nsaids...

[julie miller]

I think NSAID's are great.
I routinely put all my trauma pateints (tolerating po) on routine, round the clock ibuprofen.
(excluding those 80 or over, with a history of pud, or renal insufficiency)
I believe, and there is some (although not very well designed) data, that it reduces narcotic requirements, thereby reducing narcotic side effects of constipation and sedation.
I have been doing this for six years now and have stopped them very few times for patient intolerance (nausea), but very rarely.
I am convinced that ibuprofen is safe and effective.
Julie Miller
Surgeon
Royal Melbourne Hospital


----- Original Message ----
From: Charlene M Morris <cvmmorris at gmail.com>
To: "Trauma &, Critical Care mailing list" <trauma-list at trauma.org>
Sent: Friday, June 20, 2008 1:31:58 AM
Subject: Re: nsaids...

For those on coumadin therapy-- celexocob is pretty much the only acceptable
NSAID, although often prohibitively expensive for uninsured patients. And
although I agree re: GI bleed precaution, ALL Rx have side effects as we
know.

Primum no nocere.

C M Morris


On 6/19/08, McSwain, Norman E Jr. <nmcswai at tulane.edu> wrote:
>
> What is the data to support increased GI hemorrhage in significant
> numbers from this specific drug. I have not seen it.
>
> Norman
>
> Norman McSwain MD
> Professor, Tulane School of Medicine
> Trauma Director, Charity Hospital Trauma Center
> norman.mcswain at tulane.edu
> 504 988 5111
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of
> joe.nemeth at mcgill.ca
> Sent: Thursday, June 19, 2008 8:53 AM
> To: trauma-list at trauma.org
> Subject: nsaids...
>
>
> Regarding the post about ketorolac...
>
> Unless you want an unnecessary UGI bleed don't use it...if you want
> NSAIDs use ibuprofen: much better GI SFX profile, cheaper...if patient
> cannot tolerate PO meds, use narcotics...
>
> One last tidbit about NSAIDs: definitely should reconsider other
> options in pts. above 60....
>
> joe
>
> Emergency Medicine
> McGill University Health Centre
> Montreal
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