Marcum Zachary A, Hanlon Joseph T
Drs. Marcum and Hanlon are in the Division of Geriatric Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, PA; and Dr. Hanlon is also at the Geriatric Research Education and Clinical Center (GRECC), and the Center for Health Equity Research and Promotion (CHERP), Veterans Affairs Pittsburgh Healthcare System (VAPHS).
Ann Longterm Care. 2010;18(9):24-27.
Older adults commonly take nonsteroidal anti-inflammatory drugs (NSAIDs) chronically. Studies of older adults show that chronic NSAID use increases the risk of peptic ulcer disease, acute renal failure, and stroke/myocardial infarction. Moreover, chronic NSAID use can exacerbate a number of chronic diseases including heart failure and hypertension, and can interact with a number of drugs (eg, warfarin, corticosteroids). Preferred analgesics in older adults that may have a lower risk of these adverse drug reactions include acetaminophen, a nonacetylated salicylate (eg, salsalate), a short half-life NSAID (eg, ibuprofen), or low-dose opioid/opioid-like agents in combination with acetaminophen (in appropriate patients).
老年人通常长期服用非甾体抗炎药（NSAIDs）。针对老年人的研究表明，长期使用NSAIDs会增加消化性溃疡疾病、急性肾衰竭以及中风/心肌梗死的风险。此外，长期使用NSAIDs会加重包括心力衰竭和高血压在内的多种慢性疾病，并且会与多种药物（如华法林、皮质类固醇）发生相互作用。在老年人中，可能具有较低这些药物不良反应风险的首选镇痛药包括对乙酰氨基酚、非乙酰化水杨酸酯（如双水杨酸酯）、半衰期短的NSAIDs（如布洛芬），或与对乙酰氨基酚联合使用的低剂量阿片类/阿片样药物（适用于合适的患者）。
