The case of a 61-year-old man who gradually developed similar inflammatory changes in the ascending colon during prolonged intake of a slow-release form of diclofenac is presented, and the literature on nonsteroidal antiinflammatory drug-induced intestinal [ncbi.nlm.nih.gov]

There are four presentations recognised: patients with an atopic tendency – urticaria is the usual presentation, rarely involving the airways. 80% of intolerant-to-NSAID patients are atopic. in nonatopics, urticaria and anaphylactic reactions, or urticaria [dermnetnz.org]

• Inflammation

  Small intestine inflammation and bleeding (enteropathy) due to NSAIDs must be considered in the evaluation of anemia in patients with arthritis. [ncbi.nlm.nih.gov]

  Very rare reactions (occuring in less than 1 in 100 people) include: Inflammation of the bladder; Nephrotic syndrome; Acute renal failure; Photosensitivity; Hepatitis (inflammation of the liver); Aseptic meningitis; Blurred vision; Tinnitus. [healthengine.com.au]

  Arthritis (Joint Inflammation) Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. [medicinenet.com]

  Eur J Rheum Inflamm 1983:6:36-40. [physioroom.com]

  Non-steroidal anti-inflammatory medications (NSAIDs) treat both pain and inflammation. Inflammation is a contributing factor in most back and neck pain conditions, so reducing inflammation often helps alleviate the pain. [spine-health.com]

• Anemia

  Small intestine inflammation and bleeding (enteropathy) due to NSAIDs must be considered in the evaluation of anemia in patients with arthritis. [ncbi.nlm.nih.gov]

  Key terms Anemia — A lack of hemoglobin—the compound in blood that carries oxygen from the lungs throughout the body and brings waste carbon dioxide from the cells to the lungs, where it is released. [medical-dictionary.thefreedictionary.com]

  […] development of anemia [40]. [arthritis-research.biomedcentral.com]

  If you have anemia, kidney or liver disease, stomach or peptic ulcers, heart disease, high blood pressure, bleeding or clotting problems, asthma or growth in the nose (nasal polyps). [my.clevelandclinic.org]

  […] with ns-NSAIDs is increased lower-GI-tract mucosal permeability and inflammation.83 ns-NSAIDs cause direct damage to the surface epithelium, increasing intestinal permeability, which results in a tissue reaction known as inflammatory enteropathy.25 Anemia [dovepress.com]

• Congestive Heart Failure

  Other heart-related side effects such as high blood pressure, congestive heart failure, and palpitations have also been reported. [drugs.com]

  NSAIDs associated with increased risk of congestive heart failure in elderly patients taking diuretics. Arch Intern Med 1998; 158: 1108–1112. 6. Page J, Henry D. [journals.lww.com]

  Heart failure Several large cohort studies have looked at the association between heart failure and NSAID use. [futuremedicine.com]

  Heart and bleeding conditions Bleeding problems (people who have a history of prolonged bleeding time or who bruise easily). High blood pressure that is difficult to control. Active congestive heart failure. History of stroke or heart attack. [my.clevelandclinic.org]

• Asymptomatic

  CONCLUSIONS: Mild asymptomatic EAH was found to occur in 4% of the volunteer ultraendurance mountain runner study group and was associated with a mean weight gain of 1.32 kg (range, -1.5 to 1.6 kg) during the race. [ncbi.nlm.nih.gov]

  Most NSAID ingestions are asymptomatic or are associated with only minimal gastrointestinal (GI) symptoms, such as nausea, emesis, abdominal pain, and GI bleeding. Hepatic injury resulting in increased liver enzymes and liver failure can occur. [pedsinreview.aappublications.org]

  Therefore, results from the current study, which focused on clinically relevant events, might not be generalizable to asymptomatic heart failure. [journals.lww.com]

  The USPSTF recommends against routinely providing [the service] to asymptomatic patients. The USPSTF found at least fair evidence that [the service] is ineffective or that harms outweigh benefits. I. [aafp.org]

• Fatigue

  In addition, some people taking NSAIDs have experienced asthma attacks, bleeding, fatigue, headache, insomnia, low neutrophil levels, urticaria (hives), vertigo and seizures. [drugs.com]

  Common side effects of prescription NSAIDs may include: dizziness headache nausea diarrhea excess gas constipation extreme weakness or fatigue dry mouth. Serious, but rare, side effects of prescription NSAIDs may include: Allergic reaction. [familydoctor.org]

