Which factor increases GI bleeding risk when using non-COX-2 NSAIDs?

Which factor increases GI bleeding risk when using non-COX-2 NSAIDs?

• A. Age over 75
• B. Concurrent corticosteroids
• C. Concurrent anticoagulants
• D. All of the above

Answer: (D)

Non-COX-2 NSAIDs raise the risk of GI bleeding by how they irritate the stomach lining and inhibit protective prostaglandins, making ulcers and bleeding more likely. Age over 75 increases baseline vulnerability of the GI tract and often comes with more comorbidities and polypharmacy, all of which amplify this risk. Taking corticosteroids at the same time as NSAIDs further weakens the stomach’s defenses, increasing ulcer formation. Using anticoagulants with NSAIDs adds a bleeding tendency, so any injury to the GI mucosa is more likely to result in significant bleeding. When these factors occur together, the risk is notably higher, which is why all of these contribute to GI bleeding risk with non-COX-2 NSAIDs. In Beers criteria-informed practice, minimize NSAID use in older adults and consider alternatives or protective measures when such risk factors are present.

Non-COX-2 NSAIDs raise the risk of GI bleeding by how they irritate the stomach lining and inhibit protective prostaglandins, making ulcers and bleeding more likely. Age over 75 increases baseline vulnerability of the GI tract and often comes with more comorbidities and polypharmacy, all of which amplify this risk. Taking corticosteroids at the same time as NSAIDs further weakens the stomach’s defenses, increasing ulcer formation. Using anticoagulants with NSAIDs adds a bleeding tendency, so any injury to the GI mucosa is more likely to result in significant bleeding. When these factors occur together, the risk is notably higher, which is why all of these contribute to GI bleeding risk with non-COX-2 NSAIDs. In Beers criteria-informed practice, minimize NSAID use in older adults and consider alternatives or protective measures when such risk factors are present.