NSAIDrelated

NSAID-related refers to the effects, risks, interactions, and management considerations associated with nonsteroidal anti-inflammatory drugs (NSAIDs). Common NSAIDs include ibuprofen, naproxen, aspirin, diclofenac, and ketorolac. They relieve pain and inflammation and lower fever by inhibiting cyclooxygenase enzymes, COX-1 and COX-2, with aspirin producing irreversible COX-1 inhibition at usual doses.

Therapeutic use hinges on balancing efficacy with safety. NSAIDs provide analgesia for mucculoskeletal pain and reduce inflammation, but they can cause adverse effects. Gastrointestinal injury ranges from dyspepsia to ulcers and bleeding; renal effects include reduced perfusion and chronic injury; cardiovascular effects vary by agent and patient risk, with some drugs linked to hypertension and thrombotic events.

Contraindications include active gastrointestinal bleeding or peptic ulcer disease, severe renal impairment, pregnancy in the third trimester, and known NSAID allergy. Caution is advised in older adults and individuals with kidney, liver, or heart disease, hypertension, or concurrent anticoagulant therapy.

Drug interactions include increased bleeding risk with anticoagulants, enhanced GI toxicity with corticosteroids or alcohol, and reduced antihypertensive efficacy with certain diuretics or ACE inhibitors. Combining multiple NSAIDs is generally discouraged.

Monitoring involves watching for abdominal pain, dark stools, reduced urine output, edema, or rising blood pressure. When risks outweigh benefits, alternatives such as acetaminophen or selecting a COX-2–selective agent with appropriate risk assessment may be considered, and the lowest effective dose for the shortest duration is advised.