  Symptoms include: headache, neck pain, neck and shoulder stiffness, shoulder pain, fatigue, dizziness, jaw pain, arm pain, weakness of the arm(s), visual disturbances, and tinnitus. [medicinenet.com]

  Acute fatigue, flu-like symptoms. Very bad back pain. Feeling very tired and weak. Can I take NSAIDs if I'm being treated for high blood pressure? NSAIDs can cause high blood pressure (hypertension) in some people. [my.clevelandclinic.org]

• Nausea

  A 44-year-old-male visited our out-patient department with symptoms of nausea, vomiting, and general weakness that had developed over the previous 2 weeks. He had history of medication, nonsteroidal anti-inflammatory drugs. [ncbi.nlm.nih.gov]

  GIT:  Aspirin and released salicylic acid irritate gastric mucosa, cause epigastric distress, nausea and vomiting.  It also stimulates CTZ. 7. Urate excretion:  Aspirin in high dose reduces renal tubular excretion of urate 17 18. 8. [slideshare.net]

  Common side effects are nausea, vomiting, diarrhea, constipation, decreased appetite, rash, dizziness, headache, and drowsiness. [medicinenet.com]

  As has been shown in other Cochrane reviews, women who use NSAIDs must be aware that NSAIDs may cause adverse effects such as nausea, vomiting, headache and drowsiness. [cochrane.org]

• Vomiting

  A 44-year-old-male visited our out-patient department with symptoms of nausea, vomiting, and general weakness that had developed over the previous 2 weeks. He had history of medication, nonsteroidal anti-inflammatory drugs. [ncbi.nlm.nih.gov]

  Common side effects are nausea, vomiting, diarrhea, constipation, decreased appetite, rash, dizziness, headache, and drowsiness. [medicinenet.com]

  Serious side effects that require immediate medical attention include: ringing in your ears blurry vision rash, hives, and itching fluid retention blood in your urine or stools vomiting and blood in your vomit severe stomach pain chest pain rapid heartbeat [healthline.com]

  GIT:  Aspirin and released salicylic acid irritate gastric mucosa, cause epigastric distress, nausea and vomiting.  It also stimulates CTZ. 7. Urate excretion:  Aspirin in high dose reduces renal tubular excretion of urate 17 18. 8. [slideshare.net]

• Constipation

  The most common treatment-related adverse events for tramadol/APAP were somnolence (6.5%), nausea (4.6%), and constipation (3.3%). Mean tramadol/APAP dose was 4.1 tablets (154 mg tramadol/ 1332 mg APAP). [ncbi.nlm.nih.gov]

  The most common side effects are: vomiting, nausea, constipation, diarrhea, reduced appetite, headache, dizziness, rash, and drowsiness. NSAIDs also may cause swelling of the arms and legs due to the retention of fluid from their renal effects. [rxlist.com]

  Constipations disturb blood circulation. Irrational diet: lack of vitamins, eating fast-food without any beverage can also lead to varicose veins among young women. [varicose-default.zcpa.info]

  Gastrointestinal side effects that may occur include bloating, diarrhea, constipation, irritation of the lining of the stomach, nausea or vomiting. NSAIDs may also affect kidney function and reduce how quickly blood flows through the kidneys. [drugs.com]

• Abdominal Pain

  He reported a history of recurrent episodes of colic abdominal pain during the past 25 years; he underwent three surgical operations for this condition. [ncbi.nlm.nih.gov]

  Advanced Search: • Use “ “ for phrases o [ “pediatric abdominal pain” ] • Use – to remove results with certain terms o [ “abdominal pain” –pediatric ] • Use OR to account for alternate terms o [teenager OR adolescent ] [msdmanuals.com]

  Most NSAID ingestions are asymptomatic or are associated with only minimal gastrointestinal (GI) symptoms, such as nausea, emesis, abdominal pain, and GI bleeding. Hepatic injury resulting in increased liver enzymes and liver failure can occur. [pedsinreview.aappublications.org]

  Research has shown that women with dysmenorrhoea have high levels of prostaglandins, hormones known to cause cramping abdominal pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that act by blocking prostaglandin production. [cochrane.org]

