Nonrheumatologic uses of NSAIDS

Nonsteroidal antiinflammatory drugs (NSAIDs) have several salient indications outside of their role in rheumatology. Two major uses are treatment of dysmenorrhea and patent ductus arteriosus. Other established roles encompass treatment of fever, pain, Bartter's syndrome, and thromboembolic disorders. Animal and human studies are being done on the use of NSAIDs in cancer, diabetes, psoriasis, and shock, just to name a few investigative areas. NSAIDs are not a panacea nor are they wonder drugs to be used indiscriminately. When these drugs first were marketed in the 1970s, they were considered safe agents with little toxicity. However, the side-effect profile of the NSAIDs has been, and continues to be, better identified over the past few years and warrants judicious use of these drugs. Their adverse effects potentially include gastric distress (possibly hemorrhage), allergic urticaria or bronchospasm in asthma patients, azotemia, arrested labor, skin reactions, and water retention. NSAIDs are relatively safe agents with a growing list of new indications. Future clinical evaluation holds the key to the balance between their emerging toxicities and indications.