COX-2 Inhibitors

COX-2 inhibitors are NSAIDs that are specific to the cyclooxygenase 2 enzyme (COX-2). COX-2 inhibitors work like other NSAIDS except their effects are more specific for the COX-2 enzyme, so there are fewer side effects including a reduced risk of stomach ulcers.  NSAIDs improve pain by reducing prostaglandin levels. Prostaglandins sensitize nerves to inflammatory mediators. COX-2 inhibitors carry a "Black Box Warning" for increased risk of myocardial infarction and stroke.

Class Drugs

• Celecoxib

Class Mechanism of Action

Inhibits cyclooxygenase 2 enzyme for prostaglandin synthesis

• Reversible

Class Applications

Anti-inflammatory

Analgesic

• NSAIDS decrease prostaglandins. Prostaglandins increase sensitivity of nerves to inflammation mediators such as bradykinin, histamine, etc.

Class Adverse Effects

GI

• Less risk of GI bleeding and dyspepsia than other non-specific NSAIDS

Black Box Warning: Cardiac Effects

• Increased risk of MI and stroke

Avoid in pregnancy

• Third trimester use increases risk of premature closure of ductus arteriosus in the fetus.

Drug Table

Drug Name	Application	Comments	Image
Celecoxib			"Celebrity" "Cocks (male chicken)"