Short-Course Systemic and Topical Non-Steroidal Anti-Inflammatory Drugs: Impact on Adverse Renal Events in Older Adults with Co-Morbid Disease

Drugs & Aging ◽  
2020 ◽  
Author(s):  
Cynthia Ciwei Lim ◽  
Andrew Teck Wee Ang ◽  
Hanis Bte Abdul Kadir ◽  
Puay Hoon Lee ◽  
Bandy Qiuling Goh ◽  
...  
Keyword(s):  
Older Adults ◽  
Short Course ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Osteoarthritis in Older Adults: Nonsteroidal Anti-Inflammatory Drugs Versus Opioids

2019 ◽  
Vol 34 (10) ◽  
pp. 674-677
Author(s):  
Callan Banks ◽  
Krystal Hughes ◽  
Cassandra Simpkins ◽  
David P. Elliott
Keyword(s):  
Older Adults ◽  
Treatment Option ◽  
Treatment Options ◽  
Persistent Pain ◽  
Careful Monitoring ◽  
Patient Profile ◽  
Central Nervous System Depression ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Upper Gastrointestinal

Persistent pain in older adults as a result of osteoarthritis (OA) has various treatment options, and all of them have significant risks. An oral nonsteroidal anti-inflammatory drug (NSAID) or an opioid can be considered as a treatment option when persistent pain is not controlled by nonpharmacological interventions and regularly scheduled doses of acetaminophen. However, NSAIDs are nephrotoxic and may cause upper gastrointestinal bleeding. These risks can be mitigated through the initiation of a proton-pump inhibitor and careful monitoring of renal function and serum electrolytes. A low-dose opioid taken as needed can be considered as a treatment option if the pain is not controlled by NSAIDs as long as the risks associated with central nervous system depression and dose escalation as a result of tolerance are monitored closely. The complete patient profile must be taken into consideration when determining the best option.

scholarly journals Association of Non‐Steroidal Anti‐Inflammatory Drugs with Kidney Health in Ambulatory Older Adults

2020 ◽  
Author(s):  
Jonathan G. Amatruda ◽  
Ronit Katz ◽  
Carmen A. Peralta ◽  
Michelle M. Estrella ◽  
Harini Sarathy ◽  
...  
Keyword(s):  
Older Adults ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Kidney Health

scholarly journals Non-steroidal anti-inflammatory drugs use in older adults decreases risk of Alzheimer’s disease mortality

PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0222505 ◽  
Author(s):  
Julián Benito-León ◽  
Israel Contador ◽  
Saturio Vega ◽  
Alberto Villarejo-Galende ◽  
Félix Bermejo-Pareja
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Disease Mortality ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals A Machine Learning Approach to Identify Predictors of Potentially Inappropriate Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Use in Older Adults with Osteoarthritis

2020 ◽  
Vol 18 (1) ◽  
pp. 155
Author(s):  
Jayeshkumar Patel ◽  
Amit Ladani ◽  
Nethra Sambamoorthi ◽  
Traci LeMasters ◽  
Nilanjana Dwibedi ◽  
...  
Keyword(s):  
Machine Learning ◽  
Older Adults ◽  
The United States ◽  
Gradient Boosting ◽  
Study Cohort ◽  
Real World Data ◽  
Extreme Gradient Boosting ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Using Data

Evidence from some studies suggest that osteoarthritis (OA) patients are often prescribed non-steroidal anti-inflammatory drugs (NSAIDs) that are not in accordance with their cardiovascular (CV) or gastrointestinal (GI) risk profiles. However, no such study has been carried out in the United States. Therefore, we sought to examine the prevalence and predictors of potentially inappropriate NSAIDs use in older adults (age > 65) with OA using machine learning with real-world data from Optum De-identified Clinformatics® Data Mart. We identified a retrospective cohort of eligible individuals using data from 2015 (baseline) and 2016 (follow-up). Potentially inappropriate NSAIDs use was identified using the type (COX-2 selective vs. non-selective) and length of NSAIDs use and an individual’s CV and GI risk. Predictors of potentially inappropriate NSAIDs use were identified using eXtreme Gradient Boosting. Our study cohort comprised of 44,990 individuals (mean age 75.9 years). We found that 12.8% individuals had potentially inappropriate NSAIDs use, but the rate was disproportionately higher (44.5%) in individuals at low CV/high GI risk. Longer duration of NSAIDs use during baseline (AOR 1.02; 95% CI:1.02–1.02 for both non-selective and selective NSAIDs) was associated with a higher risk of potentially inappropriate NSAIDs use. Additionally, individuals with low CV/high GI (AOR 1.34; 95% CI:1.20–1.50) and high CV/low GI risk (AOR 1.61; 95% CI:1.34–1.93) were also more likely to have potentially inappropriate NSAIDs use. Heightened surveillance of older adults with OA requiring NSAIDs is warranted.

OUTCOMES OF SHORT-COURSE ORAL CORTICOSTEROID WITH NON-STEROIDAL ANTI-INFLAMMATORY DRUGS FOR EARLY STAGE OFFROZEN SHOULDER AT KOSHI ZONAL HOSPITAL

2018 ◽  
Vol 5 (3) ◽  
pp. 246
Author(s):  
Yagya RajKharel ◽  
Shambhu Sah ◽  
Rem Kumar Rai ◽  
Nabin Subedi ◽  
Anurag Raj Adhikari ◽  
...  
Keyword(s):  
Oral Corticosteroid ◽  
Early Stage ◽  
Short Course ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Nonsteroidal Anti-Inflammatory Drugs and Opioids in Postsurgical Dental Pain

2020 ◽  
Vol 99 (7) ◽  
pp. 777-786 ◽  
Author(s):  
E.V. Hersh ◽  
P.A. Moore ◽  
T. Grosser ◽  
R.C. Polomano ◽  
J.T. Farrar ◽  
...  
Keyword(s):  
Naproxen Sodium ◽  
Analgesic Efficacy ◽  
Optimal Dose ◽  
Dental Pain ◽  
Third Molars ◽  
Short Course ◽  
Surgical Extraction ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Versus Risk

Postsurgical dental pain is mainly driven by inflammation, particularly through the generation of prostaglandins via the cyclooxygenase system. Thus, it is no surprise that numerous randomized placebo-controlled trials studying acute pain following the surgical extraction of impacted third molars have demonstrated the remarkable efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen sodium, etodolac, diclofenac, and ketorolac in this prototypic condition of acute inflammatory pain. Combining an optimal dose of an NSAID with an appropriate dose of acetaminophen appears to further enhance analgesic efficacy and potentially reduce the need for opioids. In addition to being on average inferior to NSAIDs as analgesics in postsurgical dental pain, opioids produce a higher incidence of side effects in dental outpatients, including dizziness, drowsiness, psychomotor impairment, nausea/vomiting, and constipation. Unused opioids are also subject to misuse and diversion, and they may cause addiction. Despite these risks, some dental surgical outpatients may benefit from a 1- or 2-d course of opioids added to their NSAID regimen. NSAID use may carry significant risks in certain patient populations, in which a short course of an acetaminophen/opioid combination may provide a more favorable benefit versus risk ratio than an NSAID regimen.

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