Episode 33: NSAIDS: Considering the Risks and Benefits
In our 33rd episode we follow-up our discussion of osteoarthritis by examining the risks and benefits of oral anti-inflammatories including Cox-2 inhibitors. We review the effects on pain relief and the theory of anti-inflammation. We discuss the possible gastrointestinal effects and possible approaches to reduce the risk. We consider the cardiovascular risks and debate the choices in prescribing. We finish by struggling to get in the last word.
1) Eradication of H. Pylori decreases the chance of a GI bleed in patients about to receive NSAIDs
2) Misoprostol decreases the chance of bleeds but increases the number of GI side effects
3) PPI added to ASA (in patients with previous ulcer on ASA)
4) Naprosyn possibly protective for cardiac events
5) Possible impaired fracture healing with NSAIDs