scholarly journals Cardiovascular and cerebrovascular risk with nonsteroidal anti-inflammatory drugs and cyclooxygenase 2 inhibitors: latest evidence and clinical implications

2017 ◽  
Vol 8 (6) ◽  
pp. 173-182 ◽  
Author(s):  
Andrea Fanelli ◽  
Daniela Ghisi ◽  
Pierangelo Lora Aprile ◽  
Francesco Lapi
Keyword(s):  
Term Treatment ◽  
Cyclooxygenase 2 ◽  
Thrombotic Risk ◽  
Long Term Treatment ◽  
Pressure Development ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
High Doses ◽  
The Right ◽  
Meta Analyses

Observational studies and meta-analyses have shown that the administration of nonsteroidal anti-inflammatory drugs (NSAIDs), especially when prescribed at high doses for long periods of time, can potentially increase the risk of cardiovascular diseases. The increased thrombotic risk related to the use of NSAIDs is mainly due to their cyclooxygenase 2 selectivity. The dosage use, the formulation selected and the duration of the therapy are other factors that can significantly impact on the cardiovascular risk. In order to minimize the risk, prescription of the right drug based on the patient’s features and the different safety profiles of several NSAIDs that are available on the market is key for their appropriate administration. Despite the baseline cardiovascular and gastrointestinal risk of each patient, monitoring of patients is suggested for increases in blood pressure, development of edema, deterioration of renal function, or gastrointestinal bleeding during long-term treatment with NSAIDs.

Multimodality imaging in patients with post-cardiac injury syndrome

Heart ◽  
2020 ◽  
Vol 106 (9) ◽  
pp. 639-646 ◽  
Author(s):  
Beni R Verma ◽  
Michael Chetrit ◽  
James L Gentry III ◽  
Andrew Noll ◽  
Ahmed Bafadel ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Multimodality Imaging ◽  
Cardiac Injury ◽  
Clinical Decision ◽  
Term Treatment ◽  
Acute Pericarditis ◽  
Pericardial Diseases ◽  
Long Term Treatment ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

This review article is focused on the role of echocardiography, cardiac CT and cardiac magnetic resonance (CMR) imaging in diagnosing and managing patients with post-cardiac injury syndrome (PCIS). Clinically, the spectrum of pericardial diseases under PCIS varies not only in form and severity of presentation but also in the timing varying from weeks to months, thus making it difficult to diagnose. Pericarditis developing after recent or remote myocardial infarction, cardiac surgery or ablation if left untreated or under-treated could worsen into complicated pericarditis which can lead to decreased quality of life and increased morbidity. Colchicine in combination with other anti-inflammatory agents (non-steroidal anti-inflammatory drugs) is proven to prevent and treat acute pericarditis as well as its relapses under various scenarios. Imaging modalities such as echocardiography, CT and CMR play a pivotal role in diagnosing PCIS especially in difficult cases or when clinical suspicion is low. Echocardiography is the tool of choice for emergent bedside evaluation for cardiac tamponade and to electively study the haemodynamics impact of constrictive pericarditis. CT can provide information on pericardial thickening, calcification, effusions and lead perforations. CMR can provide pericardial tissue characterisation, haemodynamics changes and guide long-term treatment course with anti-inflammatory agents. It is important to be familiar with the indications as well as findings from these multimodality imaging tools for clinical decision-making.

Non-steroidal anti-inflammatory drugs as candidates for the prevention or treatment of Alzheimer’s disease: Do they still have a role?