• Dyspepsia

  Of a group of 4,256 hospitalized patients receiving therapy with NSAIDs, 221 patients with persistent dyspepsia underwent endoscopic examination of the upper segment of the gastrointestinal tract. [ncbi.nlm.nih.gov]

  Though tolerability of celecoxib is better than traditional NSAIDs, still abdominal pain, dyspepsia and mild diarrhoea are the common side effects. [slideshare.net]

  They cause side effects including gastrointestinal (GI) disorders (from minor dyspepsia through to major ulcers, bleeding and perforation), kidney effects and cardiovascular effects. [jpharmacol.com]

  When used in this way, the most frequent side effects are dyspepsia, diarrhea and abdominal pain (15). It is particularly important for the clinician to know which NSAIDs present the greatest gastrointestinal complication risk. [scielo.isciii.es]

  Some fairly common reactions (occuring in more than 1 in 20 people)to NSAIDs include: Nausea; Dyspepsia (discomfort with digestion); GI ulceration or bleeding; Raised liver enzymes; Diarrhoea; Headache; Dry eyes; Dizziness; Salt and fluid retention; Hypertension [healthengine.com.au]

• Hypertension

  Results Whenever possible, a NSAID should be avoided in patients with treatment-resistant hypertension, high risk of cardiovascular disease and severe chronic kidney disease (CKD). [gut.bmj.com]

  There was a statistically significant relationship between NSAID usage and having hypertension (p = 0.013, OR 2.064, 95% CI 1.16 - 3.65). 78 of the antihypertensive and 88% of the analgesic/NSAIDs users explained the purpose of the drug usage properly [ncbi.nlm.nih.gov]

  The risk associated with NSAIDs was higher when the attributed etiology of heart failure was hypertension. [journals.lww.com]

  Non-narcotic analgesic dose and risk of incident hypertension in US women. Hypertension 2005;46:500-7. 30. Dedier J, Stampfer MJ, Hankinson SE, Willett WC, Speizer FE, Curhan GC. Nonnarcotic analgesic use and the risk of hypertension in US women. [scielo.isciii.es]

• Hypotension

  […] from colchicine, three from ibuprofen, and one from naproxen. [1] AAPCC NPDS outcomes are defined as follows: None Minor: Minimally bothersome with rapid resolution (eg, self-limited GI symptoms, drowsiness, skin irritation, sinus tachycardia without hypotension [emedicine.medscape.com]

  Orthostatic Hypotension Orthostatic hypotension symptoms include: LightheadednessWeaknessBlurred vision Syncope or passing out Causes of orthostatic hypotension include: Dehydration, Anemia, Medication Blood loss Low blood pressure Heat related illnesses [medicinenet.com]

  In patients with diminished kidney perfusion (hypotension, cirrhosis, congestive heart failure, diuretic use or blood loss), the kidneys increase prostaglandin synthesis to raise the filtration rate and secure an adequate renal flow. [scielo.isciii.es]

• Arthritis

  No significant differences in type and duration of arthritis condition, type and dose of NSAID taken, and duration of treatment between gallstone patients and gallstone-free patients were found. [ncbi.nlm.nih.gov]

  […] has prospectively followed patient status and outcomes, drug side effects, and the economic impact of illness for >11,000 arthritis patients at 8 participating institutions in the United States and Canada. [chiro.org]

• Back Pain

  See Medications for Back Pain and Neck Pain NSAIDs are available in over-the-counter and prescription strength. They can be used to address short-term back, neck, and muscle pain. [spine-health.com]

  METHODS: The Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR) cohort is a prospective, multicenter, observational study cohort of patients with early inflammatory back pain. [ncbi.nlm.nih.gov]

  Thirty nine women of childbearing age who suffer from back pain took part in the study, and received diclofenac (100mg once daily), naproxen (500mg twice daily) and etoricoxib (90mg once daily) or placebo. [sciencedaily.com]

  NSAIDs are good at treating pain caused by slow tissue damage, such as arthritis pain. NSAIDs also work well fighting back pain, menstrual cramps and headaches. [my.clevelandclinic.org]

  Many cases of back pain involve inflammation, and NSAIDs can be effective in treating them. Aspirin and ibuprofen are NSAIDs, used to treat inflammatory forms of arthritis. [collinsdictionary.com]

