List common risks and adverse effects associated with NSAID use in athletes.

• A. Gastrointestinal irritation/ulceration, renal impairment with dehydration, hypertension, increased bleeding risk, decreased kidney function in heat or dehydration, potential interactions with other meds.
• B. No adverse effects.
• C. Increased hydration.
• D. NSAIDs are illegal.

Answer: (A)

NSAIDs carry several well-known risks for athletes, especially in situations common to sports like sweating, heat, or heavy training. The stomach lining can be irritated because these drugs reduce protective prostaglandins, which increases the chance of gastritis, ulcers, and even GI bleeding. In athletes who are dehydrated or exercising in heat, the kidneys are already under stress, and NSAIDs can further impair kidney function by reducing blood flow to the kidneys, raising the risk of acute injury. Blood pressure can rise because NSAIDs promote sodium and water retention, which isn’t ideal for someone managing cardiovascular load or recovery. They also affect platelets, which can slow clotting and increase bleeding risk, a concern with injuries or contact sports. Finally, NSAIDs can interact with other medications (like anticoagulants, diuretics, or certain blood pressure drugs), altering effects or increasing adverse effects.

These risks aren’t negated by simply staying well hydrated, and NSAIDs are not illegal substances in sports; they’re medications that must be used with awareness of potential adverse effects and interactions.