COX-2 inhibitor

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COX-2 inhibitor

A drug class that relieves inflammation and pain by inhibiting the action of cyclooxygenase-2.

Prostanoids that mediate inflammation, pain, and fever are synthesized through the action of cyclooxygenase-2 (COX-2), an enzyme that is constitutively expressed in the brain but can be induced in other tissues by cytokines. In both osteoarthritis and rheumatoid arthritis, COX-2 inhibitors have been shown to be superior in pain relief to acetaminophen and placebo, and equivalent to nonselective nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen and naproxen. In rheumatoid arthritis, COX-2 inhibitors are not disease-modifying drugs. Because nonselective NSAIDs inhibit not only COX-2 but also inhibit COX-1, which plays a role in platelet aggregation and gastric mucosal protection, their use is associated with a higher risk of gastrointestinal bleeding than that of selective COX-2 inhibitors. Like NSAIDs, however, the selective agents can cause liver and kidney toxicity, fluid retention, and hypertension. One of them (rofecoxib) was withdrawn by the manufacturer after 5 years on the market because of an unacceptably high incidence of heart attack and thrombotic stroke in patients receiving it for 18 months or more. For these reasons and because they are more expensive than NSAIDs, COX-2 inhibitors are indicated chiefly in patients who are at increased risk of gastrointestinal bleeding.

COX-2 inhibitor

n.
Any of a class of nonsteroidal anti-inflammatory drugs that selectively block prostaglandin formation so as to cause minimal gastrointestinal side effects.

COX-2 inhibitor

Cyclooxygenase-2 inhibitor Pain management A class of analgesics with fewer side effects than those of conventional NSAIDs–which inhibit both cyclooxygenases–COX-1 and COX-2; COX-1 protects the gastric mucosa, preventing ulcers, bleeding, and other digestive tract problems. See COX-2, Prostaglandin.

COX-2 in·hib·i·tor

(in-hibi-tŏr)
A drug class that relieves inflammation and pain by inhibiting the action of cyclooxygenase-2.
References in periodicals archive ?
As far as prevention or antineoplastic therapy is concerned, low-dose aspirin therefore emerges as a particularly attractive option for antithrombotic and antitumor therapy, clearly superior to the more selective COX2 inhibitors which possess cardiovascular side effects and also superior to the classical NSAIDS, none of which shares with aspirin its unique selectivity of inhibition of the platelet COX1 enzyme.
Cardiovascular toxicity was reported following the release of COX2 inhibitors onto the pharmaceutical market, and further studies showed this to be a feature of all NSAIDs.
39) Two other RCTs reported that both esomeprazole 20 mg and 40 mg were significantly superior to placebo in relieving upper GI symptoms in patients taking COX2 inhibitors and in patients taking nonselective NSAIDs (FIGURE 2).
Acute pain is currently treated using several drug classes effective in decreasing pain intensity by a siginifcant level, namely opioids, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), COX2 (Cyclooxygenase2) inhibitors, weak COX1 (Cyclooxygenase1) and COX2 inhibitors, and local anesthetics.
More costly COX2 inhibitors should be reserved for patients who fail acetaminophen therapy, who have no history of congestive heart failure, and who are at high risk for developing a GI bleed or ulcer, he added