Cyclooxygenase-2 inhibitor celecoxib: A possible cause of gastropathy and hypoprothrombinemia

Citation
Jd. Linder et al., Cyclooxygenase-2 inhibitor celecoxib: A possible cause of gastropathy and hypoprothrombinemia, SOUTH MED J, 93(9), 2000, pp. 930-932
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
SOUTHERN MEDICAL JOURNAL
ISSN journal
0038-4348 → ACNP
Volume
93
Issue
9
Year of publication
2000
Pages
930 - 932
Database
ISI
SICI code
0038-4348(200009)93:9<930:CICAPC>2.0.ZU;2-7
Abstract
Gastrointestinal side effects from nonsteroidal anti-inflammatory drugs (NS AIDs) result mainly from inhibition of the enzyme cyclooxygenase (COX)-1; i t is responsible for the synthesis of prostaglandin E-2, which leads to inc reased mucosal blood flow, increased bicarbonate secretion, and mucus produ ction, thus protecting the gastrointestinal mucosa, In inflammation, COX-2 is induced, causing synthesis of the prostaglandins in conditions such as o steoarthritis and rheumatoid arthritis. Two NSAIDs (celecoxib and rofecoxib ) with very high specificity for COX-2 and virtually no activity against CO X-I at therapeutic doses have been approved for clinical use. In trials of celecoxib and rofecoxib, only 0.02% of patients had clinically significant gastrointestinal bleeding, compared to a 1% to 2% yearly incidence of sever e gastrointestinal side effects with NSAIDs, Our patient had arthritis of t he hips and chronic atrial fibrillation and was on warfarin therapy for str oke prevention; less than a week after starting celecoxib therapy, gastroin testinal bleeding and hypoprothrombinemia occurred.