Nonsteroidal Anti-Inflammatory Poisoning
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- 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
- Nonsteroidal medications are available by prescription and over-the-counter.
- NSAIDs include: