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Emergency Medical Minute


Mar 29, 2019

Author: Don Stader, MD

Educational Pearls:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) are effective pain relievers but come with important side effects
  • NSAIDs inhibit COX-1 and/or COX-2, which decreases the production of prostaglandins, which reduce pain and inflammation
  • Side effects of NSAIDS include increased rates myocardial infarction, stroke, and gastrointestinal bleeding, CVA
  • Effective pain reliever doses of many NSAIDs are lower than typically prescribed (i.e. ibuprofen 400 mg is as effective as 800 mg but with less risk of side effects)
  • Topical NSAIDs can be an alternative to reduce systemic effects
  • Selective Cox-2 inhibitors have less GI side effects

Editor note: What is ALTO? It’s alternative to opioids and consists of multi-modal pain control to reduce exposure to opioids. Check out more here and here.



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Summarized by Will Dewispelaere, MS3 | Edited by Erik Verzemnieks, MD