Existing disease states can influence drug therapy. Patients with decreased renal function require appropriate dose adjustments. The use of NSAIDs requires additional care and monitoring of patients with decreased renal function (72,112-115) or with compromised cardiovascular function. If patients are taking antihypertensive medications such as angiotensin-converting enzyme inhibitors and diuretics, the use of NSAIDs can interfere with their pharmacological effects (116-122). Also, patients with cardiovascular disease such as congestive heart failure requires special care for the use of NSAIDs because, in this patient population, they are most susceptible to the decreased renal perfusion effect associated with NSAIDs (123-126).
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