The concept of colonization resistance: a study of the influence of antimicrobial agents on the aerobic flora of the bowel

Contains fulltext : mmubn000001_116506431.pdf (publisher's version ) (Open Access)Promotores : J. van der Meer en H. Clasener cum laude199 p

Self-rated health and physician-rated health as independent predictors of mortality in elderly men

Stress-related psychiatric disorders across the life spa

[Interaction between NSAIDs and acetylsalicylic acid disregarded]

Item does not contain fulltextIn 2013 the European Medicines Agency declared that diclofenac is contraindicated in patients with arterial thrombotic complications, based on a meta-analysis of randomised controlled trials on the adverse reactions of NSAIDs. The same decision was taken for coxibs some years earlier. The Dutch authorities (CBG/MEB) informed physicians and pharmacists about this decision without taking into account whether these patients were using prophylactic acetylsalicylic acid or not. It has been shown that NSAIDs with high COX-1 affinity like ibuprofen and naproxen cause a pharmacodynamic interaction with the inhibition of thromboxane synthesis by acetylsalicylic acid. This interaction does not occur with relatively COX-2-selective NSAIDs such as coxibs and diclofenac. Therefore, in patients who use acetylsalicylic acid for thromboprophylaxis, contraindicating coxibs or diclofenac is not justified, on the contrary: they are preferable