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VIOXX mechanism (COX-1 & 2) explained

COX-2 INHIBITORS  Mechanism, risk, etc.


Article explains the action of COX-1 & COX-2 inhibitors (what was used to justify VIOXX and Celebrex) the drugs that accounted for over 60,000 deaths--jk.





Published online before print March 21, 2005, doi:10.1161/01.CIR.0000160005.90598.41

(Circulation. 2005;111:1713-1716.)
2005 American Heart Association, Inc.;111/13/1713

AHA Science Advisory (American Heart Association)

The Use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

A Science Advisory From the American Heart Association

Joel S. Bennett, MD; Alan Daugherty, PhD; David Herrington, MD, MHS; Philip Greenland, MD; Harold Roberts, MD; Kathryn A. Taubert, PhD

Recent clinical trial data have raised questions about the degree to which patients and their physicians should consider an increased  risk of cardiovascular or cerebrovascular events when selecting medications for pain relief. In September 2004, Merck announced a voluntary worldwide withdrawal of Vioxx (rofecoxib) because of an increased risk of heart attack and stroke. In early December 2004, the US Food and Drug Administration (FDA)  announced a "black box" warning for Bextra (valdecoxib), stating that its use in patients undergoing coronary artery bypass grafting is contraindicated. A week later, the National Institutes of Health suspended the use of Celebrex (celecoxib) in the APC (Adenoma Prevention with Celecoxib) clinical trial because of increased cardiovascular events. The drug was not removed from the market, but the FDA advised physicians to consider alternate therapy or to use the smallest effective dose of Celebrex. Three days later, the National Institutes of Health announced that the ADAPT (Alzheimer’s Disease Anti-inflammatory