Использование НПВП может считаться относительно безопасным, если их назначать в наиболее эффективной дозе и на минимальный срок — не более 10 дней [1]. Но это не распространяется на пациентов с факторами риска (возраст старше 65 лет, язвенная болезнь в анамнезе, злоупотребление алкоголем и пр.) [2] и пациентов с риском респираторных осложнений, инфарктом миокарда, бронхиальной астмой, почечной недостаточностью [1].
Кратковременный приём НПВП у предрасположенных к осложнениям пациентов
Риски сочетания НПВП и АСК при периоде наблюдения — 1 неделя
Клинический случай: кратковременный приём — серьёзные последствия
Выводы
Источники:
1. Aminoshariae A., Kulild J. C., Donaldson M. Short-term use of nonsteroidal anti-inflammatory drugs and adverse effects: an updated systematic review //The Journal of the American Dental Association. – 2016. – Т. 147. – №. 2. – С. 98-110.
2. Sostres C, Gargallo CJ, Arroyo MT, Lanas A: Adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs, aspirin and coxibs) on upper gastrointestinal tract. Best Pract Res Clin Gastroenterol. 2010, 24: 121-132.
3. Singh G: Gastrointestinal complications of prescription and over-thecounter nonsteroidal anti-inflammatory drugs: a view from the ARAMIS database. Arthritis, Rheumatism, and Aging Medical Information System. Am J Ther. 2000, 7: 115-121.
4. Perez Gutthann S, Garcia Rodriguez LA, Raiford DS: Individual nonsteroidal anti-inflammatory drugs and other risk factors for upper gastrointestinal bleeding and perforation. Epidemiology. 1997, 8: 18-24.
5. Hernandez-Diaz S, Garcia-Rodríguez LA: Association between nonsteroidal anti-inflammatory drugs and upper gastrointestinal tract bleeding/ perforation. An overview of epidemiologic studies published in the 1990s. Arch Intern Med. 2000, 160: 2093-2099.
6. Huang J-Q, Sridhar S, Hunt RH: Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic ulcer disease: a meta-analysis. Lancet. 2002, 359: 14-22.
7. Sostres C, Gargallo CJ, Lanas A. Nonsteroidal anti-inflammatory drugs and upper and lower gastrointestinal mucosal damage. Arthritis Res Ther. 2013;15 Suppl 3(Suppl 3):S3.
8. Larkai EN, Smith JL, Lidsky MD, Graham DY: Gastroduodenal mucosaand dyspeptic symptoms in arthritic patients during chronic steroidal antiinflammatory drug use. Am J Gastroenterol. 1987, 82: 1153-1158.
9. Armstrong CP, Blower AL: Non-steroidal anti-inflammatory drugs and life threatening complications of peptic ulceration. Gut. 1987, 28: 527-532.
10. Goldstein JL, Lowry SC, Lanza FL, Schwartz HI, Dodge WE. The impact of low-dose aspirin on endoscopic gastric and duodenal ulcer rates in users of a non-selective non-steroidal anti-inflammatory drug or a cyclo-oxygenase-2-selective inhibitor. Aliment Pharmacol Ther. 2006 May 15;23(10):1489-98.
11. Lanas A, García-Rodríguez LA, Arroyo MT, Gomollón F, Feu F, González-Pérez A, Zapata E, Bástida G, Rodrigo L, Santolaria S, Güell M, de Argila CM, Quintero E, Borda F, Piqué JM; Asociación Española de Gastroenterología. Risk of upper gastrointestinal ulcer bleeding associated with selective cyclo-oxygenase-2 inhibitors, traditional non-aspirin non-steroidal anti-inflammatory drugs, aspirin and combinations. Gut. 2006 Dec;55(12):1731-8.
12. Goldstein JL, Cryer B. Gastrointestinal injury associated with NSAID use: a case study and review of risk factors and preventative strategies. Drug Healthc Patient Saf. 2015 Jan 22;7:31-41.
R1352530-16052025-HCP
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