Nsaids

Question 1

What does NSAIDs stand for?

Answer 1

Non-Steroidal Anti-Inflammatory Drugs

NSAIDs are commonly used for pain relief and inflammation reduction.

Question 2

What should be monitored in patients taking NSAIDs?

Answer 2

Blood pressure, renal function, liver function, haemoglobin

Especially in those with risk factors for gastrointestinal bleeding.

Question 3

What are warning signs of gastrointestinal bleeding associated with NSAID use?

Answer 3

• Black stools or ‘coffee ground’ vomit
• Progressive unintentional weight loss
• Difficulty swallowing
• Iron deficiency anaemia
• Swollen ankles or feet
• Unexplained, persistent recent-onset dyspepsia
• Worsening of asthma

These symptoms may indicate serious complications.

Question 4

What actions should be taken if warning signs occur in NSAID patients?

Answer 4

Advise patient to report immediately to a doctor

Quick response is crucial for safety.

Question 5

What factors should be considered when prescribing NSAIDs?

Answer 5

Gl and CVS risk, high dose or regular dose, appropriate duration of treatment

Individual patient assessment is important.

Question 6

What is the recommended dosage strategy for NSAIDs?

Answer 6

Lowest effective dose for the shortest period of time

Long-term treatment should be reviewed periodically.

Question 7

How should oral NSAIDs be taken?

Answer 7

With or just after food

This helps to reduce gastrointestinal side effects.

Question 8

Who should be co-prescribed gastro-protection when taking NSAIDs?

Answer 8

• Patients of any age prescribed NSAIDs for osteoarthritis or rheumatoid arthritis
• Patients over 45 years prescribed NSAIDs for lower back pain

Proton pump inhibitors are commonly used for gastro-protection.

Question 9

What should patients be informed about regarding NSAID interactions?

Answer 9

Need to check with a pharmacist or doctor before taking any new medication

Especially over-the-counter NSAIDs.

Question 10

What are potential interactions of NSAIDs?

Answer 10

• Increased risk of convulsions with quinolones
• Enhanced anticoagulant effect with coumarins and phenindione
• Enhanced effects of sulfonylureas
• Increased risk of bleeding with dabigatran, heparins, SSRIs, venlafaxine, antiplatelets
• Increased nephrotoxicity with ciclosporin, tacrolimus, diuretics
• May reduce excretion of lithium or methotrexate
• Increased side effects with other NSAIDs, aspirin
• Antagonise hypotensive effect of beta-blockers, calcium-channel blockers, ACE inhibitors, angiotensin-II receptor antagonists, alpha-blockers, nitrates

Awareness of these interactions is essential for safe medication management.