Celecoxib Pharmacology : Usmle Step 1 : Dr G Bhanu Prakash

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Celecoxib Pharmacology : Usmle Step 1 : Dr G Bhanu Prakash

Classification
______________
Nonsteroidal Anti-Inflammatory Drug (NSAID)
Selective COX-2 inhibitor
Mechanism of Action

Specifically inhibits cyclooxygenase-2 (COX-2) enzyme
Reduces the synthesis of prostaglandins, thus decreasing inflammation, pain, and fever
Less gastric irritation compared to non-selective NSAIDs as it does not inhibit COX-1 significantly

Indications
____________
Osteoarthritis and Rheumatoid Arthritis: pain relief and anti-inflammatory effects
Ankylosing Spondylitis
Management of Acute Pain
Familial Adenomatous Polyposis (FAP): used to decrease the number of colorectal polyps

Administration
_______________
Oral, usually as a capsule

Pharmacokinetics
___________________
Well absorbed from the gastrointestinal tract
Hepatic metabolism by cytochrome P450 enzymes
Excretion mainly in the urine and feces

Side Effects
____________
Gastrointestinal: Less likely to cause gastric ulcers and bleeding compared to non-selective NSAIDs
Cardiovascular: Increased risk of thrombotic events, such as myocardial infarction and stroke
Skin: Rash
Renal: Possible impairment in renal function

Contraindications
___________________
Known hypersensitivity to celecoxib
History of cardiovascular disease or high risk of cardiovascular events
Sulfa allergy: Celecoxib has a sulfonamide moiety and should be avoided in patients with a sulfa allergy

Monitoring
___________
Regularly monitor for signs of gastrointestinal, cardiovascular, and renal side effects
Liver function tests: Periodic monitoring may be appropriate

Interactions
_____________
May increase the levels of warfarin and lithium
May decrease the diuretic effect of certain antihypertensive medications

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