Once upon a time there was a country called Humania, which was known all over the world for its wealth and prosperity. Countless treasures were hidden in the bosom of this country. And, obviously, that was the main reason for many hostile warriors to attack the Humania, bringing devastation, sorrow, and suffering to the peaceful inhabitants of the country. The most inimical warriors were those from the Army of Pain and Inflammation.
Happily, there lived a noble knight, named Sir Aspirin in the country of Humania. He always struggled against the Army of Pain and Inflammation, repulsing the attacks of hostile intruders in different parts of the country. But years passed by, and Sir Aspirin became old. His strength grew weak, his vigilance became dull, and he could not fight back all the attacks of Pain and Inflammation any more. Besides, people began to notice that sometimes during long battles Sir Aspirin accidentally injured some of the civil inhabitants of Humania.
Then three brothers from overseas were invited to the Humania with the aim to help Sir Aspirin. Their names were Vioxx, Bextra, and Celebrex and they were the knights of the secret order with the weird and mysterious name COX-2 Inhibitors. Vioxx, Bextra, and Celebrex were all young and very powerful. The warriors of Pain and Inflammation trembled before the only appearance of three brothers. For some time Humania gained peace and serenity.
However, those days did not last long. Soon two of the brothers appeared to be stuck in the corruption and abuse of power. They started to bring more risks than benefits to the inhabitants of Humania, and therefore Vioxx and Bextra were banished from the country. Since Celebrex was not noticed in any illegal activities, he was allowed to stay in Humania under the supervision of the experienced and wise Sir Aspirin.
People say that the country of Humania still exists somewhere in the World, and the young Celbrex together with old Sir Aspirin still fight against the hostile Army of Pain and Inflammation…
Part 2: Medical
Well, that will do with the fairy tales of Scheherazade. Now let us try to answer the key questions on the COX-2 inhibitors using more common language with fewer epithets and metaphors.
What are COX-2 inhibitors?
COX-2 inhibitors belong to a relatively new class of pain-relieving medications. They are called to relieve pain and reduce inflammation within human organism just like the older non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen, ibuprofen, etc.
What is the history of COX-2 inhibitors?
COX-2 enzyme was discovered in 1998 and since then there were three COX-2 inhibitors approved in the USA: valdecoxib (Bextra), rofecoxib (Vioxx) and celecoxib (Celebrex). All the medications were extremely popular among patients seeking for quick and efficient pain relief, as well as among doctors, trying to find the optimal solution for arthritis pain and other types of chronic pain.
However, after considering the received data showing the harmful influence of COX-2 inhibitors on the human cardiovascular system (the incidents of heart attacks and strokes were reported among the patients treated with some COX-2 inhibitors), Vioxx and Bextra were withdrawn from the American market. For the time being, it is only Celebrex, which is still available in the U.S. pharmacies.
How do COX-2 inhibitors work?
COX-2 inhibitors are designed to selectively block one of the enzymes, naturally occurring in the human body. This enzyme is called cyclooxygenase type 2 or just COX-2. This very enzyme participates in the production of prostaglandins – chemical messengers, which are responsible for pain and inflammation. Blocking of the COX-2 enzymes results in pain relief and reduced inflammation.
What are the benefits of COX-2 inhibitors?
The main benefit of COX-2 inhibitors is that these medications block only COX-2 enzymes and do not affect COX-1. The point is that COX-1 enzymes are responsible for the protection of lining inside human digestive tract. All the NSAIDs block both COX-1 and COX-2 enzymes. As the result, they relieve pain and inflammation, but also decrease the protection of stomach. That is why all the NSAIDs, when used regularly for a long time, can cause stomach irritation, heartburn, bleeding or even ulcers. COX-2 inhibitors, on the other side, do not interfere with the stomach protective system.
What are the side effects of COX-2 inhibitors?
The most common side effect of COX-2 inhibitors, namely Celebrex (since all the others were withdrawn from the market) is headache. Less common adverse reactions are diarrhea, upset stomach, sinus irritation, and respiratory infection.
At the same time, the side effect, which is far from common, but which causes the most serious concerns about COX-2 inhibitors use, is the cardiovascular effect. It is said that this type of medications have been associated with high blood pressure, kidney damage, heart attacks, and stroke – that is why, all COX-2 inhibitors contain a special warning on their label.
Nick
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