TY - JOUR AU - Yakovleva, O O AU - Zhamba, A O AU - Doroshkevych, I O AU - Vitruk, T K PY - 2018/11/23 Y2 - 2024/03/29 TI - Cardiac toxicity of coxibs: mechanisms of development and their prevention JF - Pain medicine JA - PMJUA VL - 3 IS - 3 SE - Review DO - 10.31636/pmjua.v3i3.3 UR - https://painmedicine.org.ua/index.php/pnmdcn/article/view/154 SP - 27-32 AB - <p>Development of highly selective COX-2 inhibitors – coxibs has proved a decreased risk of gastrointestinal toxicity, which was typical for non-selective NSAIDS, according to the evidence-based medicine. But such situation caused an imbalance in the impact on the synthesis of arachidonic acid metabolites: inhibition of COX-2 vasodilatatory prostacyclins and activation of thromboxane synthesis by platelets, which is accompanied by the increase in the frequency of thrombotic complications – myocardial infarctions and strokes. Some meta-analyses have proved this association: the higher is COX-2 inhibitors selectivity – the higher are CV-risks and cardiovascular toxicity of coxibs. Discontinuation or limitation of indications of coxibs, assessment of risk / benefit ratio is recommended in the conditions of comorbidity of CVS pathology, pain syndromes in rheumatology. Drugs of choice are moderately selective COX-2 inhibitors = meloxicam and nimesulide.</p> ER -