What medication class should be avoided in patients with a history of gastrointestinal bleeding?

The medication class that should be avoided in patients with a history of gastrointestinal bleeding is nonsteroidal anti-inflammatory drugs (NSAIDs). This is due to the known side effects of NSAIDs, which can increase the risk of gastrointestinal (GI) irritation and bleeding. NSAIDs work by inhibiting cyclooxygenase (COX) enzymes, which are involved in the production of prostaglandins that help protect the gastric mucosa. When this protective mechanism is impaired, it can lead to ulceration and bleeding, particularly in individuals who have a history of GI issues.

In contrast, while anticoagulants and thrombolytics can also increase bleeding risk, they are typically avoided for different reasons that involve their mechanism of action and the specific indications for use. Beta-blockers cannot be directly linked to an increased risk of gastrointestinal bleeding and may be used in patients with a history of GI bleeding for their cardiac protective effects. Therefore, NSAIDs are definitively contraindicated in patients with a known history of gastrointestinal bleeding due to their capacity to exacerbate already existing issues related to the GI tract.