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Therapeutic Use of Carbonic Anhydrase Inhibitors and Their Multiple Drug Interactions
Published in Peter Grunwald, Pharmaceutical Biocatalysis, 2019
Andrea Angeli, Claudiu T. Supuran
Celecoxib is the first selective COX-2 inhibitor to be approved for clinical practice in the treatment of patients with rheumatoid arthritis, osteoarthritis and for management of the pain of these conditions (Skarke et al., 2012). However, this class is putative gastrointestinal safety advantages compared with other NSAIDs. Celecoxib is metabolized primarily by CYP2C9 and may be increased or decreased by CYP2C9 modifiers such as fluconazole (200 mg once/day), fluvastatin, and zafirlukast. When, it was administered concomitantly with celecoxib, plasma level of coxib drug increased two folds (Garnett, 2001). It also inhibits CYP2D6 and may increase serum concentrations for a substantial number of agents that are substrates for CYP2D6, including many antidepressants (selective serotonin reuptake inhibitors, tricyclic antidepressants), antifungals, antipsychotics (flecainide, propafenone, haloperidol, etc.), analgesics such as codeine, and β-blockers (Werner et al., 2003). Significant interactions were reported for the administration of celecoxib with lithium. In fact, it decreases the clearance of lithium by inhibiting synthesis of renal prostaglandins, thereby elevating its plasma levels and lead to toxic effects (Gunja et al., 2002; Slørdal et al., 2003). Celecoxib showed an antagonistic drug-interaction with many anti-cancer drugs as doxorubicin (El-Awady et al., 2011) and platin derivative drugs such as cisplatin or oxaliplatin (Bijman et al., 2008; Chen et al., 2013; Kong et al., 2016).
Reduction and Fixation of Sacroiliac joint Dislocation by the Combined Use of S1 Pedicle Screws and an Iliac Rod
Published in Kai-Uwe Lewandrowski, Donald L. Wise, Debra J. Trantolo, Michael J. Yaszemski, Augustus A. White, Advances in Spinal Fusion, 2003
Kai-Uwe Lewandrowski, Donald L. Wise, Debra J. Trantolo, Michael J. Yaszemski, Augustus A. White
Recently, the development of drugs that selectively inhibit the cyclooxygenase-2 enzyme has significantly changed the way in which NSAIDS are prescribed. These COX-2 inhibitors have been shown to have significantly fewer side effects than the nonselective NSAIDS, especially in regards to gastrointestinal bleeding. Much interest has also arisen as to the possibility of using these COX-2 inhibitors after spinal fusion. It has been shown that perioperative use of celecoxib or rofecoxib can significantly reduce pain and opioid use in patients undergoing spinal fusion. This same study also demonstrated that these medicines do not have to be discontinued preoperatively and that their use did not increase the risk of intraoperative bleeding [32]. In addition, a study by Lewis et al. [33] indicated that postoperative use of COX-2 inhibitors did not lead to an increased number of pseudarthroses. They found that the fusion rate in rats at 8 weeks after posterolateral spinal fusion was not statistically different in those rats receiving celecoxib versus the control group. They did, however, find a statistically significantly higher rate of nonunion (50%) in those rats who received indomethacin postoperatively. Although these early results with COX-2 inhibitors after spinal fusion are encouraging, there needs to be more research with human studies before stating their definite safety.
Medicinal Plants and Natural Products from Caatinga Biome with Anti-Inflammatory Activity
Published in Parimelazhagan Thangaraj, Lucindo José Quintans Júnior, Nagamony Ponpandian, Nanophytomedicine, 2023
Jackson Roberto Guedes da Silva Almeida, Ana Paula de Oliveira, Juliane Cabral Silva, Mariana Gama e Silva, Raimundo Gonçalves de Oliveira, Vítor Prates Lorenzo
Inhibition of cyclooxygenases (COX-1 and COX-2 by NSAIDs [e.g., indomethacin]) is one of the main targets for anti-inflammatory therapy. However, due to the adverse effects of COX-1 inhibition by these drugs, such as renal and gastrointestinal toxicity, selective COX-2 inhibitors have been developed. Among NSAIDs, piroxicam, meloxicam, naproxen and nimesulide are first-generation selective COX-2 inhibitors, while celecoxib, rofecoxib, etoricoxib, valdecoxib, parecoxib and lumiracoxib are highly selective second-generation alternatives (Chagas-Paula et al., 2015).
Transdermal delivery of acemetacin loaded microemulsions: preparation, characterization, in vitro – ex vivo evaluation and in vivo analgesic and anti-inflammatory efficacy
Published in Journal of Dispersion Science and Technology, 2023
Emre Şefik Çağlar, Mehmet Evren Okur, Buket Aksu, Neslihan Üstündağ Okur
Due to the obvious importance of the cyclooxygenase (COX) pathway in inflammation and, hence, the biochemical identification of pain, nonsteroidal anti-inflammatory medications (NSAIDs), which include both conventional nonselective NSAIDs and selective COX-2 inhibitors, are widely used in pain management.[1] Acemetacin (ACM), the glycolic acid ester of indomethacin, is a nonselective COX-2 inhibitor. ACM, like other NSAIDs, is practically water-insoluble and inhibits prostaglandin production, resulting in an anti-inflammatory, analgesic, and antipyretic effect. Rheumatoid arthritis, osteoarthritis, low back pain, acute gout, dysmenorrhea, toothache, and postoperative pain are among the conditions for which it is prescribed. ACM is excreted via the hepatic and renal systems.[2,3]