A Critical Appraisal of COX-2 Selective Inhibition and Analgesia: How Good So Far?

Authors

  • Pedro F. Bejarano MD,

    Corresponding author
    1. Department of Anesthesiology, Critical and Palliative Care, Centro Oncológico MD Anderson International-Espana, Madrid, Spain.
      Address correspondence and reprint requests to: Pedro F. Bejarano, MD, Apartado de Correos 6134, 28028 Madrid-SPAIN. Tel: 91-7130672; fax: 91-7130672; E-mail: bejaranodiaz@terra.es
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  • Juan F. Herrero MD

    1. Department of Physiology, Universidad de Alcala, 28871 Alcala de Henares, Madrid, Spain
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  • Institution: Department of Physiology, Universidad de Alcala, 28871 Alcala de Henares, Madrid, SPAIN. Financial support received from the Department of Physiology, Universidad de Alcala, Alcala de Henares, Madrid, Spain.

Address correspondence and reprint requests to: Pedro F. Bejarano, MD, Apartado de Correos 6134, 28028 Madrid-SPAIN. Tel: 91-7130672; fax: 91-7130672; E-mail: bejaranodiaz@terra.es

Abstract

Abstract:  The development of COX-2 selective inhibitors has opened a new era of clinical investigation in NSAIDs. Discussion of the established concepts of inflammation and therapeutical uses of these drugs has changed the rationale for its clinical use and therapeutic labeling of these drugs. A comprehensive discussion across basic science and clinical areas involved in each of these concepts is presented. This led to a remarkable re-evaluation of our insights on their traditionally proposed mechanisms of analgesia, their side-effects, and the clinical indication of NSAIDs as “over the counter” pain killers. This may shift physicians toward a more rational use of this drug class.

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