NSAIDs

Question 1

What are the roles of COX 1?

Answer 1

Constitutive -– prostaglandins used for normal physiological functions such as
stomach mucous production
regulation of gastric acid
kidney water excretion

Question 2

What are the roles of COX-2?

Answer 2

Induced - Used for signalling pain and inflammation – prostaglandins used in inflammatory response

Stimulated only as part of immune response

Production is stimulated by inflammatory cytokines and growth factors

Question 3

What were the

Cox-2 Preferential inhibitors ?

Answer 3

A number of NSAIDs developed before the discovery of COX-2 isoenzyme were later found to be selective for COX-2, and COX-1 sparing. Although not as selective as the coxibs, they were called COX-2 preferential inhibitors.

• Meloxicam
• Nimesulide
• Etodolac
• Nabumetone

Question 4

What drug is now sold as a P medicine due to risk of cardiovascular effects?

Answer 4

Oral diclofenac

Question 5

What are the adverse effects of NSAIDs?

Answer 5

Gastro-intestinal adverse events - prescribe with PPI in those of high risk