...

AB0598 Nephrotoxicity of nsaid in patients with degenerative and inflammatory diseases

BackgroundNSAID are the major pathogenic agents in the treatment of patients with inflammatory and degenerative arthropathies. Their use is associated with multiple side effects, such as: Gastrointestinal bleeding, worsening of...

Investigation of Preoperative Kidney Function and Postoperative Administration of NSAIDs in Patients Undergoing Elective Orthopaedic Surgery

Investigation of Preoperative Kidney Function and Postoperative Administration of NSAIDs in Patients Undergoing Elective Orthopaedic Surgery

Treatment with Peg-IFNα2a/ribavirin and low-dose NSAID for patients with chronic hepatitis C and rheumatoid syndrome

To examine the safety and efficiency of using Peg-IFNα2a/ribavirin and low-dose NSAID therapy in patients with rheumatoid syndrome (RS) and chronic hepatitis C (CHC). A group of 10 patients (group 1) known to have RS and established CHC undergoing Peg-IFNα2a/ribavirin and low-dose NSAID therapy was compared with a control group of 10 patients (group 2) also with CHC and associated RS, with no antiviral treatment. Their charts were reviewed for serological and clinical signs of rheumatic disease evolution while undergoing this type of treatment. At the end of a follow-up period of 12 months, patients receiving low-dose NSAID and Peg-IFNα2a/ribavirin therapy showed a sustained virusological response and also decreased levels of inflammation serological markers, with an improvement in the clinical rheumatic symptoms. In contrast, patients in group 2 showed no significant clinical modification in their rheumatic status. Peg-IFNα2a/ribavirin and low-dose NSAID in patients with RS and CHC appear to be well tolerated and can be efficient for rheumatic manifestations. Further controlled studies are required to confirm the results.

Increased proton pump inhibitor and NSAID exposure in irritable bowel syndrome: results from a case-control study

BackgroundPatients with irritable bowel syndrome (IBS) seen by a gastroenterologist often utilize medications that may alter intestinal homeostasis. The question arises whether exposure to these drugs is associated with the development of IBS symptoms. Aim of this study was therefore to assess the use of PPIs and NSAIDs in patients with IBS versus controls.MethodsCases of IBS from the last 5 years were reviewed. All patients having had at least one prescription for a particular drug (PPIs, NSAIDs, SSRIs, diuretics, ACE inhibitors) in the 6 months prior to the time of initial symptom onset were considered exposed. The control group consisted of individuals randomly selected from the general population.Results287 cases of IBS were retrieved for analysis together with 287 age and sex-matched controls. Exposure to PPIs and NSAIDs was significantly higher in IBS patients, whereas no association between ACE inhibitor use and IBS was found. PPIs were not significantly associated when excluding patients with gastrointestinal reflux disease or functional dyspepsia. Exposure to SSRIs was also positively associated with IBS, but only when patients with psychiatric comorbidity were included in the analyses.ConclusionsMedications that may alter intestinal homeostasis such as NSAIDs and PPIs were more frequently used in IBS patients compared to controls. This association might be relevant for everyday clinical practice, but it is remains to be elucidated whether this association is of etiological nature.

Evaluation of COX-2 Selective Inhibitor for the Protection of Intestinal Mucosal Damage in Comparison to NSAIDs in Patients With Rheumatoid Arthritis

Evaluation of COX-2 Selective Inhibitor for the Protection of Intestinal Mucosal Damage in Comparison to NSAIDs in Patients With Rheumatoid Arthritis

Extended Interpleural Blockas a Method of Postoperative analgesia in Children with Idiopathic Scoliosis

Objective. To assess the efficacy of extended interpleural block in the early postoperative period in children operated for idiopathic scoliosis using thoracic approach. Material and Methods. Forty two patients of 14 to 18 years of age operated on for idiopathic scoliosis through thoracic approach were examined. Postoperative anesthetization was performed by interpleural analgesia in patients from the study group (n = 23), and by administration of narcotic analgesics and NSAIDs in patients from the control group (n = 19). Visual analog scale (VAS) was used to appreciate the adequacy of anesthesia. Respiratory function was examined using spirometry. Results. In the control group, postoperative anesthetization was required earlier than in the study group, recovery agitation symptoms were observed in two cases, and four children (21 %) had vomiting and nausea. In the study group, reduction in analgesic daily intake was noted, with more effective adequacy of anesthetization in terms of VAS scores as compared to the control group. Spirometry findings showed that interpleural analgesia exerted a positive effect on respiratory function in patients from the study group. Conclusion. Interpleural analgesia used during surgical correction of scoliotic deformity through thoracic approach provides effective postoperative anesthetization.

