NSAID-Induced Gastroduodenal Ulceration

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NSAID-Induced Gastroduodenal Ulceration
The widespread use of NSAIDs, including aspirin, attests to the efficacy of these agents for relieving pain, inflammation and fever. However, it is now well recognised that a significant disadvantage of NSAID use is an increased risk of gastroduodenal ulcers. Strategies to minimise these events include: avoiding NSAIDS, using the lowest effective dose, avoiding certain concomitant medications (e.g. corticosteroids) or use of one of the new generation of highly selective cyclo-oxygenase type 2 (COX-2) inhibitor NSAIDs. For patients who are at high risk of developing adverse gastric events (e.g. the elderly and those with a prior history of ulcer), pharmacological prophylaxis may be appropriate and possibly cost effective. The prostaglandin misoprostol and the proton pump inhibitor omeprazole are the most promising agents for prevention of gastroduodenal ulcers.

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