Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):This class of drug is the most commonly used medication in the world. OTC NSAIDs include Ibuprofen (Advil® and Motrin), naproxen (Aleve), and aspirin. NSAIDs are used primarily to treat inflammation, pain, and fever, by blocking prostaglandin production. However, prostaglandins are needed to create mucosal protection for the lining of the stomach, and if blocked, serious damage can occur. NSAIDs also inhibit platelets that help with blood coagulation and hemostasis, and can interfere with kidney function. There is no risk-free NSAID dose (includes low-does aspirin).

NSAID-Induced PUBS, known together as Perforations (erosions of the stomach and small intentional lining), Ulcers, and GI Bleeds, cause over 100,000 hospitalizations annually. Chronic NSAID use (90+ days) showed serious damage to the small intestine in 70% of the subjects. Patients over 60 with perforations have a 30% chance of dying

Acetaminophen (APAP):Tylenol ™, Datril™, and others do not have anti-inflammatory effects like NSAIDs but are commonly taken for chronic pain. Used in over 600 Medications

  • Annually, acetaminophen (APAP) toxicity kills nearly 500 people and causes 56,000 ER visits, 2,600 hospitalizations, and 100,000+ calls to Poison Control Centers
  • Overdose of acetaminophen is the leading cause of Acute Liver Failure (ALF). ALF may feel like flu symptoms over several days. Coma and death can rapidly occur in one-third of ALF cases.
  • AL can occur using the maximum 4 grams (gm) per day dose for five or more consecutive days. 10% of ALF victims used 2-4 daily gm.
  • APAP causes half of all ALFs. Of these cases, 38% had combined two or more APAP-containing preparations.
  • Alcohol used with more than 2gm of APAP can cause ALF.