When initiating NSAIDs and steroids, NPs must take into consideration basic underlying conditions and history

When initiating NSAIDs and steroids, NPs must take into consideration basic underlying conditions and history to ensure safety and effectiveness of medication. Gastrointestinal risks: NSAIDs are associated with an increased risk of bleeding, ulcers, and perforation. Gastric adverse effects are likely due to the inhibition of COX-1, preventing the creation of prostaglandins that protect the gastric mucosa (Ghlichloo, 2023). The NP should asses for history of peptic ulcers, GI bleed, or concurrent use of medications that increase risks of bleeding (corticosteroids, aspirin). Prophylaxis with a proton pump inhibitor (PPI) is recommended for patients at risk, including those with a history of peptic ulcers, those taking glucocorticoids, and older adults. PPIs (ex: omeprazole, lansoprazole) reduce ulcer generation by suppressing production of gastric acid (Burchum