2020 ◽  
Vol 17 ◽  
Author(s):  
Alberto Villarejo-Galende ◽  
Marta González-Sánchez ◽  
Víctor A. Blanco-Palmero ◽  
Sara Llamas Velasco ◽  
Julián Benito-León
Keyword(s):  
Clinical Trials ◽  
Inflammatory Responses ◽  
Basic Research ◽  
Epidemiological Studies ◽  
Population Based ◽  
Term Treatment ◽  
Prevalence Studies ◽  
Long Term Treatment ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Purpose of Review: to provide an updated analysis of the possible use of non-steroidal anti-inflammatory drugs (NSAIDs) as treatments for Alzheimer´s disease (AD). Recent Findings: Neuroinflammation in AD is an active field of research, with increasing evidence from basic and clinical studies for an involvement of innate or adaptive immune responses in the pathophysiology of AD. Few clinical trials with anti-inflammatory drugs have been performed in the last decade, with negative results. Summary: Besides the information gathered from basic research, epidemiological studies have provided conflicting findings, with most case-control or prevalence studies suggesting an inverse relationship between NSAIDs use and AD, but divided results in prospective population-based incident cohort studies. Clinical trials with different NSAIDs are almost unanimous in reporting an absence of clear benefit in AD. Conclusion: : the modulation of inflammatory responses is a promising therapeutic strategy in AD. After three decades of research, it seems that conventional NSAIDs are not the best pharmacological option, both for their lack of clear effects and for an unfavorable side-effect profile in long-term treatment. The development of other anti-inflammatory drugs as candidate treatments in AD may benefit from the knowledge acquired with NSAIDs.

scholarly journals HYALURONIC ACID PREPARATIONS IN BIG JOINT OSTEOARTHRITIS MANAGEMENT

2021 ◽  
pp. 80-96
Author(s):  
O. V. Kalashnikov ◽  
O. M. Sulyma ◽  
T. I. Osadchuk ◽  
А. V. Kalashnikov ◽  
V. B. Zayets ◽  
...  
Keyword(s):  
Side Effects ◽  
Term Treatment ◽  
Safety Level ◽  
Orthopedic Surgeons ◽  
Effi Ciency ◽  
Long Term Treatment ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
And Function

Abstract. The authors of the paper analyzed the experience of domestic and foreign experts on the effi-ciency of HA preparation in big joint osteoarthritis management. Task of the study is to analyze literature sources to identify the efficiency of HA preparations in big joints osteoarthritis management. Materials and methods: articles published by specialized scientific journals, paper collections, internet sources. Results: The analysis of literature sources determined the essential role of HA in joint cartilage nutrition and function. The researches tend to believe that an ideal HA preparation must be as close as possible to the physiological HA of joint’s synovial fluid. The HA preparation elaborated in our state, Artropatch meets these demands completely. Conclusions. Modern HA injectable preparations are expedient on the 1-3 stage of OA. Anti-inflammatory effect of HA preparations predetermines the possibility to decrease the intake dose and period of non-steroid anti-inflammatory drugs, consequently decreasing the risk of many unfavorable side effects of NSAIPs. The high safety level of HA preparations and no significant side effects after long-term treatment make them widely used in clinical practice of modern orthopedic surgeons.

scholarly journals Cardiovascular side effects of non-steroidal anti-inflammatory drugs in the light of recent recommendations.Diclofenac is not more dangerous

2015 ◽  
Vol 156 (13) ◽  
pp. 516-520 ◽  
Author(s):  
Viktor József Horváth ◽  
Gy. Ádám Tabák ◽  
Gergely Szabó ◽  
Zsuzsanna Putz ◽  
Csaba Géza Koós ◽  
...  
Keyword(s):  
Side Effects ◽  
Acetylsalicylic Acid ◽  
Latency Period ◽  
The Elderly ◽  
Term Treatment ◽  
Cardiovascular Side Effects ◽  
Long Term Treatment ◽  
Gastrointestinal Side Effects ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Among their beneficial effects, non-steroidal anti-inflammatory drugs may also exert several side effects which depend on the dosage and the type of these medications. The most frequent gastrointestinal side effects usually develop shortly after the beginning of their administration, but others such as cardiovascular interactions (which are present much less frequently than gastrointestinal side effects) can also occur after the beginning of drug administration without a latency period. For a long-term treatment, non-steroidal anti-inflammatory drugs are most frequently used in the elderly population where patients typically have high cardiovascular risk and take other medicines, e.g. low dose acetylsalicylic acid that can interact with non-steroidal anti-inflammatory drugs; in this aspect diclofenac may cause less side effects. In this review, the authors briefly review cardiovascular side effects of non-steroidal anti-inflammatory drugs, the processes which potentially influence them, therapeutic consequences and their interaction with acetylsalicylic acid. Orv. Hetil., 2015, 156(13), 516–520.

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