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COX-2 inhibitors

Do not inhibit platelet function.

Possess equivalent efficacy to selective NSAID’s, but their advantage is the result of a more favorable side effect profile.

Cyclooxygenase-2 selective inhibitors were developed to decrease risk of gastrointestinal complications.

Reduce risk of gastrointestinal complications by approximately 50% compared to traditional NSAIDs, but the risk is still double compared to nonusers.

Relative contraindications to their use in the presence of liver disease.

Discourage polyp and tumor growth.

May decrease carcinogenesis by decreasing proliferation, angiogenesis and metastases, while increasing apoptosis in cells.

May increase thrombotic events by inhibiting the production of prostacyclin without affecting the production of thromboxaneA2.

Increased risk of thrombotic cardiovascular events compared with placebo.

Vary in affinity from drug to drug for COX-1 and COX-2 isoforms with rofecoxib inhibiting COX-2 80 times more than COX-1 isoform and celecoxib inhibits COX-2 9 times more than COX-1 and the degree of inhibition of COX-2 over COX-1 for ibuprofen and naproxen is 0.4 and 0.3, respectively.

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