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  • 1 Debreceni Egyetem, Általános Orvostudományi Kar, Debrecen, Nagyerdei krt. 98., 4032

Absztrakt:

A nemszteroid gyulladáscsökkentő gyógyszerek a leggyakrabban javasolt fájdalomcsillapítók. A reumatológiai gyakorlatban a fájdalom és a gyulladás csökkentésére egyaránt használjuk, ugyanakkor a terápiás ajánlások is fokozott óvatosságra intenek e gyógyszercsoport használata során, azok jól ismert lehetséges – gastrointestinalis, cardiovascularis és renalis – mellékhatásai miatt. Különösen igaz ez az idősebb életkorú vagy fiatalabb, de polimorbid betegek esetében. Miután hazánkban is öregedő populációval kell számolnunk, alapvető fontosságú, hogy a gyakorló orvos tisztában legyen a nemszteroid gyulladáscsökkentők alapvető farmakokinetikai sajátosságaival, gyógyszer-interakcióival, mellékhatásprofiljával, és a saját szakterületén belül mindig a legújabb irányelvek mentén használja ezeket a gyógyszereket. Orv Hetil. 2018; 159(44): 1783–1788.

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  • 1

    Wongrakpanich S, Wongrakpanich A, Melhado K, et al. A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly. Aging Dis. 2018; 9: 143–150.

  • 2

    Vane JR, Botting RM. Mechanism of action of non-steroidal anti-inflammatory drugs. Am J Med. 1998; 104: 2S–8S.

  • 3

    Szamosi S. Application of topical non-steroid anti-inflammatory drugs in rheumatological pain management. [A topikus nem szteroid gyulladásgátló helye a reumatológiai fájdalomcsillapításban.] Magy Reumatol. 2017; 58: 20–24. [Hungarian]

  • 4

    American College of Rheumatology Ad Hoc Group on Use of Selective and Nonselective Nonsteroidal Antiinflammatory Drugs. Recommendations for the use of selective and nonselective nonsteroidal antiinflammatory drugs: an American College of Rheumatology White paper. Arthritis Rheum. 2008; 59: 1058–1073.

  • 5

    Verbeeck RK, Richardson CJ, Blocka KL. Clinical pharmacokinetics of piroxicam. J Rheumatol. 1986; 13: 789–796.

  • 6

    Balding L. The World Health Organisation analgesic ladder: its place in modern Irish medical practice. Ir Med J. 2013; 106: 122–124.

  • 7

    Meara AS, Simon LS. Advice from professional societies: appropriate use of NSAIDs. Pain Med. 2013; 14(Suppl 1): S3–S10.

  • 8

    Burmester G, Lanas A, Biasucci L, et al. The appropriate use of non-steroidal anti-inflammatory drugs in rheumatic disease: opinions of multidisciplinary European expert panel. Ann Rheum Dis. 2011; 70: 818–822.

  • 9

    Simon LS, Weaver AL, Graham DY, et al. Anti-inflammatory and upper gastrointestinal effects of celecoxib in rheumatoid arthritis: a randomized controlled trial. JAMA 1999; 282: 1921–1928.

  • 10

    Silverstein FE, Faich G, Goldstein JL, et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study. A randomized controlled trial. Celecoxib Long-term Arthritis Safety Study. JAMA 2000; 284: 1247–1255.

  • 11

    Sheng H, Shao J, Kirkland SC, et al. Inhibition of human colon cancer cell growth by selective inhibition of cyclooxygenase-2. J Clin Invest. 1997; 99: 2254–2259.

  • 12

    Morales DR, Lipworth BJ, Guthrie B, et al. Safety risks for patients with aspirin-exacerbated respiratory disease after acute exposure to selective nonsteroidal anti-inflammatory drugs and COX-2 inhibitors: Meta-analysis of controlled clinical trials. J Allergy Clin Immunol. 2014; 134: 40–45.

  • 13

    Cheng Y, Austin SC, Rocca B, et al. Role of prostacyclin in the cardiovascular response to thromboxane A2. Science 2002; 296: 539–541.

  • 14

    McGettigan P, Henry D. Cardiovascular risk and inhibition of cyclooxygenase: a systematic review of the observational studies of selective and nonselective inhibitors of cyclooxygenase 2. JAMA 2006; 296: 1633–1644.

  • 15

    Hippisley-Cox J, Coupland C. Risk of myocardial infarction in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case-control analysis. BMJ 2005; 330: 1366.

  • 16

    Coxib and traditional NSAID Trialists’ (CNT) Collaboration, Bhala N, Emberson J, Merhi A, et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet 2013; 382: 769–779.

  • 17

    Nissen SE, Yeomans ND, Solomon DH, et al. Cardiovascular safety of celecoxib, naproxen, or ibuprofen for arthritis. N Engl J Med. 2016; 375: 2519–2529.

  • 18

    Schjerning Olsen AM, Fosbøl EL, Lindhardsen J, et al. Duration of treatment with nonsteroidal anti-inflammatory drugs and impact on risk of death and recurrent myocardial infarction in patients with prior myocardial infarction: a nationwide cohort study. Circulation 2011; 123: 2226–2235.

  • 19

    Cannon CP, Curtis SP, FitzGerald GA, et al. Cardiovascular outcomes with etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: a randomised comparison. Lancet 2006; 368: 1771–1781.

  • 20

    Rostom A, Dube C, Wells G, et al. Prevention of NSAID-induced gastroduodenal ulcers. Cochrane Database Syst Rev. 2002; 4: CD002296.

  • 21

    Sabzwari SR, Qidwai W, Bhanji S. Polypharmacy in elderly: a cautious trail to tread. J Pak Med Assoc. 2013; 63: 624–627.

  • 22

    Ungprasert P, Cheungpasitporn W, Crowson CS, et al. Individual non-steroidal anti-inflammatory drugs and risk of acute kidney injury: a systematic review and meta-analyses of observational studies. Eur J Intern Med. 2015; 26: 285–291.

  • 23

    Capone ML, Sciulli MG, Tacconelli S, et al. Pharmacodynamic interaction of naproxen with low-dose aspirin in healthy subjects. J Am Coll Cardiol. 2005; 45: 1295–1301.

  • 24

    Farkouh ME, Greenberg JD, Jeger RV, et al. Cardiovascular outcomes in high risk patients with osteoarthritis treated with ibuprofen, naproxen or lumiracoxib. Ann Rheum Dis. 2007; 66: 764–770.

  • 25

    Hodinka L, Bálint G, Budai E, et al. Peroral and transdermal application of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of regional musculoskeletal pain syndromes. [Nem szteroid gyulladáscsökkentők peroralis és transdermalis alkalmazása regionális mozgásszervi fájdalmi szindrómákban.] Orv Hetil. 2017; 158(Suppl 3): 3–30. [Hungarian]

  • 26

    Archetti M. Tollerabilità dei FANS: recenti acquisizioni. Diseases & Drugs 2013; Numero 5, Septembre/Ottobre.

  • 27

    European Medicines Agency. Updated advice on use of high-dose ibuprofen. EMA 325007/2015, 22 May 2015.

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