Cardiac toxicity of coxibs: mechanisms of development and their prevention
Journal Title: Medicina bolu - Year 2018, Vol 3, Issue 3
Abstract
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 theevidence-based medicine. But such situation caused an imba-lance in the impact on the synthesis of arachidonic acid me-tabolites: inhibition of COX-2 vasodilatatory prostacyclins and activation of thromboxane synthesis by platelets, which is ac-companied by the increase in the frequency of thrombotic com-plications– myocardial infarctions and strokes. Some meta-analyses have proved this association: the higher is COX-2 in-hibitors 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-2inhibitors = meloxicam and nimesulide.
Authors and Affiliations
O. A. Yakovleva, A O Zhamba, I O Doroshkevych, T K Vitruk
Keywords
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- EP ID EP444098
- DOI 10.31636/pmjua.v3i3.3
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