Nizatidine Prevents Peptic Ulceration in High-Risk Patients Taking Nonsteroidal Anti-inflammatory Drugs

Millions of Americans use over-the-counter analgesics on a daily basis, and nearly 100 million nonsteroidal anti-inflammatory drug (NSAID) prescriptions are filled per year. In high-risk patients, these medications can disrupt kidney hemodynamics and precipitate community-acquired acute kidney injury (CA-AKI). The risk of NSAID-associated CA-AKI increases 3- to 5-fold in patients taking renin-angiotensin system inhibitors and diuretics concurrently. CA-AKI increases the risk of developing chronic kidney disease (CKD) or accelerating progression of pre-existing CKD. Importantly, many cases of NSAID-induced CA-AKI may be avoided by identifying high-risk patients and providing patient and provider education on when to avoid these medications and minimize risk.

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Effects of Acetylsalicylic Acid in Preterm Preeclampsia Prevention

Revista de Chimie ◽

10.37358/rc.18.5.6289 ◽

2018 ◽

Vol 69 (5) ◽

pp. 1203-1206

Author(s):

Denis Serban ◽

Ciprian Crisan ◽

Costela Serban ◽

Iulia Bianca Micu Serbu ◽

Nilima Kundani ◽

...

Keyword(s):

High Risk ◽

Acetylsalicylic Acid ◽

First Trimester ◽

Time Interval ◽

Low Doses ◽

Aggregation Effect ◽

Risk Patients ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Risk Of Preeclampsia

Acetylsalicylic acid, classified under the non-steroidal anti-inflammatory drugs (NSAIDS) has well known anti-inflammatory, anti-pyretic properties, anti-platelet aggregation effect and analgesic properties. Pre-eclampsia (PE) is a pathology of pregnancy characterized by the onset of hypertension and often accompanied by the lost of significant amount of protein in the urine. In pregnant women with risk of preeclampsia, low doses of aspirin have been shown to have a beneficial effect on the incidence of this disorder. Using a retrospective design, we screened for preeclampsia all pregnancies followed in a time interval of 2 years. We have observed that in preeclampsia high risk patients based on the screening done between 11 to 13 weeks and 6 days, the administration of low doses of acetylsalicylic acid reduced the burden of disease. Identifying the pregnancy having high risk for preeclampsia in the first trimester helps us in decision making for initiating prophylactic treatment with Aspirin.

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Comparative effectiveness of pharmacologic and endoscopic interventions for prevention of post-ERCP pancreatitis: a network meta-analysis

Endoscopy International Open ◽

10.1055/a-1005-6366 ◽

2020 ◽

Vol 08 (01) ◽

pp. E29-E40 ◽

Cited By ~ 1

Author(s):

Basile Njei ◽

Thomas R. McCarty ◽

Thiruvengadam Muniraj ◽

Prabin Sharma ◽

Priya A. Jamidar ◽

...

Keyword(s):

High Risk ◽

Stent Placement ◽

Meta Analysis ◽

Preventive Strategy ◽

Pancreatic Stent ◽

High Risk Patients ◽

Cochrane Database ◽

Risk Patients ◽

Inflammatory Drugs ◽

Effective Preventive Strategy

Abstract Background and study aims While several interventions may decrease risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis, it remains unclear whether one strategy is superior to others. The purpose of this study was to compare the effectiveness of pharmacologic and endoscopic interventions to prevent post-ERCP pancreatitis among high-risk patients. Methods A systematic review was performed to identify randomized controlled trials from PubMed, Embase, Web of Science, and Cochrane database through May 2017. Interventions included: rectal non-steroidal anti-inflammatory drugs (NSAIDs), aggressive hydration with lactated ringerʼs (LR) solution, and pancreatic stent placement compared to placebo. Only studies with patients at high-risk for post-ERCP pancreatitis were included. Bayesian network meta-analysis was performed and relative ranking of treatments was assessed using surface under the cumulative ranking (SUCRA) probabilities. Results We identified 29 trials, comprising 7,862 participants comparing four preventive strategies. On network meta-analysis, compared with placebo, rectal NSAIDs (B = – 0.69, 95 % CI [–1.18; – 0.21]), pancreatic stent (B = – 1.25, 95 % CI [–1.81 to –0.69]), LR (B = – 0.67, 95 % CI [–1.20 to –0.13]), and combination of LR plus rectal NSAIDs (B = – 1.58; 95 % CI [–3.0 to –0.17]), were all associated with a reduced risk of post-ERCP pancreatitis. Pancreatic stent placement had the highest SUCRA probability (0.81, 95 % CI [0.83 to 0.80]) of being ranked the best prophylactic treatment. Conclusions Based on this network meta-analysis, pancreatic stent placement appears to be the most effective preventive strategy for post-ERCP pancreatitis in high-risk patients.

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