Issue 2

Anticoagluation Medication



Often, treatment with anticoaugluation drugs are recommended in individuals to guard against clots resulting in heart attacks and strokes. Aspirin has been advocated as a useful initial guard against these devestating diseases. Recently, however, many NSAIDS such as VIOXX and Celebrex have been shown to actually have an increase in CVA's and MI's. One theory is that ASA inhibits platelet coagulation. Any other NSAID the person may be taking interferes with the action of ASA. Thus, any NSAID will intefere with the action of ASA and result in more cardiovascular events than ASA alone. However, many of these patients suffer from pain, such as the significant pain asssociated with arthritis. If a patient is taking ASA, would you recommend any pain reliever to further decrease the pain experienced more than the action ASA itself would result in. If so, which pain reiever would you recommend in this hypothetical patient?