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- Naproxen, aspirin, and ibuprofen are all NSAIDs available over the counterUniversity of Chicago: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
- COX-2 discovered by Daniel SimmonsRedOrbit: 11 Utahns Win Science Awards (November 7, 2005)
- COX-2 inhibitors were developed to aid in decreasing gastric irritationNational Cancer Institute: Cyclooxygenase (COX)Inhibitors
- Vioxx: Withdrawn from the market in 2004U.S.Food and Drug Administration: FDA Public Health Advisory: Safety of Vioxx
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COX Inhibitors are non-steroidal anti-inflammatory drugs (NSAIDs) which can reduce pain and inflammation by blocking cyclooxygenase (COX) enzymes.UpToDate: HOW THEY WORK
Types of NSAIDs
There are 2 types of NSAIDs. Those that inhibit the COX-2 enzyme only (COX-2 Inhibitors) are referred to as selective — they target only the COX enzymes that occur with inflammation. Inhibition of COX-1 enzymes can result in irritation of the stomach lining. Nonselective NSAIDs block both COX-1 and COX-2 enzymes. creating the potential for ulcers.UpToDate: Types of NSAIDs MedicineNet: Definition of Cox-2 MedicineNet: Definition of Cox-1Controversy
As of mid-2008, the only COX-2 inhibitor available in the U.S. is Celebrex. Research has raised the concern that COX-2 Inhibitors could increase the risk of heart attack and stroke. A March 2008 Pfizer study suggested that the dosage of COX inhibitors be decreased, especially for long term use.Reuters: UPDATE 2-Celebrex Risky in High-Risk Patients, Study Finds (March 31, 2008) The Lupus Site: Vioxx Withdrawal Prompts Reevaluation of COX-2 Inhibitor Safety (October11, 2004)-
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Do COX-2 inhibitors raise blood pressure more than nonselective NSAIDs and placebo? J Hypertens. 2009 Dec http://bit.ly/5LHmBp #pharmacology
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have been described including ion pairing of carboxylic acid containing inhibitors with Arg-120 of COX-1
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