• Blurred Vision

  Very rare reactions (occuring in less than 1 in 100 people) include: Inflammation of the bladder; Nephrotic syndrome; Acute renal failure; Photosensitivity; Hepatitis (inflammation of the liver); Aseptic meningitis; Blurred vision; Tinnitus. [healthengine.com.au]

  Lastly, neurologic toxicity can present with drowsiness, confusion, nystagmus, blurred vision, diplopia, headache, and tinnitus.[20] Enhancing Healthcare Team Outcomes The general public widely uses NSAIDs because of their wide range of commonly encountered [ncbi.nlm.nih.gov]

  Head (vision, hearing, etc.): Blurred vision. Ringing in the ears. Photosensitivity (greater sensitivity to light). Very bad headache. Change in strength on one side is greater than the other, trouble speaking or thinking, change in balance. [my.clevelandclinic.org]

  Blurred vision or other vision problems also are possible side effects. For these reasons, anyone who takes these drugs should not drive, use machines or do anything else that might be dangerous until they have found out how the drugs affect them. [medical-dictionary.thefreedictionary.com]

• Tinnitus

  The side effects of aspirin use include upset stomach, heartburn, nausea, tinnitus (ringing in the ears), headache, and diaorrhea. Aspirin has an effect on the blood clotting system, which means that bleeding within the damaged tissue may increase. [physioroom.com]

  Decreased hearing or ringing in the ears (also called tinnitus). Jaundice (the yellowing of the skin and the whites of the eyes). Abdominal cramping. Heartburn. Indigestion. [familydoctor.org]

  Very rare reactions (occuring in less than 1 in 100 people) include: Inflammation of the bladder; Nephrotic syndrome; Acute renal failure; Photosensitivity; Hepatitis (inflammation of the liver); Aseptic meningitis; Blurred vision; Tinnitus. [healthengine.com.au]

  Lastly, neurologic toxicity can present with drowsiness, confusion, nystagmus, blurred vision, diplopia, headache, and tinnitus.[20] Enhancing Healthcare Team Outcomes The general public widely uses NSAIDs because of their wide range of commonly encountered [ncbi.nlm.nih.gov]

   CNS side effects include headache, dizziness, blurring of vision, tinnitus and depression.  Rashes, itching and other hypersensitivity phenomena are infrequent.  They are not to be prescribed to pregnant woman and should be avoided in peptic ulcer [slideshare.net]

• Urticaria

  Studies, review articles, and commentaries on aspirin-induced asthma and aspirin- or NSAID-induced urticaria/angioedema were included in the review. [ncbi.nlm.nih.gov]

  There are four presentations recognised: patients with an atopic tendency – urticaria is the usual presentation, rarely involving the airways. 80% of intolerant-to-NSAID patients are atopic. in nonatopics, urticaria and anaphylactic reactions, or urticaria [dermnetnz.org]

• Photosensitivity

  Photosensitivity to ketoprofen: mechanisms and pharmacoepidemiological data. Drug Safety 2000; 22: 339-349. Dermatology. Ed. Bolognia, J et al. 2nd edition 2007. Mosby Cousin F, Philips K, Favier B, Bienvenu J, Nicolas JF. Drug-induced urticaria. [dermnetnz.org]

  […] causing very high blood pressure requiring emergency treatment Nonnucleoside reverse transcriptase inhibitors Increases metabolism of these drugs, reducing their efficacy Oral contraceptives Increases metabolism of these drugs, reducing their efficacy Photosensitizing [msdmanuals.com]

  Very rare reactions (occuring in less than 1 in 100 people) include: Inflammation of the bladder; Nephrotic syndrome; Acute renal failure; Photosensitivity; Hepatitis (inflammation of the liver); Aseptic meningitis; Blurred vision; Tinnitus. [healthengine.com.au]

• Skin Rash

  rash skin irritation, reddening, itching or rash (if skin products are used, such as a cream). [betterhealth.vic.gov.au]

  All NSAIDs also carry the risk of potential skin reactions. Patients should be alert for symptoms such as skin reddening, rash or blisters. [fda.gov]

  Epigastric distress is complained, but gut bleeding is not significant.  Skin rashes, dizziness and other CNS manifestations have occurred.  Haemolytic anaemia is a rare but serious complication.  Pharmacokinetics:  Oral absorption is slow but almost [slideshare.net]

