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 One of them (rofecoxib) was withdrawn by the manufacturer after 5 years on the market because of an unacceptably high incidence of heart attack and thrombotic stroke in patients receiving it for 18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 ?
This is, of course, the opening, not the concluding, part of the story, because until each of our herbal coxibs, or natural medications, is systematically tested for scientific and beneficial activity, there won't be a standard to measure actual clinical effects.
Opioid users had significantly higher all-cause mortality (75 deaths per 1,000 person-years) than did either NSAID users (48 deaths per 1,000 person-years) or coxib users (47 deaths per 1,000 person-years).
By inhibiting the production of PGs, as both nonselective NSAIDs and coxibs do, these agents can exacerbate--and theoretically cause--fluid imbalance, electrolyte disorders and kidney problems during a marathon.
The survey revealed that spending on coxibs accounted for just 14 per cent of total funding for treatment of osteoarthritis.
Cardiovascular adverse events -- including myocardial infarction, stroke, new or worsening of pre-existing arterial hypertension, congestive heart failure, and several less severe CV events -- were monitored and retrospectively related to the use of coxibs, tNSAIDs and glucocorticoids.
Cardiovascular outcomes in new users of coxibs and non-steroidal anti-inflammatory drugs.
This is now a phenomenon that I think is greater than a coxib issue, even though we clearly had the first signs from a coxib," he said.
All the media attention has focused on the COX-2-selective inhibitors as the drugs that cause heart attacks, but when you look at the coxibs compared to non-coxibs--and this is very important--it turns out the coxibs do not cause heart attacks any more than the non-COX-2 drugs, except for rofecoxib (Vioxx), which has a higher rate than all the other non-coxibs.
Table 1: Coxibs currently on the market Generic Name Originator Any Indication etoricoxib Merck & Co Arthritis, osteo Arthritis, rheumatoid Pain, musculoskeletal Pain, post-operative Dysmenorrhoea celecoxib Pfizer Arthritis, rheumatoid Arthritis, osteo Pain, musculoskeletal valdecoxib Pfizer Arthritis, rheumatoid Arthritis, osteo Pain, musculoskeletal Dysmenorrhoea parecoxib sodium Pfizer Pain, post-operative
Although there is no cure for most forms of osteoarthritis, various therapies can help patients manage symptoms such as NSAIDs, Coxibs, local analgesics, intra-articular corticosteroid injection and/or surgery.
Compared with nonselective NSAIDs, more CV events were observed with coxibs (hazard ratio 1.