Selective COX 2 Inhibitors

Question 1

10-20x more selective for COX 2 
Half life of 11h
No effect on platelet aggregation
Interact with warfarin (CYP2C9)
Half GIT disturbance compared to nonselective
Edema and HTN documented

Answer 1

Celexocib

Question 2

Bipyridine derivative
2nd gen COX2 inh
Highest selectivity ratio for COX2 (106:1)
Metabolized by CYP450 and excreted in urine
Half life of 22 hrs

Answer 2

Etoricoxib ( arcoxia )

Question 3

Enolcarboxamide related to piroxicam
Preferential inhibition to COX2 (2:1)
Half life of 20h
Inhibit TXA2 synthesis but no decrease plt function

Answer 3

Meloxicam (Mobic)

Question 4

Diaryl substituted isoxazole
Highly selective for COX2
No effect on plt agg. and bleeding time
Withdrawn from market

Answer 4

Valdecoxib ( Rofecoxib )

Question 5

Prodrug of valdecoxib

For post op pain (IV or IM)

Answer 5

Parecoxib

Question 6

Inhibits COX2 isoenzyme without affecting COX1
With analgesic, antipyretic, anti-inflammatory
No impact on platelet aggregation
Renally toxic
Higher incidence of CV thrombotic events in rofecoxib and valdecoxib

**for chronic pain safest to use is CELECOXIB

Answer 6

Selective COX2 inhibitor