Fish Oil

Fish Oil

Key points:

- Fish oil has been reported to have anti-inflammatory and immunosuppressive effects, and it also result in decreased platelet activity. (beware of procedures)
- Long chain omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have anti-inflammatory properties when taken in doses greater than 2.7g daily.
- It is safe to use but compliance and cost is an issue as to have the inflammatory effect, patient needs to take quite many tablets per day. The following table is from therapeutic guideline:

References:
therapeutic guideline: rheumatology. Getting to know your drug.

NSAIDs - How to prevent GI bleed?

NSAIDs - How to prevent GI bleed?


I saw a young man today with likely ankylosing spondylitis. I started him on NSAIDs. He told me that he suffers from reflux, this brings up a question, how can I reduce the GI side effect?

How does it work ? (This is to remind myself, I seriously can't remember)

Key points:

1. No one NSAID is safer another. 

2. Use low dose NSAIDs for the shortest time possible. 

3. COX-2 NSAIDs seem to have less GI side-effects

4. Co-infection of H. Pylori and the use of NSAIDs increase the risk of GI ulcer by 60 folds and bleeding by 6 folds. 

5. Other drugs which can increase bleeding risks include: anti platelets, anti coagulants, anti depressants, corticosteroids, cigarette, smoking and excessive ETOH consumption.

6. Some other risk factors of GI bleed: 

7. Consider the use of PPI in high risk groups: 

Reference:

Australian therapeutic guideline