Which Beers criterion notes risk for GIB, kidney failure, and HF with NSAIDs?

• A. BEERS: NSAIDs
• B. BEERS: Digoxin
• C. BEERS: Warfarin
• D. BEERS: Acetaminophen

Answer: (A)

In Beers Criteria, NSAIDs are singled out for older adults because of multiple serious risks they pose: gastrointestinal bleeding, kidney injury, and potential worsening of heart failure. The reason lies in how NSAIDs work—they inhibit cyclooxygenase enzymes, which lowers prostaglandin production. Prostaglandins help protect the stomach lining and support renal blood flow. When their production is reduced, older adults become more prone to peptic ulcers and GI bleeding, the kidneys are more likely to suffer decreased perfusion leading to kidney injury, and fluid balance can be disrupted, which can worsen heart failure.

Other options are important in the Beers context for different reasons, but they don’t collectively align with the trio of risks tied to NSAID use. Digoxin, Warfarin, and Acetaminophen each carry their own concerns, but the specific combination of GI bleed risk, kidney failure risk, and HF exacerbation is most directly associated with NSAIDs.