Osteoarthritis, Celebrex, and Ibuprofen

Sample Answer

1. What is the first-line therapy for osteoarthritis and the mechanism of action?

Oral anti-inflammatory, non-steroidal drugs (NSAIDs) are the first-line therapy for osteoarthritis (OA). Nowaczyk et al. (2022) explain that NSAIDs have anti-inflammatory and analgesic effects. Thus, they are prescribed to control symptoms of the local inflammatory process of OA. NSAIDs mechanism of action primarily entails the inhibition of cyclooxygenase, resulting in the formation of prostaglandins that inhibit the inflammatory process.

2. Sally expresses concern about all the recent news about heart problems and celecoxib (Celebrex). What information should be included in a teaching plan to help her understand about taking celecoxib and the benefits and risks?

I would inform Sally that celecoxib is a drug used to treat osteoarthritis since it helps to improve pain, movement, quality of life, and drug safety. I would enlighten her that celecoxib is slightly more efficient in alleviating pain and promotes better joint function than other NSAIDs (Nowaczyk et al., 2022).

Celecoxib is effective as traditional NSAIDs like naproxen, Ibuprofen, and diclofenac, but it has fewer GI side effects. Thus, it may not lead to stomach irritation like the Ibuprofen she was taking. Furthermore, I would inform her that drug regulatory agencies have warned of an increased risk of heart problems with celecoxib (Puljak et al., 2018). However, there is low-quality evidence showing that celecoxib leads to heart problems.

3. Ibuprofen and celecoxib are both nonsteroidal anti-inflammatory drugs. Explain how they are similar and different.

Ibuprofen and Celecoxib are both NSAIDs. They inhibit the cyclooxygenase (COX) enzyme, which has two isoforms (COX‐1 and COX‐2). COX‐1 is a constitutive member of normal cells, while COX‐2 has a role in the mediation of inflammation, pain, and fever (Puljak et al., 2018). However, Ibuprofen belongs to the traditional NSAIDs while Celecoxib belongs to the newer class of NSAIDs. Ibuprofen is a non‐selective NSAID, whereas Celecoxib is a selective COX‐2 inhibitor. Ibuprofen is associated with gastrointestinal toxicity, while Celecoxib was developed to prevent GI side effects associated with the traditional NSAIDs (Puljak et al., 2018).

References

• Nowaczyk, A., Szwedowski, D., Dallo, I., & Nowaczyk, J. (2022). Overview of First-Line and Second-Line Pharmacotherapies for Osteoarthritis with Special Focus on Intra-Articular Treatment. International journal of molecular sciences, 23(3), 1566. https //doi.org/10.3390/ijms23031566
• Puljak, L., Marin, A., Vrdoljak, D., Markotic, F., Utrobicic, A., & Tugwell, P. (2018). Celecoxib for osteoarthritis. The Cochrane database of systematic reviews, 5(5), CD009865. https //doi.org/10.1002/14651858.CD009865.pub2