for reducing cardiovascular risk) need to be careful if they also use other NSAIDs, as the latter may block the cardioprotective effects of aspirin. In addition, people on daily aspirin therapy (e.g. If a COX-2 inhibitor is taken, one should not use a traditional NSAID (prescription or over-the-counter) concomitantly. For example, concurrent use of NSAIDs and quinolones may increase the risk of quinolones' adverse central nervous system effects, including seizure. NSAIDs, like all drugs, may interact with other medications. Many of these events are avoidable a review of physician visits and prescriptions estimated that unnecessary prescriptions for NSAIDs were written in 42% of visits.
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An estimated 10-20% of NSAID patients experience dyspepsia, and NSAID-associated upper gastrointestinal adverse events are estimated to result in 103,000 hospitalizations and 16,500 deaths per year in the United States, and represent 43% of drug-related emergency visits. These effects are dose-dependent, and in many cases severe enough to pose the risk of ulcer perforation, upper gastrointestinal bleeding, and death, limiting the use of NSAID therapy. The two main adverse drug reactions (ADRs) associated with NSAIDs relate to gastrointestinal (GI) effects and renal effects of the agents. The widespread use of NSAIDs has meant that the adverse effects of these drugs have become increasingly prevalent. In 2001 NSAIDs accounted for 70,000,000 prescriptions and 30 billion over-the-counter doses sold annually in the United States. Aspirin inhibits platelet aggregation by inhibiting the action of thromboxane A 2. This is useful in the management of arterial thrombosis and prevention of adverse cardiovascular events.
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4.7 Selective COX-2 inhibitors (Coxibs).4.6 Fenamic acid derivatives ( Fenamates ).