Substance
Nonsteroidal anti-inflammatory agents

[Other Names]
Ibuprofen
Ketoprofen
Naproxen
and many others

Pathology
Inhibition of prostacyclin and prostaglandin E₂ production resulting in acute renal failure.

Symptoms
Nausea, vomiting, gastrointestinal distress and bleeding, tinnitus, metabolic acidosis, CNS depression, respiratory depression, mild hepatic toxicity, acute renal failure, seizures.

Emergency Measures
Activated charcoal for recent ingestions; intravenous fluids: administration of gastric protectants, e.g., proton pump inhibitors or H₂ receptor antagonists.

Comments
Baseline renal and hepatic function should be assessed. Most toxic exposures to this class of agents are successfully treated and resolve fully without residual sequelae.