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Antes de indicar un antiinflamatorio no esteroideo (AINE) se debe evaluar cada caso individual en cuanto a factores de riesgo, como edad, uso de otros agentes potencialmente agresivos al tracto gastrointestinal, tabaquismo y uso concomitante de aspirina, para seleccionar la mejor opción de tratamiento para cada paciente en particular y determinar la necesidad de terapia gastroprotectora. Dada la posibilidad de riesgo cardiovascular, de los COX-2 selectivos, también se deben analizar los factores de riesgo cardiovascular que tenga nuestro paciente antes de iniciar un medicamento de este tipo, principalmente teniendo en cuenta que el efecto protector de los COX-2 selectivos disminuye considerablemente en pacientes que reciben terapia con aspirina.
Palabras clave:
Antiinflamatorios no esteroideos (AINE)
COX-1
COX-2
Efectos gastrointestinales
Gastropatía
Before nonsteroidal anti-inflammatory drugs (NSAIDs) are indicated, risk factors such as age, the use of other drugs potentially harmful to the gastrointestinal tract, smoking, and concomitant use of aspirin should be evaluated, to select the most appropriate option for each patient and determine the need for gastroprotective therapy. Because of the possibility of cardiovascular risk posed by COX-2 selective NSAIDs, cardiovascular risk factors should also be analyzed in each patient before starting treatment of this type, mainly bearing in mind that the protective effect of COX-2 selective NSAIDs is substantially reduced in patients taking aspirin.
Key words:
Nonsteroidal anti-inflammatory drugs (NSAIDs)
COX-1
COX-2
Gastrointestinal effects
Gastropathy
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