• Pruritus

  Rashes and pruritus are seen in < 1% patients. Edema and reversible azotaemia have been observed.  Tenoxicam:  A congener of piroxicam with similar properties and uses. 42 43. [slideshare.net]

• Irritability

  Because most NSAIDs block COX-1 enzymes and thus reduce the production of these prostaglandins, they may irritate the stomach’s lining. Such irritation can cause digestive upset, peptic ulcers, and bleeding in the digestive tract. [msdmanuals.com]

  […] indirect way NSAIDs cause GI irritation job of cytoprotective prostaglandins stimulate bicarbonate production, stimulate mucous production ______ and _____ protect gastric cells from gastric acid Ideally, NSAIDs should inhibit _____ and not ______. [quizlet.com]

  skin rash skin irritation, reddening, itching or rash (if skin products are used, such as a cream). [betterhealth.vic.gov.au]

  Elderly people or those taking other medicines that irritate the stomach are more likely to experience life-threatening GI side effects, such as stomach or intestinal bleeding. [drugs.com]

• Nystagmus

  Lastly, neurologic toxicity can present with drowsiness, confusion, nystagmus, blurred vision, diplopia, headache, and tinnitus.[20] Enhancing Healthcare Team Outcomes The general public widely uses NSAIDs because of their wide range of commonly encountered [ncbi.nlm.nih.gov]

• Renal Insufficiency

  Miscellaneous adverse effects and contraindications  May decrease the glomerular filtration rate, particularly in patients with renal insufficiency.  Occasionally produce mild hepatitis  Prolong bleeding time.  Aspirin irreversibly inhibits platelet [slideshare.net]

[…] ability in RA, and 60-80% as great as NSAID treatment in reduction in tender joint counts in RA. [ncbi.nlm.nih.gov]

Since there is no proven treatment for the GIN yet, we can carefully suggest that moderate to high dosage corticosteroid can be helpful for prognosis in case of acute granulomatous interstitial nephritis of patients with AKI. [ncbi.nlm.nih.gov]

Usually, the prognosis for peripheral neuropathy is good if the cause can be successfully treated or prevented. Ankle Pain (Tendinitis) Ankle pain is commonly due to a sprain or tendinitis. [medicinenet.com]

[…] effects Cell Survival/drug effects Cells, Cultured DNA Replication/drug effects Disease Models, Animal Female Humans Ibuprofen/administration & dosage* Indomethacin/administration & dosage* Ketorolac/administration & dosage* Male Ossification, Heterotopic/etiology [ncbi.nlm.nih.gov]

The risk associated with NSAIDs was higher when the attributed etiology of heart failure was hypertension. [journals.lww.com]

Abstract The authors performed a systematic review to summarize the epidemiologic evidence on the association between use of nonsteroidal antiinflammatory drugs (NSAIDs) and the risk of dementia. [ncbi.nlm.nih.gov]

The purposes of this article are to review the pathophysiology of prostaglandin synthesis and inhibition, the mechanisms of action, pharmacokinetics, pharmacological effects, and potential adverse reactions of aspirin and the newly released NSAIDs. [ncbi.nlm.nih.gov]

The pathophysiology of aseptic meningitis is uncertain, and there are probably multiple mechanisms involved. The condition has been observed in all age-groups and can occur after the use of a wide spectrum of pharmacologic agents. [mdmag.com]

Pathophysiology More than 20 drugs fall under the category of NSAID. [emedicine.medscape.com]

STUDY DESIGN: Data were from the National Birth Defects Prevention Study, a multisite population-based, case-control study of risk factors for birth defects. [ncbi.nlm.nih.gov]

Preventive Services Task Force. The use of aspirin for primary prevention of colorectal cancer: a systematic review prepared for the U.S. Preventive Services Task Force. Ann Intern Med 2007;146:365–75. [aafp.org]

The relative efficacies of various therapies in preventing ulcers, healing ulcers, or preventing complications remain to be established. FULL TEXT [annals.org]

Low doses of aspirin, less than 325 mg/day, taken for preventing heart attacks and strokes, also are associated with stomach and intestinal adverse reactions; however, the heart attack and stroke preventing actions of the low doses may compensate for [rxlist.com]

June 2015 Volume 56, Issue 7 Free ARVO Annual Meeting Abstract | June 2015 Topical Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in the prevention of cystoid macular edema after cataract surgery. [iovs.arvojournals.org]