Interní Med. 2008; 10(9): 384-386

Nonsteroidal anti-inflammatory drugs, anticoagulation, antiplatelet medications, changes gastric and duodenal mucosa

prof. MUDr. Petr Dítě DrSc¹, MUDr. Ivo Novotný², prof. MUDr. Miroslav Penka CSc³

¹ III. interní klinika gastroenterologická, FN Brno-Bohunice

² Interní hepatogastroenterologická klinika MU a FN Brno, Oddělení klinické hematologie MU a FN Brno

³ Oddělení klinické hematologie, FN Brno

Nonsteroidal anti-inflammatory drugs, anticoagulation and antiplatelet medications belong to the most frequently prescribed medications. In spite of their high therapeutic effectiveness these medications cause serious gastrointestinal complications. Their indication must be carefully considered including the knowledge of their advantages and disadvantages. In the case a patient is on these medications during an endoscopic treatment, this information is important, so that the endoscopic examination is safe and the risk of bleeding complications minimalized. It is always necessary to consider whether patients receiving nonsteroidal anti-inflammatory drugs are in high risk (old age, history of peptic ulcer disease etc.). If so the treatment should include proton pump inhibitor or the medication should be replaced by less dangerous drug based on cyclooxygenase II inhibition. Similar considerations are recommended for patients who are on anti-platelet medications and anticoagulation. Acetylosalicylic acid in patients in high risk should be replaced by another medication or concomitent treatment with proton pump inhibitor should be given. It is recommended to stratify patients undergoing endoscopic examination according their risk of complications. It is optimal to perform the endoscopy as an elective procedure after discontinuation of medications with potential of bleeding and with an adequate support with regard to complications.

Keywords: nonsteroidal antiinflammatory drugs, acetylosalicylic acid, proton pump inhibitors.

Published: November 1, 2008  Show citation