Review article

Gastrointestinal Complications of NSAIDs and Anticoagulants

Željko Krznarić
Ana Kunović

Abstract

The use of chronic oral or systemic nonselective nonsteroidal anti-inflammatory drugs (NSAID) to treat various conditions, from pain, fever and inflammation to primary and secondary prophylaxis of cardiovascular and cerebrovascular diseases, is associated with a wide range of symptomatic adverse events, the most frequent and serious of which is gastropathy. A careful assessment of patients’ risk factors (high age, concomitant anticoagulants, steroids and aspirin therapy and previous history of peptic ulceration) for developing NSAIDrelated gastrointestinal complications should be undertaken prior to initiation of any NSAIDs. There are two main approaches to the prevention of gastrointestinal complications related to chronic NSAID use: COX-2 specific inhibitor therapy or nonselective NSAID therapy with one of the gastroprotective agents (misoprostol, proton-pump inhibitors (PPI), high doses of H2 antagonist). A PPI should be used for healing of NSAID-associated ulcers. Acute gastrointestinal bleeding is a severe complication in patients receiving long-term oral anticoagulant therapy, and the concomitant use of NSAIDs increases the risk of bleeding.

Keywords

acid related disorders; nonsteroidal anti-inflammatory drug; anticoagulant therapy; cyclooxygenase

Hrčak ID:

102970

URI

https://hrcak.srce.hr/102970

Publication date:

18.4.2013.

Article data in other languages: croatian

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