When prescribing NSAIDs, the risk of GI toxicity is higher in which group?

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Study for the Foundation Year Pharmacy – Clinical Practice Test. Prepare with detailed questions, step-by-step explanations, and test format insights. Enhance your readiness and confidence!

Multiple Choice

When prescribing NSAIDs, the risk of GI toxicity is higher in which group?

Explanation:
Age-related vulnerability increases the risk of NSAID-related GI toxicity. NSAIDs inhibit COX enzymes, lowering prostaglandin production, which normally protects the gastric mucosa by promoting mucus and bicarbonate, maintaining mucosal blood flow, and supporting repair. When this protection is reduced, the stomach lining becomes more prone to injury from acid, leading to gastritis, ulcers, and potential GI bleeding. In older adults, risk is higher due to factors such as more frequent use of other medicines that raise bleeding risk (anticoagulants, antiplatelets, corticosteroids), a higher prevalence of peptic ulcers and Helicobacter pylori infection, diminished mucosal defense and healing with age, and greater polypharmacy and comorbidity. Therefore, the likelihood of GI toxicity from NSAIDs is greatest in the elderly.

Age-related vulnerability increases the risk of NSAID-related GI toxicity. NSAIDs inhibit COX enzymes, lowering prostaglandin production, which normally protects the gastric mucosa by promoting mucus and bicarbonate, maintaining mucosal blood flow, and supporting repair. When this protection is reduced, the stomach lining becomes more prone to injury from acid, leading to gastritis, ulcers, and potential GI bleeding. In older adults, risk is higher due to factors such as more frequent use of other medicines that raise bleeding risk (anticoagulants, antiplatelets, corticosteroids), a higher prevalence of peptic ulcers and Helicobacter pylori infection, diminished mucosal defense and healing with age, and greater polypharmacy and comorbidity. Therefore, the likelihood of GI toxicity from NSAIDs is greatest in the elderly.

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