Rheumatology Question 24 Instructor

List five risk factors for NSAID-induced ulceration. How can this risk be minimized?

  • Advanced age (particularly over 60)
  • Past history of GI ulceration or hemorrhage
  • Higher NSAID doses
  • Concurrent anticoagulant use
  • Concurrent corticosteroid use
  • Use of multiple NSAIDs
  • Alcohol use

To minimize the risk of NSAID-induced mucosal injury, alternative analgesics (such as acetaminophen) should be used when possible. When using NSAIDs, use the lowest effective dose.

COX-2 selective agents reduce the likelihood of gastric complications by approximately 50%, relative to non-selective agents.

Misoprostol or a PPI can be used with non-selective NSAIDs to reduce the likelihood of GI ulceration and bleeding.

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