For Discussion NSAIDs: gastroprotection or selective COX-2 inhibitor?

摘要: Conventional nonsteroidal anti-inflammatory drugs (NSAIDs) are effective adjuvant analgesics commonly encountered in palliative care. However, these associated with adverse effects that primarily due to gastrointestinal toxicity, resultant serious complications such as gastroduodenal perforations, ulcers and bleeds. This toxicity has been attributed inhibition of cyclooxygenase-1 (COX-1). Factors known increase this risk include age above 65 years, classification NSAID terms COX-1/COX-2 selectivity, previous history coadministration aspirin, anticoagulants corticosteroids. Selective inhibitors cyclooxygenase-2 (COX-2) were developed an attempt reduce association; trials date confirm do indeed have reduced incidence toxicity. Prior the introduction COX-2 selective inhibitors, patients at high often coprescribed a gastroprotective agent (such misoprostol or proton pump inhibitor) conventional NSAID. review discusses merits both options devises treatment strategy for safe cost-effective use care population.