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Aging and disease    2018, Vol. 9 Issue (1) : 143-150     DOI: 10.14336/AD.2017.0306
Review |
A Comprehensive Review of Non-Steroidal Anti-Inflammatory Drug Use in The Elderly
Wongrakpanich Supakanya1,*, Wongrakpanich Amaraporn2, Melhado Katie1, Rangaswami Janani3
1Department of Medicine, Einstein Medical Center, Philadelphia, Pennsylvania, PA 19141, USA.
2Department of Pharmacy, Mahidol University, Bangkok 10400, Thailand
3Division of Nephrology, Department of Medicine, Einstein Medical Center, Philadelphia, PA 19144, USA
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Abstract  

NSAIDs, non-steroidal anti-inflammatory drugs, are one of the most commonly prescribed pain medications. It is a highly effective drug class for pain and inflammation; however, NSAIDs are known for multiple adverse effects, including gastrointestinal bleeding, cardiovascular side effects, and NSAID induced nephrotoxicity. As our society ages, it is crucial to have comprehensive knowledge of this class of medication in the elderly population. Therefore, we reviewed the pharmacodynamics and pharmacokinetics, current guidelines for NSAIDs use, adverse effect profile, and drug interaction of NSAIDs and commonly used medications in the elderly.

Keywords Non-steroidal anti-inflammatory drug      NSAIDs      elderly      geriatric conditions      pleiotropic effects     
Corresponding Authors: Wongrakpanich Supakanya   
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These two authors contribute equally to this work

Issue Date: 01 February 2018
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Wongrakpanich Supakanya
Wongrakpanich Amaraporn
Melhado Katie
Rangaswami Janani
Cite this article:   
Wongrakpanich Supakanya,Wongrakpanich Amaraporn,Melhado Katie, et al. A Comprehensive Review of Non-Steroidal Anti-Inflammatory Drug Use in The Elderly[J]. Aging and disease, 2018, 9(1): 143-150.
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http://www.aginganddisease.org/EN/10.14336/AD.2017.0306     OR     http://www.aginganddisease.org/EN/Y2018/V9/I1/143
Gastrointestinal toxicity•Dyspepsia
•Gastroduodenal ulcers
•GI bleeding and perforation
Cardiovascular adverse effects•Edema
•Hypertension
•Congestive heart failure
•Myocardial infarction
•Stroke and other Thrombotic events
Nephrotoxicity•Electrolyte imbalance
•Sodium retention
•Edema
•Reduce glomerular filtration rate
•Nephrotic syndrome
•Acute interstitial nephritis
•Renal papillary necrosis
•Chronic kidney disease
Table 1  NSAIDs’ common adverse effect profile.
MedicationInteractions
Antiplatelets (aspirin, clopidogrel)Increases risk of GI bleeding
Angiotensin-converting-enzyme inhibitor (ACEI) and Angiotensin Receptor Blockers (ARB)Increases in blood pressure by attenuating antihypertensive effects
Beta blockersIncreases in blood pressure by attenuating antihypertensive effects
Calcium antagonistsIncreases in blood pressure by attenuating antihypertensive effects
CorticosteroidsIncreases risk of GI bleeding
Digitalis glycosidesIncrease serum digoxin level
DiureticsIncreases in blood pressure by attenuating antihypertensive effects
MethotrexateNSAIDs reduce renal excretion of methotrexate, causing methotrexate toxicity.
Selective serotonin reuptake inhibitors (SSRIs)Increases risk of GI bleeding
Warfarin and other anticoagulantsIncreases risk of GI bleeding
Table 2  Drug interaction of NSAIDs and commonly used medications.
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