Retrospective Evaluation of Adverse??Drug Reactions Induced??by??Nonsteroidal Anti-Inflammatory Drugs (original) (raw)
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Adverse drug reactions in a primary care population prescribed non-steroidal anti-inflammatory drugs
Scandinavian Journal of Primary Health Care, 2015
Objective. To determine how often patients with musculoskeletal (MSK) complaints prescribed a non-steroidal anti-infl ammatory drug (NSAID) subsequently consult their general practitioner (GP) with a non-serious adverse drug reaction (ADR). Design. Cohort study. Setting. A healthcare database containing the electronic GP medical records of over 1.5 million patients throughout the Netherlands. Patients. A total of 16 626 adult patients with MSK complaints prescribed an NSAID. Main outcome measures. The patients ' medical records were manually assessed for the duration of NSAID use for a maximum of two months, and consultations for complaints predefi ned as potential ADRs were identifi ed. Subsequently, the likelihood of an association with the NSAID use was assessed and these potential ADRs were categorized as likely, possible, or unlikely ADRs. Results. In total, 961 patients (6%) consulted their GP with 1227 non-serious potential ADRs. In 174 patients (1%) at least one of these was categorized as a likely ADR, and in a further 408 patients (2.5%) at least one was categorized as a possible ADR. Dyspepsia was the most frequent likely ADR, followed by diarrhoea and dyspnoea (respectively 34%, 8%, and 8% of all likely ADRs). Conclusion. Of the patients with MSK complaints prescribed an NSAID, almost one in 30 patients re-consulted their GP with a complaint likely or possibly associated with the use of this drug. The burden of such consultations for non-serious ADRs should be taken into account by GPs when deciding whether treatment with an NSAID is appropriate.
Journal of investigational allergology & clinical immunology, 2007
The single-blind, placebo controlled oral challenge (SBPCOC) is the definitive way to diagnosis nonsteroidal anti-inflammatory drug (NSAID)-induced reactions. To evaluate 223 NSAID-sensitive patients by means of SBPCOC, and to describe the main clinical patterns found. A prospective study was carried out, including 2 patient groups with case histories consistent with NSAID-induced reactions. Of the 223 patients, 174 were diagnosed on the basis of a positive SBPCOC. The second group consisted of 49 patients who were referred because of a documented history of anaphylaxis after taking NSAIDs, and these underwent SBPCOC with potent cyclooxygenase (COX)-1/COX-2 inhibitors, except those reported as being responsible for the reaction. The type of SBPCOC reaction, the NSAID reactivity pattern, and the associated diseases were the main classification criteria. Two broad categories of NSAID-induced reactions were identified: the cross-reactive and selective syndromes. The 150 patients who sh...
NSAIDS induced cutaneous adverse drug reaction – a case series
2020
Nonsteroidal anti-inflammatory drugs (NSAIDs) are common cause of cutaneous adverse reactions (CADR’s). Though there are fairly high numbers of agents which commonly cause CADR, NSAID’s holds no exception. NSAIDs can cause multiple cutaneous complications like urticaria, angioedema, acneiform eruption, stevens johnson syndrome (SJS), toxic epidermal necrolysis (TEN), vasculitis, fixed drug eruption (FDE) etc. NSAIDs are very frequently prescribed drugs and even one of the frequent over the counter sold medications, thus making it more important to have a more detailed knowledge of the vast cutaneous complications it can cause. The present case series focuses on the conglomeration of the few cases of cutaneous complications experienced by the patients on NSAID’s therapy. Keywords: NSAIDs, severe cutaneous adverse reactions (SCARs), cutaneous adverse drug reactions (CADRs), stevens johnson syndrome (SJS), fixed drug eruptions (FDEs), fixed dose combination (FDC), over the count...
