How rational COX-2 inhibitors are?

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Dear members,

Risk and Adverse effects of COX2 inhibitors.

Cardiovascular risk of COX-2 specific inhibitors is due to the prostaglandins which are involved in regulation of blood pressure by the kidneys.Long term use of COX-2 inhibitors can reduce whole body PGI2 production without affecting TXA2 contents of platelets, and thus disturb the cardioprotective PGI2:TXA2 ratio which enhances prothrombosis. Although the -2 inhibitors cause a lower incidence of ulcers than the non-selective NSAIDs, the frequency of less severe stomach and intestinal side effects is similar. The most common side effects of the -2 inhibitors are: stomach upset, stomach pain, diarrhea, gas or bloating, and sore throat.

There are a large number of other possible effects, which although infrequent may be serious and require prompt medical attention: black and tarry stools, red blood in stools, bloody vomit, vomiting material that looks like coffee grounds, excessive tiredness, unusual bleeding or bruising, itching, lack of energy, loss of appetite, pain in the upper right part of the stomach, yellowing of the skin or eyes, flu-like symptoms, rash, pale skin, unexplained weight gain,

swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs, hoarseness, difficulty swallowing, or breathing. Regards,Dr. K. M. Jaiswal.Lecturer, Dept. of PharmacologyGMC, Nagpur.

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Dear members,

Celecoxib was introduced in 1999 and rapidly became the most frequently prescribed new drug in the United States. A Spanish study found that between January 2000 and June 2001, 7% of NSAID prescriptions and 29% of NSAID expenditures were for COX-2 inhibitors. Over the period of the study, COX-2 inhibitors rose from 10.03% of total NSAIDs prescribed by specialty physicians to 29.79%, and from 1.52% to 10.78% of NSAIDs prescribed by primary care physicians .The cause of the rapid widespread acceptance of Celecoxib and Rofecoxib by physicians was the publication of two large trials, the Celecoxib Long-term Arthritis Safety

Study CLASS study in JAMA (JAMA 284 (10): 1247–55. doi:10.1001/jama.284.10.1247. PMID 10979111)., and the Vioxx Gastrointestinal Outcomes Research VIGOR study in the New England Journal of Medicine.{ N. Engl. J. Med. 343 (21): 1520–8, doi:10.1056/NEJM200011233432103. PMID 11087881.} Both publications concluded that COX-2 specific NSAIDs were associated with significantly fewer adverse gastrointestinal effects Regards,Dr. K. M. Jaiswal.Lecturer, Dept. of PharmacologyGMC, Nagpur.

From: Kavita Jaiswal <kp_jaiswal@...>netrum <netrum >Sent: Tue, 15 February, 2011 12:10:26 PMSubject: How rational COX-2 inhibitors are?

Dear members,

Risk and Adverse effects of COX2 inhibitors.

Cardiovascular risk of COX-2 specific inhibitors is due to the prostaglandins which are involved in regulation of blood pressure by the kidneys.Long term use of COX-2 inhibitors can reduce whole body PGI2 production without affecting TXA2 contents of platelets, and thus disturb the cardioprotective PGI2:TXA2 ratio which enhances prothrombosis. Although the -2 inhibitors cause a lower incidence of ulcers than the non-selective NSAIDs, the frequency of less severe stomach and intestinal side effects is similar. The most common side effects of the -2 inhibitors are: stomach upset, stomach pain, diarrhea, gas or bloating, and sore throat.

There are a large number of other possible effects, which although infrequent may be serious and require prompt medical attention: black and tarry stools, red blood in stools, bloody vomit, vomiting material that looks like coffee grounds, excessive tiredness, unusual bleeding or bruising, itching, lack of energy, loss of appetite, pain in the upper right part of the stomach, yellowing of the skin or eyes, flu-like symptoms, rash, pale skin, unexplained weight gain, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs, hoarseness, difficulty swallowing, or breathing. Regards,Dr. K. M. Jaiswal.Lecturer, Dept. of PharmacologyGMC, Nagpur.