Strategies to optimize treatment with NSAIDs in patients at risk for gastrointestinal and cardiovascular adverse events

Background: NSAIDs, including cyclooxygenase (COX)-2 inhibitors, are among the most widely prescribed medications worldwide. However, NSAIDs have been associated with gastrointestinal (GI) toxicity. The cardiovascular (CV) toxicity associated with COX-2 inhibitors and some other NSAIDs further complicates the choice of therapy. Objective: The aim of this commentary was to appraise current NSAID treatment strategies and provide clinicians with guidance on the GI and CV risks of these strategies and choosing an appropriate treatment in individual patients. Methods: A literature search of PubMed was conducted (1989-August 2009) to gather relevant studies, meta-analyses, reviews, and treatment guidelines using the following terms, either alone or in combination: NSAID, gastrointestinal, cardiovascular, toxicity, gastroprotection, proton pump inhibitor, COX-2 inhibitor, aspirin, fixed-dose combination, and adherence. Results: Based on the data from the literature search, gastroprotective strategies (eg, proton pump inhibitors [PPIs]) are underused in patients at risk for NSAIDrelated GI complications, including in those patients most at risk. Risk factors for GI toxicity with NSAID use include high NSAID dose, a history of NSAID-associated GI adverse events or the presence of upper GI symptoms, advanced age, corticosteroid use, concurrent aspirin use, and certain comorbidities (eg, rheumatoid arthritis). Risk factors for CV toxicity with NSAID use include established CV disease or an estimated 10-year CV risk >20%. Findings from randomized controlled trials have suggested that, in patients with an increased risk for GI complications, the use of a nonselective NSAID with a PPI may be at least as effective as the use of a COX-2 selective inhibitor in preventing the recurrence of ulcer complications. In patients with a high GI risk and a moderate CV risk, the use of a COX-2 inhibitor with a PPI may be appropriate. Conclusions: The choice of NSAID should be tailored to the GI and CV risks in the patient. The risk profile can be affected by numerous factors, including NSAID dosing and concurrent aspirin use. Thus, individualized risk stratification should be the clinician's primary consideration when selecting treatment.

Using NSAIDs in cardiovascular disease

The risk of unwanted cardiovascular effects associated with NSAIDs has been publicised in the UK in recent years by the Medicines and Healthcare products Regulatory Agency (MHRA)1,2 and the National...

To use or not to use: the dilemma of NSAIDs and craniotomy

To use or not to use: the dilemma of NSAIDs and craniotomy

Etoricoxib

Etoricoxib is a selective cyclo-oxygenase (COX)-2 inhibitor, approved in Europe for the symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and acute gouty arthritis. Etoricoxib provided similar symptomatic relief to nonselective NSAIDs in patients with these conditions, and to celecoxib in patients with osteoarthritis. The drug was associated with fewer uncomplicated upper gastrointestinal (GI) adverse events than nonselective NSAIDs, and was noninferior to diclofenac in terms of the rate of thrombotic cardiovascular (CV) events. Etoricoxib may be considered as a treatment option for patients requiring NSAID therapy, particularly those at risk of upper GI events, after careful consideration of significant risk factors for CV events (including uncontrolled hypertension). As with all NSAIDs, the potential GI and CV risks of treatment with etoricoxib should be weighed against the potential benefits in individual patients, and it should be administered at the lowest effective dose for as short a duration as possible.