Thérapie
Non-steroidal anti-inflammatory drugs (NSAIDs) are used chronically to reduce pain and inflammation in patients with arthritic conditions, and also acutely as analgesics by many patients. Both therapeutic and adverse effects of NSAIDs are due to inhibition of cyclooxygenase (COX) enzyme. NSAIDs are classified as non-selective and COX-2-selective inhibitors (COXIBS) based on their extent of selectivity for COX inhibition. However, regardless of their COX selectivity, reports are still appearing on the GI side effect of NSAIDs particularly on the lower gastrointestinal (GI) tract and the harmful role of their controlled release formulations. In addition, previously unpublished data stored in the sponsor's files, question the GI sparing properties of rofecoxib, a COXIB that has been withdrawn due to cardiovascular (CV) side effects. Presently, the major side effects of NSAIDs are the GI complications, renal disturbances and CV events. There is a tendency to believe that all NSAIDs are associated with renal and CV side effects, a belief that is not supported by solid evidence. Indeed, lower but still therapeutics doses of some NSAIDs may be cardioprotective. In this review, we briefly discuss the GI toxicity of the NSAIDs and assess their renal and CV adverse effects in more detail.
Nonsteroidal anti-inflammatory drugs-induced hypersensitivity reactions
Romanian Neurosurgery
The role of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in neurosurgical practice is a secondary one, however they are still constantly involved in perioperative management of pain or in nonoperative management of acute radiculopathy. Beside the well-known adverse reactions (ADRs), the neurosurgeon practitioner should also take in account the drug hypersensitivity reactions (DHRs) of NSAIDs and be able to deal with it. The aim of this paper was to review the diagnostic and management steps for NSAIDs-induced Hypersensitivity Reactions. The actual stratification of NSAIDs-induced Hypersensitivity Reactions is based on understanding of the heterogeneity of immunological/non-immunological mechanisms of reactions and complexity of clinical manifestations. Practically, this stratification allows the physician to assess suspicion of DHR, based on anamnesis and clinical analysis, and to consider further practical steps to manage and eventually confirm the diagnosis. Drug allergies are co...
Allergy, 2013
Hypersensitivity reactions to aspirin (acetylsalicylic acid) and other nonsteroidal anti-inflammatory drugs (NSAIDs) constitute only a subset of all adverse reactions to these drugs, but due to their severity pose a significant burden to patients and are a challenge to the allergist. In susceptible individuals, NSAIDs induce a wide spectrum of hypersensitivity reactions with various timing, organ manifestations, and severity, involving either immunological (allergic) or nonimmunological mechanisms. Proper classification of reactions based on clinical manifestations and suspected mechanism is a prerequisite for the implementation of rational diagnostic procedures and adequate patient management. This document, prepared by a panel of experts from the European Academy of Allergy and Clinical Immunology Task Force on NSAIDs Hypersensitivity, aims at reviewing the current knowledge in the field and proposes uniform definitions and clinically useful classification of hypersensitivity reac...
Innovative Publication, 2016
Introduction: The Non-steroidal Anti-inflammatory Drugs (NSAIDs) constitute the largest group of drugs used worldwide for indications like rheumatoid arthritis, osteoarthritis, low back pain etc. Periodic evaluation of drug utilization patterns enable suitable modifications in prescription of drugs to increase the therapeutic benefit and decrease adverse effects. Objective: To analyze the prescription patterns and adverse drug reaction profile of NSAIDs prescribed in orthopedic outpatient department of Tertiary Care Hospital. Study design: observational, cross-sectional study. Results: 360 patients enrolled. Average number of drugs per prescription was 3.83. Total 1382 drugs were prescribed, out of which 418 were NSAIDs (30.24%). Ibuprofen was most commonly prescribed agent (62.79%), followed by Diclofenac (40.66%). Ibuprofen was found to be the commonest drug associated with ADRs. Conclusion: Ibuprofen was most commonly prescribed NSAID and also responsible for majority ADR. There was higher prevalence of irrational prescribing, polypharmacy and under reporting of ADR.
Nsaid( Non Steroidal Anti Inflammatory Drugs) Induced Rash: A Case Report
2019
Frequent use of non-sterodial antiinflammatory drugs(NSAIDS) has been paralleled by increasing occurrence of Adverse reactions which may vary from mild Local skin rashes to gastric irritation to, generalized symptoms even life-threatening anaphylaxis. NSAIDS are among the most commonly used drugs and are the first or second to the antibiotics based on the patient requirements. NSAID induced Hypersensitivity reactions are character by a wide pattern of symptoms which involve both Immunological and non-immunological mechanisms. Drug induced hypersensitivity reactions cannot be achieved without understanding the underlying mechanism and that history alone cannot be sufficient to accurate diagnosis