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Older Adults and NSAIDS: Avoiding Adverse Reactions

September 18th, 2015

Non-Steroidal Anti-Inflammatory Drugs or NSAIDS are a common over the counter drug that is used by many adults. They reduce inflammation but are not as dangerous as steroidal drugs that also reduce inflammation but require a prescription from your doctor. Some examples of popular NSAIDS include Motrin, Ibuprofen, Aleve, Celebrex, Naproxen,and Advil but there are literally hundreds of NSAIDS on the market. Most people take NSAIDS for common ailments like arthritic pain, headaches, post-operative pain, and general analgesia. What most people may not know is that even when taken correctly, these drugs can harm the elderly because of normal changes that occur as people age.

Because of common geriatric ailments, such as osteoarthritis and degenerative joint disease, NSAIDs are necessary, and they effectively relieve pain in the elderly. Unfortunately, NSAIDs can also potentiate, increase, or decrease the effect of many prescription drugs that this population takes. The most common and deadliest interactions are with anticoagulants, oral hypoglycemics, diuretics, and antihypertensives. One study concluded that aspirin, NSAIDs, and cardiovascular drugs caused 91% of the adverse drug reactions necessitating hospital admissions.

NSAIDs may have central and peripheral actions and this may contribute to falls. At least 16,500 NSAID-related deaths occur each year in the United States among patients with osteo- and rheumatoid arthritis, making this the 15th most common cause of death in this country. NSAIDs are associated with more adverse gastrointestinal effects than any other drug class. Roughly 20% of hospital admissions for bleeding ulcers in patients older than 60 years of age are the result of NSAID usage. The use of NSAIDs themselves may cause heart failure in geriatric patients and should be used with extreme caution in people with pre-existing heart disease.

It is important to notify your physician about all of your medications, including over the counter medications and vitamins. Because all medications are metabolized in the liver, you should never start you start a new medication without consulting a healthcare professional. Even foods can interfere with the metabolism of some drugs. Over the counter drugs have real risks for everyone but especially the elderly. Knowledge is the key to maintaining a healthy, happy lifestyle.

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