STU WK 7 Excess Glucose in Yo

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  • Mabel Cristina Rodriguez

Although osteoarthritis can not be reversed, there are medications you can take to relieve the pain.  The first line of therapy for osteoarthritis in patients with mild to moderate pain is Acetaminophen (Tylenol). However, it is important to note that overuse of Acetaminophen can cause liver damage.  Celecoxib and other NSAIDs, as well as acetaminophen, are recommended as first-line analgesics for patients with osteoarthritis and rheumatoid arthritis, according to the FDA (Kausar et al., 2021).  Acetaminophen, like NSAIDs, has analgesic and antipyretic effects. Acetaminophen, on the other hand, has been proven in trials to have no anti-inflammatory activities in the peripheral nervous system. It’s possible that acetaminophen inhibits the COX pathway in the brain but not in the rest of the body.

Regarding Sally’s concern about heart problems associated with Celebrex, it is important to educate her with the most recent data available. Celecoxib is used to treat osteoarthritis pain, soreness, edema, and stiffness (arthritis caused by a breakdown of the lining of the joints). It is also used to manage painful menstrual cycles and other types of short-term pain, such as pain caused by injuries, surgery, or other medical or dental operations, or pain caused by short-term medical disorders. Celecoxib belongs to the COX-2 inhibitors class of NSAIDs.  It works by preventing the body from producing a chemical that promotes inflammation and pain.

Celecoxib, like all NSAIDs, comes with a boxed warning from the FDA about cardiovascular risk, including an increased risk of heart attacks and strokes. When compared to ibuprofen and naproxen, large evaluations have found contradictory results as to whether celecoxib carries a non-inferior or elevated cardiovascular risk. Celebrex can also cause gastrointestinal (GI) side effects including stomach and intestinal bleeding, ulceration, and perforation. This negative effect makes it riskier for vulnerable populations like the elderly. Due to the cardiovascular risks including new or worsening hypertension, patients should have their blood pressure checked regularly while on Celebrex. All medications carry risks and side effects, however, when taken as directed, Celebrex has shown positive results in patients with osteoarthritis pain. It is important to discuss all medications, vitamins, and supplements you are taking with your healthcare provider to make sure they do not have negative interactions with Celebrex.

 Celebrex is a COX-2 inhibitor that is selective. While Celebrex is an NSAID like ibuprofen, it exclusively inhibits COX-2, whereas ibuprofen inhibits both COX-1 and COX-2. In other words, A COX-2 inhibitor is less likely to cause stomach ulcers and is hence easier on the stomach. A comparative study between celecoxib and ibuprofen showed equal tolerance and efficacy between the two in the treatment of patients with knee osteoarthritis (Reed et al., 2018, p.1741).

 Although these two medications are similar, there are differences to consider:  Ibuprofen: costs less than Celebrex; take with food to avoid upset stomach; can raise your risk of getting blood clots, a heart attack, or stroke. Celebrex: by prescription only; reduces pain and inflammation; causes less upset stomach than other NSAIDS; lasts longer than Ibuprofen; can also raise your risk of blood clots, heart attack, or a stroke. The best way to decide whether this medication is right for you is to discuss your condition with your doctor and make sure to disclose any health conditions you are experiencing along with any other medications you are currently taking.

                                                                                              References

Kausar, N., Ullah, S., Khan, M. A., Zafar, H., Atia-tul-Wahab, Choudhary, M. I., & Yousuf, S. (2021). Celebrex derivatives: Synthesis, ?-glucosidase inhibition, crystal structures and molecular docking studies. Bioorganic Chemistry, 106,        https://doi.org/10.1016/j.bioorg.2020.104499

Reed, G. W., Abdallah, M. S., Shao, M., Wolski, K., Wisniewski, L., Yeomans, N., Lüscher, T. F., Borer, J. S., Graham, D. Y., Husni, M. E., Solomon, D. H., Libby, P., Menon, V., Lincoff, A. M., & Nissen, S. E. (2018). Effect of aspirin Co-administration on the safety of Celecoxib, Naproxen, or ibuprofen. Journal of the American College of Cardiology, 71(16), 1741-1751. https://doi.org/10.1016/j.jacc.2018.02.036

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