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Analgesics during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Celecoxib is a COX-2 selective analgesic. Among 109 infants exposed to celecoxib during the first trimester, the frequency of congenital anomalies (n = 6, 5.5 percent) was not significantly increased above control rates (Kallen, 2019). Premature closure of the ductus arteriosus is a theoretical risk because of the pharmacologic action of celecoxib. Ductus closure has been demonstrated in animal models, but not reported in humans. In 24 pregnancies exposed to celecoxib, the rate of prematurity (n = 6) was increased (Bérard et al., 2018). The clinical significance of this finding is unclear.
Drugs Affecting the Musculoskeletal System
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: It is better to be avoided during the 1st and 3rd Trimesters because the pregnancy experience in humans suggests a risk of pulmonary hypertension of the newborn, spontaneous abortions (SABs), and congenital malformations linked to the use of Celecoxib.
Fraudulent celecoxib trial and other lies
Published in Peter C. Gøtzsche, Richard Smith, Drummond Rennie, Deadly Medicines and Organised Crime, 2019
Peter C. Gøtzsche, Richard Smith, Drummond Rennie
The FDA’s advisory committee concluded that, based on the full data, celecoxib exhibited no advantage in reducing ulcer complications over the two old, much cheaper drugs. The FDA’s statistical reviewer explained why the company’s arguments for the 6-month analysis were obviously invalid.7 A committee meeting in 2005 was also illuminating. All 32 participants considered that celecoxib, rofecoxib and valdecoxib increase the risk of cardiovascular events.8
Provider-directed analgesia for dental pain
Published in Expert Review of Clinical Pharmacology, 2023
There is some evidence that celecoxib has similar efficacy to ibuprofen but is inferior to the combination of 200 mg ibuprofen+500 mg acetaminophen. For instance, a Cochrane review found single‐dose oral celecoxib was an effective analgesic for postoperative pain relief, and indirect comparison suggested that the 400 mg dose had similar efficacy to ibuprofen 400 mg [89]. In a randomized, double-blind, placebo-controlled clinical trial, a single oral dose of celecoxib 200 mg, given preemptively (1 hr prior to minor oral surgical procedure) provided superior analgesic effect than ibuprofen 400 mg [90]. In a multiple dose study, celecoxib (400 mg start, then 200 mg every 12 h) provided superior pain relief to ibuprofen (400 mg every 8 h) and tramadol (100 mg every 8 h) following third molar surgery [91]. An initial loading dose of celecoxib is recommended due to its delayed analgesic response, owing to its extensive volume of distribution into off-target tissue sites [92]. An advantage of celecoxib over ibuprofen is less likelihood of GI bleeding; however, celecoxib has a potentially greater risk of cardiovascular side effects and is only available by prescription in the US, whereas ibuprofen is available OTC in 200 mg formulations. To summarize, the current evidence-based literature clearly supports the use of NSAIDs in combination with acetaminophen as first-choice analgesics for treating acute postoperative dental pain [93]. In addition to superior analgesia, NSAIDs and NSAID/acetaminophen combinations also have the advantage of reducing the burden of prescribing opioids [93].
Proximal interphalangeal-level fracture in patient with symphalangism
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Tommy Pan, Don Hoang, Alexander Payatakes
Clinical and radiographic evaluation were consistent with subacute fracture/delayed union complicating underlying bony proximal symphalangism (Grade III) (as opposed to incomplete fusion). The patient was treated with a custom thermoplastic volar finger-based splint immobilizing the PIP ‘joint’ in full extension, allowing motion at the MP and DIP levels. Discontinuation of the celecoxib was recommended. Radiographs at 3-weeks follow-up revealed persistent cortical irregularity but less prominent lucency and soft tissue swelling at the PIP level. At 6-weeks follow-up, the patient was pain-free. His ring finger was completely nontender and clinically stable with manipulation at the PIP level. Radiographs revealed mature trabecular bridging across the fracture with restoration of the congenital bony fusion (Figure 3). The splint was discontinued and the patient returned to work. At 1-year follow-up, the patient was successfully working. He was having ongoing generalized polyarthralgia, managed by his rheumatologist, and unrelated to his left ring finger injury.
COX-2 induces T cell accumulation and IFN-γ production during the development of chromium allergy
Published in Autoimmunity, 2019
Ratri Maya Sitalaksmi, Koyu Ito, Kouetsu Ogasawara, Yoshiko Suto, Madoka Itabashi, Kyosuke Ueda, Noriyasu Hirasawa, Takayuki Narushima, Nike Hendrijantini, Utari Kresnoadi, Keiichi Sasaki
Mice were inducing Cr allergy as describe in previous paper [12]. Sensitization was injected twice at an interval of 7 days via the intradermal (i.d.) route into the left and right groin of mice, 125 μl of indicated CrCl2 with 10 μg/ml of LPS in PBS (250 μl per mice) [22]. At day 7, after the 2nd sensitization, mice were challenged by i.d. injection of 25 μl of indicated dose of CrCl2 (without LPS) in sterile saline into both the left and right footpads. As a control, mice were injected with PBS and then challenged with indicated dose of CrCl2 (without LPS). Footpad swelling was measured before and at 24–72 h after the challenge using a Peacock Dial Thickness Gauge (Ozaki MFG Co. Ltd, Tokyo, Japan) [23], and the difference in footpad thickness before and after challenge was calculated. Celecoxib treatment, one hour after challenge the mice were injected by intraperitoneally (i.p.) with celecoxib once per day from for 7 days. The dose of celecoxib was 13 mg/kg of weight in 250 μl of polyethylene glycol (PEG) 400/saline (2:1, v/v). PEG400/saline (2:1, v/v) was used in control mice were injected with i.p. instead of celecoxib.