Valoración de la eficacia del lavado articular no artroscópico en pacientes con artrosis de rodilla

Objective To evaluate the efficacy of joint lavage in patients with osteoarthritis of the knee. Design We conducted an open prospective study involving 111 patients of whom 77% were females. The patients’ age range was 43–81 years and the average age 64±8.7 years. All patients had gonarthrosis as diagnosed according to the (ACR) American College of Rheumatology criteria (Kellgren radiographic grades II and III). Patients were randomly distributed between two treatment groups: a) Joint lavage without non-steroidal anti-inflammatory drugs (NAJL, n=57), and b) non-steroidal anti-inflammatory drugs alone (NSAIDs, n=54). Evaluations were done at baseline and one, three, and six months after enrollment. Clinical and demographic variables, and WOMAC index scores, were recorded and patient improvement was determined by following the OARSI guidelines. Statistical analyses included chi-square, analysis of covariance (baseline WOMAC) with one between-subject factor (treatment). Post-hoc comparisons were made with Sidak's adjustment. Results The respective improvement rates as measured by the OARSI index for the patients in the JL and NSAIDs groups were 50.9 and 31.5% at 1 month; 55.4 and 38.9% at three months; and 63.2 and 64.8% at six months. The patients in both groups were seen to improve from the first month ( P=.038). At the end of the six-month follow-up period, the WOMAC score had decreased significantly in both groups ( P=.000), with no significant differences between them. Conclusions Six months after treatment, joint lavage proved as effective as NSAIDs in patients with gonarthrosis, so it constitutes an effective therapeutic choice in those cases where NSAIDs are contraindicated.

Assessing the efficacy of non-arthroscopic joint lavage in patients with osteoarthritis of the knee

ObjectiveTo evaluate the efficacy of joint lavage in patients with osteoarthritis of the knee. DesignWe conducted an open prospective study involving 111 patients of whom 77% were females. The patients’ age range was 43–81 years and the average age 64 (8.7) years. All patients had gonarthrosis as diagnosed according to the (ACR) American College of Rheumatology criteria (Kellgren radiographic grades II and III). Patients were randomly distributed between 2 treatment groups: a) joint lavage without nonsteroidal anti-inflammatory drugs (NAJL, n=57), and b) non-steroidal anti-inflammatory drugs alone (NSAIDs, n=54). Evaluations were done at baseline and 1, 3, and 6 months after enrollment. Clinical and demographic variables, and WOMAC index scores, were recorded and patient improvement was determined by following the OARSI guidelines. Statistical analyses included c2, analysis of covariance (baseline WOMAC) with one between-subject factor (treatment). Post-hoc comparisons were made with Sidak's adjustment. ResultsThe respective improvement rates as measured by the OARSI index for the patients in the JL and NSAIDs groups were 50.9% and 31.5% at 1 month; 55.4% and 38.9% at 3 months; and 63.2% and 64.8% at 6 months. The patients in both groups were seen to improve from the first month (P=.038). At the end of the 6-month follow-up period, the WOMAC score had decreased significantly in both groups (P=.000), with no significant differences between them. ConclusionsSix months after treatment, joint lavage proved as effective as NSAIDs in patients with gonarthrosis, so it constitutes an effective therapeutic choice in those cases where NSAIDs are contraindicated.

Are NSAIDs and selective cyclo-oxygenase 2 inhibitors associated with increased risk of myocardial infarction?

Scott et al. conducted a systematic review to evaluate the risk of myocardial infarction (MI) associated with cyclo-oxygenase-2 (COX2) inhibitors and traditional NSAIDs. The review found a small increased risk of MI associated with COX2 inhibitors, particularly rofecoxib. Although a fixed-effects model of 14 case-control studies suggested a slightly increased risk of MI with NSAID use, a random-effects model of the same data and analysis of 6 cohort studies found no such link. An increased risk of MI was found in four RCTs of NSAID use in colonic adenoma. In an analysis of 14 RCTs that compared COX2 inhibitors with traditional NSAIDs in patients with arthritis, the odds ratio for MI with COX2 inhibitors was 1.6 (95% CI 1.1-2.4), although most of this risk was accounted for by rofecoxib. COX2 inhibitors were, however, associated with a reduced risk of serious gastrointestinal events. An analysis of previous systematic reviews showed increased risks of MI associated with rofecoxib and celecoxib.