The pharmacist's role in the nonsteroidal anti-inflammatory drug selection process.

The pharmacist provides an integral role in pain management and treatment by focusing on the selection and evaluation of analgesic agents in a process that is patient specific and patient centered. Counseling patients (and the families of patients) who are using nonsteroidal anti-inflammatory drugs (NSAIDs) for acute musculoskeletal pain and inflammation regarding the appropriate use of these agents is a key component of the pharmacist's overall pharmacotherapeutic role. This article reviews the importance of explaining the therapeutic and nontherapeutic effects of NSAIDs and cautions, contraindications, dosing parameters, and the avoidance of multiple NSAID use to patients and prescribers. The article also discusses the need to evaluate the cytochrome P450 system and the patient's pharmacotherapy and comorbid disease history to identify potential drug interactions. Evaluation of patients for comorbidities, allergies, and gastrointestinal, renal, hepatic, hematologic, and cardiovascular risks is also addressed, as are essential laboratory tests and the special needs of elderly patients.