Nonsteroidal anti-inflammatory drugs and gastroduodenal injury

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a commonly prescribed and over-the-counter class of drugs in the United States, with widespread use for various indications. The increased risk of gastrointestinal toxicity with the use of nonsteroidal medications has been well recognized. Pathogenesis of nonsteroidal toxicity is direct as well as systemic, secondary to prostaglandin inhibition. There are several risk factors to identify patients at a high risk for nonsteroidal toxicity. NSAID-related ulcer complications can be reduced by prophylaxis with prostaglandin analog drugs such as misoprostol or high-dosage proton-pump inhibition.