Gastrointestinal effects of nonsteroidal anti-inflammatory therapy.
Clinical symposium : COX-2-Specific Inhibitors : Basic Science and Clinical Implications. Dallas, TX, USA, 1998/04/01.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for the treatment of many conditions including rheumatoid arthritis, osteoarthritis, gouty arthritis, the joint and muscle discomfort associated with systemic lupus erythematosus, and other musculoskeletal disorders.
Yet, their benefits, which are believed to be a result of their ability to inhibit cyclooxygenase-2 (COX-2), are accompanied by considerable toxicity.
NSAIDs'untoward effects are attributed to their inhibition of the constitutively expressed enzyme cyclooxygenase-1 (COX-1), with attendant suppression of the synthesis of prostanoids, substances that mediate key homeostatic functions.
Side effects include suppression of hemostasis through inhibition of platelet aggregation, adverse effects in patients with heart failure and cirrhosis, and those with certain renal diseases, as well as complicating antihypertensive therapies involving diuretics or bêta-adrenoceptor blockade.
Perhaps most importantly, NSAIDs disrupt the gastrointestinal mucosal-protective and acid-limiting properties of prostaglandins, frequently leading to upper gastrointestinal erosions and ulceration, with possible subsequent hemorrhage and perforation.
These complications can be reduced through identification of patients at risk, with circumspect use of NSAIDs, careful functional monitoring, and, in the case of gastrointestinal toxicity, co-administration of such agents as misoprostol or omeprazole. (...)
Mots-clés Pascal : Antiinflammatoire non stéroïde, Chimiothérapie, Facteur risque, Ulcère, Gastroduodénal, Effet secondaire, Toxicité, Prévalence, Physiopathologie, Stratégie, Traitement, Prévention, Homme, Article synthèse, Analgésique, Appareil digestif pathologie, Estomac pathologie, Intestin pathologie, Toxicologie
Mots-clés Pascal anglais : Non steroidal antiinflammatory agent, Chemotherapy, Risk factor, Ulcer, Gastroduodenal, Secondary effect, Toxicity, Prevalence, Pathophysiology, Strategy, Treatment, Prevention, Human, Review, Analgesic, Digestive diseases, Gastric disease, Intestinal disease, Toxicology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0345985
Code Inist : 002B02U04. Création : 14/12/1999.