PHA 3112 Chapter Notes - Chapter 71: Colorectal Cancer, Rheumatoid Arthritis, Rheumatic Fever
10 Dec 2016
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Ch 71 cyclooxygenase inhibitors: nonsteroidal anti-inflammatory drugs & acetaminophen. Cyclooxygenase inhibitor family contain aspirin & related drugs. These drugs work by inhibiting cyclooxygenase (cox), Cox: enzyme convert arachidonic acid prostaglandins & prostacyclin, thromboxane a2 [txa2. 2 forms of cyclooxygenase: cyclooxygenase-1 (cox-1): found in all tissues & mediates benefi(cid:272)ial pro(cid:272)esses; (cid:862)good cox(cid:863, cyclooxygenase-2 (cox-2): produced at tissue injury sites & mediates inflammation & sensitizes re(cid:272)eptors to pai(cid:374)ful sti(cid:373)uli (cid:894)(cid:373)ediates pai(cid:374)ful pro(cid:272)esses(cid:895); (cid:862)(cid:271)ad cox(cid:863) Inhibition of cox-1 (good cox) causes mostly harmful effects: gastric erosion & ulceration, bleeding tendencies, renal impairment. Inhibition of cox-1 also has one very beneficial effect: protection against mi & stroke (secondary to reduced platelet aggregation) Inhibition of cox-2 (bad cox) causes mostly beneficial effects: Inflammation suppression: pain alleviation, fever reduction, protection against colorectal cancer. Inhibition of cox-2 also has two adverse effects: renal impairment, promotion of mi & stroke (secondary to suppressing vasodilation) Table 71-1 cyclooxygenase-1 and cyclooxygenase-2: functions and effect of inhibition.
