Editorials

Non-steroidal anti-inflammatory drugs and elderly patients

Aches and pains are a feature of growing old, but managing these symptoms in elderly people can pose problems. Patients have often used paracetamol and aspirin, which are available over the counter without prescription, before consultation. Opiates cause constipation and non-steroidal anti-inflammatory drugs cause ulcers. Although these associations are well known, 20 million prescriptions for non-steroidal anti-inflammatory drugs (many for elderly people) were dispensed in 1993 in Britain, at a cost of over pounds sterling180m.¹

Several factors affect the relative risk of adverse gastrointestinal effects during treatment with non-steroidal anti-inflammatory drugs. These include the age of the patient^{2 3 4 5 6 7 8}; their medical history^{3 4 6 7}; the drug used and its dosage^{4 9}; its route of administration¹⁰ and the duration of treatment^{3 4 8}; the concomitant use of more than one such drug⁴; and other independent risk factors, particularly alcohol use, anti-coagulant treatment, corticosteroid treatment, . . . [Full text of this article]

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