5-Minute Emergency Consult
Nonsteroidal Anti-Inflammatory Poisoning
Nonsteroidal Anti-Inflammatory Poisoning is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Inhibit cyclooxygenase (COX), thereby blocking the conversion of arachidonic acid to prostaglandin.
- Typically morbidity is low when an NSAID is ingested
- Most literature on nonselective NSAID toxicity involves ibuprofen exposure likely due to its OTC availability.
- Fatalities have been reported with large ingestions.
- Greater potential for toxicity with underlying CHF or renal failure:
- NSAIDs cause sodium and water retention and decrease renal blood flow.
- Little overdose experience with the COX-2 inhibitors (celecoxib); treatment should be the same as for the traditional NSAIDs.
- Patients may ingest rofecoxib and valdecoxib from stored supplies even though both are no longer available in US
Etiology
Etiology
- Nonsteroidal medications are available by prescription and over-the-counter.
- NSAIDs include:
- Diclofenac
- Diflunisal
- Etodolac
- Fenoprofen
- Ibuprofen
- Indomethacin
- Ketoprofen
- Ketorolac
- Meclofenamate
- Meloxicam
- Nabumetone
- Naproxen
- Oxaprozin
- Piroxicam
- Sulindac
- Tolmetin
-- To view the remaining sections of this topic, please sign in or purchase a subscription --
Basics
Description
Description
- Inhibit cyclooxygenase (COX), thereby blocking the conversion of arachidonic acid to prostaglandin.
- Typically morbidity is low when an NSAID is ingested
- Most literature on nonselective NSAID toxicity involves ibuprofen exposure likely due to its OTC availability.
- Fatalities have been reported with large ingestions.
- Greater potential for toxicity with underlying CHF or renal failure:
- NSAIDs cause sodium and water retention and decrease renal blood flow.
- Little overdose experience with the COX-2 inhibitors (celecoxib); treatment should be the same as for the traditional NSAIDs.
- Patients may ingest rofecoxib and valdecoxib from stored supplies even though both are no longer available in US
Etiology
Etiology
- Nonsteroidal medications are available by prescription and over-the-counter.
- NSAIDs include:
- Diclofenac
- Diflunisal
- Etodolac
- Fenoprofen
- Ibuprofen
- Indomethacin
- Ketoprofen
- Ketorolac
- Meclofenamate
- Meloxicam
- Nabumetone
- Naproxen
- Oxaprozin
- Piroxicam
- Sulindac
- Tolmetin
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Citation
Rosen, Peter, et al., editors. "Nonsteroidal Anti-Inflammatory Poisoning." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307598/all/Nonsteroidal_Anti_Inflammatory_Poisoning.
Nonsteroidal Anti-Inflammatory Poisoning. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307598/all/Nonsteroidal_Anti_Inflammatory_Poisoning. Accessed January 29, 2020.
Nonsteroidal Anti-Inflammatory Poisoning. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307598/all/Nonsteroidal_Anti_Inflammatory_Poisoning
Nonsteroidal Anti-Inflammatory Poisoning [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2020 January 29]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307598/all/Nonsteroidal_Anti_Inflammatory_Poisoning.
* Article titles in AMA citation format should be in sentence-case
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BT - 5-Minute Emergency Consult
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