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Gastroprotective Strategies Among NSAID Users: Anne-Pascale Bartleman October 19, 2007
Gastroprotective Strategies Among NSAID Users: Anne-Pascale Bartleman October 19, 2007
• Arthritis
• Musculoskeletal injury
• Headache
• Menstruation
Who takes them?
• 20% Canadians older than 65 had
prescription!
• Cox-2 Inhibitor
– Allow COX 1 to function
Misoprostol
Pros
• 40% GI complications when taking NSAIDs
Cons
• Dose related diarrhea in 20%
• QID dosing
Omeprazole (Losec) 20 mg po OD
While taking
Pantoprazole (Pantoloc) 40 mg po OD NSAID
Esomeprazole (Nexium) 40 mg po OD
Cox 2 Inhibitor
Pros
• Low rates discontinuation
• Decrease risk serious GI complications 60% vs
traditional NSAID
Cons
• Increased risk of MI!
• Contraindicated NYHA Class II-IV, CAD or
cerebrovascular disease
• Sucralfate
• PMHx/Meds:
– Hypertension (Metoprolol 12.5 mg po BID)
– Atrial Fibrillation (Coumadin as directed)
• What are his risk factors?
– Anticoagulated
– Age?