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 One of them (rofecoxib) was withdrawn by the manufacturer after 5 years on the market because of an unacceptably high incidence of heart attack and thrombotic stroke in patients receiving it for 18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.

Farlex Partner Medical Dictionary © Farlex 2012

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.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

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.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

COX-2 in·hib·i·tor

(in-hibi-tŏr)
A drug class that relieves inflammation and pain by inhibiting the action of cyclooxygenase-2.
Medical Dictionary for the Dental Professions © Farlex 2012
References in periodicals archive ?
Collectively, these studies demonstrate significantly reduced GI complications with COX-2 selective inhibitors, compared with NS-NSAIDs, and a reduction in potential fatalities resulting from GI complications.
There is evidence regarding a possible risk for CV thrombo-embolic events with COX-2 selective inhibitors as well as the NS-NSAIDs.
Because the COX-2 selective inhibitors have been shown to have no effect on platelet aggregation, at least within clinical doses, they appear to be the drugs of choice for those patients who require concomitant anticoagulation with warfarin and an NSAID.
In this trial the authors set out to compare the upper gastrointestinal safety of COX-2 selective inhibitors versus traditional NSAIDs in a way that simulated standard clinical practice.
They found that there were significantly fewer upper gastrointestinal clinical events with the COX-2 selective inhibitor etoricoxib than with the traditional NSAID diclofenac due to a decrease in uncomplicated events, but not in the more serious complicated events.
In those with a risk for GI bleeding, an NSAID in combination with misoprostol or a proton pump inhibitor or a COX-2 selective inhibitor, such as celecoxib, rofecoxib, or valdecoxib, is appropriate.
Patients with moderate-to-severe pain due to OA should be treated initially with an intra-articular glucocorticoid or an oral NSAID according to the ACR, (25) while the American Pain Society recommends a COX-2 selective inhibitor. (26) Intra-articular administration of a glucocorticoid should not be performed more than 3 times per year.
The ACR recommends treatment be initiated with patient education and physical therapy, a DMARD or DMARDs, and possibly a corticosteroid and/or an NSAID or COX-2 selective inhibitor. (33) When oral glucocorticoids are used, prophylaxis with a bisphosphonate, along with calcium supplementation and daily supplemental vitamin D to lower the risk of glucocorticoid-induced osteoporosis, should be considered.
For patients at high risk, COX-2 selective inhibitors are reasonable second-line agents, since they pose a lower risk of NSAID-associated gastrointestinal complications with long-term use.