Cyclooxygenase-2 inhibitors: do they have a role in emergency department prescribing?
Cyclooxygenase-2 selective inhibitors (COXIB or CSI) have been released with a fanfare as efficacious and safer alternatives to traditional non-steroidal anti-inflammatory drugs. They purport to offer equivalent degrees of analgesia and an improved safety profile. COXIB currently available in Australasia are celecoxib (Celebrex), rofecoxib (Vioxx) and etoricoxib (Arcoxia). This review discusses the pharmacology of these agents and reviews recent literature regarding their effectiveness and safety. It endeavours to answer the question 'Should we be using COXIB in emergency departments in Australasia'?
Wilton
Tanya
T
Emergency Department, Wellington Hospital, Wellington, New Zealand. tanya.wilton@ccdhb.org.nz
D000544:Alzheimer Disease / Q000188:drug therapy; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D016718:Arachidonic Acid / Q000276:immunology / Q000378:metabolism; D044362:Australasia; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D004347:Drug Interactions; D011307:Drug Prescriptions / Q000592:standards; D004358:Drug Therapy / Q000379:methods / Q000592:standards; D004363:Drug Utilization / Q000592:standards; D064420:Drug-Related Side Effects and Adverse Reactions; D004638:Emergency Treatment / Q000009:adverse effects / Q000379:methods / Q000592:standards; D019317:Evidence-Based Medicine; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006801:Humans; D007249:Inflammation; D007527:Isoenzymes / Q000037:antagonists & inhibitors*; D007674:Kidney Diseases / Q000139:chemically induced; D008565:Membrane Proteins; D009369:Neoplasms / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000592:standards; D011247:Pregnancy; D011451:Prostaglandin-Endoperoxide Synthases; D012449:Safety; D015145:Tocolysis / Q000379:methods; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D016718:Arachidonic Acid; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases