The current Journal of the American Medical Association reiterates the new pain management guideline issued by the American Geriatrics Society in May, that physicians treating patients age 75 years or older for chronic pain should avoid prescribing nonsteroidal anti-inflammatory drugs (NSAIDs), one of the most prevalent pain medications readily available over-the-counter as well as in prescription strengths. Opioids should be considered instead. The updated AGS guideline, which reverses its 2002 statement, indicates that NSAIDs should be "considered rarely, and with extreme caution,in highly selected individuals." This is due to studies that have shown serious cardiovascular and gastrointestinal tract risks associated with this class of drugs, according ro Bruce Ferrell, MD, chair of the panel that created new guideline and professor of medicine and geriatrics at the University of California, Los Angeles. These drugs also may complicate the treatment of common conditions in the older population, including high blood pressure and congestive heart failure.
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