Cardiac toxicity of coxibs: mechanisms of development and their prevention
Development of highly selective COX-2 inhibitors – coxibs has proved a decreased risk of gastrointestinal toxicity, which was typical for non-selective NSAIDS, according to the evidence-based medicine. But such situation caused an imbalance in the impact on the synthesis of arachidonic acid metaboli...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Interdisciplinary Academy of Pain Medicine
2018-11-01
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| Series: | Медицина болю |
| Subjects: | |
| Online Access: | https://painmedicine.org.ua/index.php/pnmdcn/article/view/154 |
| _version_ | 1828171754731732992 |
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| author | O O Yakovleva A O Zhamba I O Doroshkevych T K Vitruk |
| author_facet | O O Yakovleva A O Zhamba I O Doroshkevych T K Vitruk |
| author_sort | O O Yakovleva |
| collection | DOAJ |
| description | Development of highly selective COX-2 inhibitors – coxibs has proved a decreased risk of gastrointestinal toxicity, which was typical for non-selective NSAIDS, according to the evidence-based medicine. But such situation caused an imbalance in the impact on the synthesis of arachidonic acid metabolites: inhibition of COX-2 vasodilatatory prostacyclins and activation of thromboxane synthesis by platelets, which is accompanied by the increase in the frequency of thrombotic complications – myocardial infarctions and strokes. Some meta-analyses have proved this association: the higher is COX-2 inhibitors selectivity – the higher are CV-risks and cardiovascular toxicity of coxibs. Discontinuation or limitation of indications of coxibs, assessment of risk / benefit ratio is recommended in the conditions of comorbidity of CVS pathology, pain syndromes in rheumatology. Drugs of choice are moderately selective COX-2 inhibitors = meloxicam and nimesulide. |
| first_indexed | 2024-04-12T03:31:17Z |
| format | Article |
| id | doaj.art-8bde582982394c6c9b7835b9e56dbc91 |
| institution | Directory Open Access Journal |
| issn | 2414-3812 2519-2752 |
| language | English |
| last_indexed | 2024-04-12T03:31:17Z |
| publishDate | 2018-11-01 |
| publisher | Interdisciplinary Academy of Pain Medicine |
| record_format | Article |
| series | Медицина болю |
| spelling | doaj.art-8bde582982394c6c9b7835b9e56dbc912022-12-22T03:49:33ZengInterdisciplinary Academy of Pain MedicineМедицина болю2414-38122519-27522018-11-0133273210.31636/pmjua.v3i3.3154Cardiac toxicity of coxibs: mechanisms of development and their preventionO O Yakovleva0A O Zhamba1I O Doroshkevych2T K Vitruk3National Pirogov Memorial Medical University, Vinnytsia, UkraineNational Pirogov Memorial Medical University, Vinnytsia, UkraineNational Pirogov Memorial Medical University, Vinnytsia, UkraineNational Pirogov Memorial Medical University, Vinnytsia, UkraineDevelopment of highly selective COX-2 inhibitors – coxibs has proved a decreased risk of gastrointestinal toxicity, which was typical for non-selective NSAIDS, according to the evidence-based medicine. But such situation caused an imbalance in the impact on the synthesis of arachidonic acid metabolites: inhibition of COX-2 vasodilatatory prostacyclins and activation of thromboxane synthesis by platelets, which is accompanied by the increase in the frequency of thrombotic complications – myocardial infarctions and strokes. Some meta-analyses have proved this association: the higher is COX-2 inhibitors selectivity – the higher are CV-risks and cardiovascular toxicity of coxibs. Discontinuation or limitation of indications of coxibs, assessment of risk / benefit ratio is recommended in the conditions of comorbidity of CVS pathology, pain syndromes in rheumatology. Drugs of choice are moderately selective COX-2 inhibitors = meloxicam and nimesulide.https://painmedicine.org.ua/index.php/pnmdcn/article/view/154NSAIDsselectivitycoxibscardiovascular toxicityevidence-based medicine |
| spellingShingle | O O Yakovleva A O Zhamba I O Doroshkevych T K Vitruk Cardiac toxicity of coxibs: mechanisms of development and their prevention Медицина болю NSAIDs selectivity coxibs cardiovascular toxicity evidence-based medicine |
| title | Cardiac toxicity of coxibs: mechanisms of development and their prevention |
| title_full | Cardiac toxicity of coxibs: mechanisms of development and their prevention |
| title_fullStr | Cardiac toxicity of coxibs: mechanisms of development and their prevention |
| title_full_unstemmed | Cardiac toxicity of coxibs: mechanisms of development and their prevention |
| title_short | Cardiac toxicity of coxibs: mechanisms of development and their prevention |
| title_sort | cardiac toxicity of coxibs mechanisms of development and their prevention |
| topic | NSAIDs selectivity coxibs cardiovascular toxicity evidence-based medicine |
| url | https://painmedicine.org.ua/index.php/pnmdcn/article/view/154 |
| work_keys_str_mv | AT ooyakovleva cardiactoxicityofcoxibsmechanismsofdevelopmentandtheirprevention AT aozhamba cardiactoxicityofcoxibsmechanismsofdevelopmentandtheirprevention AT iodoroshkevych cardiactoxicityofcoxibsmechanismsofdevelopmentandtheirprevention AT tkvitruk cardiactoxicityofcoxibsmechanismsofdevelopmentandtheirprevention |