2.2. NSAID Use and Elderly Patients

Elderly patients frequently utilize prescription and nonprescription NSAIDs to manage acute and chronic pain. Several issues surface with NSAID use in elderly patients, including potential adverse effects and drug interactions. NSAID-induced gastrointestinal and renal toxicity as well as adverse central nervous system effects are more prevalent in elderly patients due to changes in metabolism, underlying disease states, and concurrent drug therapy. The majority of fatal gastrointestinal events associated with ketorolac use have been seen in elderly or debilitated patients. The potential for increased cardiovascular risk with NSAID use is also a factor when evaluating NSAID therapy in elderly patients. Elderly patients prescribed NSAIDs, especially those at higher risk, should be evaluated for appropriateness of therapy as well as potential for drug-drug interactions. Appropriate ketorolac therapy duration as well as appropriate dosages should also be evaluated.