Outpatient Surgery Magazine

Why Can't He Eat or Drink After Midnight? - March 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/652284

Contents of this Issue

Navigation

Page 67 of 160

6 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 6 How concerned should we be about the potential for NSAIDs to cause cardiovascular events? As you probably know, the FDA issued a strongly worded letter (osmag.net/9bTEsW) last summer, warning that NSAIDs can cause heart attacks and strokes. But the agency hasn't said whether short-term use of NSAIDs is a significant concern. The letter does clearly suggest that patients who've had cardiovascular issues — heart attacks or strokes — might face greater risks. But the risk seems to be dose- and duration- dependent. We haven't seen an increased risk with the short-term use of any of these drugs. If you look closely at the potential side effects of the 3 approved IV NSAIDs — Toradol (ketorolac), Caldolor (ibuprofen) and Dyloject (diclofenac) — all of which have COX-1 and COX-2 inhibiting properties, you'll find that ketorolac, which is more dominantly COX-1, would likely be associated with more standard NSAID risks, like bleeding, GI irritation and kidney effects. Ibuprofen and diclofenac, on the other hand, are more dominantly COX-2 and therefore might be more likely to be associated with cardiovascular issues. The bottom line is that clinicians should be aware of the potential risks, and should be selec- tive about using all NSAIDs for longer periods of time and in patients who have a history of heart-related issues. But short-term use of IV NSAIDs appears to be safe and effective in patients who have acceptable risk profiles. — Eugene R. Viscusi, MD The Link Between NSAIDs And Cardiovascular Issues DISHEARTENING? Short-term use of IV NSAIDs appears to be safe and effective in patients who have acceptable risk profiles.

Articles in this issue

Links on this page

Archives of this issue

view archives of Outpatient Surgery Magazine - Why Can't He Eat or Drink After Midnight? - March 2016 - Subscribe to Outpatient Surgery Magazine