Which medication is included in the non-COX-2 NSAIDs group considered inappropriate for older adults?

• A. Aspirin
• B. Acetaminophen
• C. Diclofenac
• D. Celecoxib

Answer: (A)

Non-COX-2 NSAIDs are traditional NSAIDs that inhibit both COX-1 and COX-2. In older adults, chronic or inappropriate use of these agents is discouraged because of higher risks of GI bleeding, kidney injury, and worsening heart failure or hypertension. Aspirin fits this nonselective NSAID category, and in Beers Criteria terms it is often considered inappropriate for routine analgesia in older adults unless there’s a clear cardiovascular indication where benefits outweigh the risks. Acetaminophen is not an NSAID, so it’s not in this group. Celecoxib is COX-2 selective, so it’s not in the non-COX-2 NSAID group. Diclofenac is another nonselective NSAID and would also be included in this category, but aspirin is the classic example highlighted in this context.