NSAIDs (Non Steroidal anti inflammatory drugs) prescription’s practice in Rheumatology Department
Shama Khan Roberta Visivic Trevor Duffy Maurice Barry
Rheumatology Department, Connolly Hospital, Blanchardstown
The treatment of inflammatory Rheumatic conditions has revolutionized in the last 2 decades shifting from the conventional oral analgesic to potent Biologics. The main aim being targeting the synovitis, and preventing joint damage, and disability.
NSAIDs are one of the commonly used, and an effective analgesic in treating inflammatory arthritis. The annual prescription figure is around 110 million, just in the USA. Despite, its efficacy, the limiting factor for its’ use is the side effects, particularly peptic ulceration, and its complications, such as haemorrhage and perforation, renal injury and cardiovascular risk.
5_ 7 % of hospital admission are related to adverse effects of NSAIDs and among them, resulting from gastrointestinal, nervous system, and allergic reactions.
A prospective study
• taking NSAIDS or not ?
• Name of the NSAIDS.
• cardiac conditions
• renal disease
• Who prescribed the medication?
Age n: 160
Below 65 : 134
Above 65 : 26
Age and NSAIDs
Below 65 Yes :57 , No :77
Above 65 Yes : 14, No: 14
Cardiac history , n :8
Patients with cardiac conditios :8
Cardiac history , Atrial fibrillation :2
IHD /PCI: 1
Patients with cardiac history and taking NSAIDs 7/8 ( 87.5%)
Name of NSAIDs taken Etoricoxib :3
Diclofenac : 3
Renal disease, n :3
Number of patients with renal disease 3
Renal disease CKD :3
Renal disease and NSAIDS 1/3 : 33.3
NSAIDs prescribed by a Rheumatologist :43%
GP : 45%
The high risk group, being above 65 and having a cardiac history ,were prescribed NSAIDs, which reflects the current prescribing practice which needs to be addressed, in order to minimise the NSAIDs related side effects in these patients