اختيار المسكن الفموي للخط الأول في التهاب مفصل الكاحل

References

DOI: 10.1016/j.rdc.2022.03.009.

• Oral NSAIDs were generally recommended for all sites of OA, but strength of recommendations (conditional/weak versus strong) varied among guidelines, primarily reflecting concerns about adverse effects.
• Oral and topical NSAIDs are the pharmacologic agents most recommended for OA, though oral formulations should be avoided in those with contraindications and intolerances, and topical formulations are not appropriate for a deep joint such as the hip.
• Acetaminophen is no longer considered "first-line" for OA due to its relative poor efficacy, though it is still an option for those who have contraindications or intolerances to NSAIDs.
• Consider adding proton pump inhibitor or misoprostol in patients at risk for upper gastrointestinal events who require treatment with NSAIDs or COX-2 inhibitors.