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With the help
of God's grace and through health education and advocacy, the
members of Mind, Body, Spirit Ministry of Ascension will strive to
enable people near and far to receive, experience, and share God's
spiritual, emotional and physical healing.
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AED Training - February 2008
 
  
WHAT'S WITH THlS VIOXX/CELEBREX STUFF?
(an article by Dr. James White)
The recent media frenzy over Merck's
voluntary recall of Vioxx has prompted a lot of
questions from the public about how this happened.
Celebrex, Vioxx, and Bextra were the
first in a new class of anti- inflammatory
medications known as COX-2 inhibitors. Despite ads that may have
led you to the
contrary, these drugs were no more effective than 800mg of Motrin.
Their development
was done to prevent some of the side effects of Motrin,
particularly the stomach
ulceration and bleeding that occurred with long term use of these
drugs (Naprosyn,
Advil,Aspirin, etc).
Motrin works by blocking prostaglandins,
a chemical associated with inflammation,
and a mediator of pain. Unfortunately, they also blocked all
prostaglandins, including
some that protected the stomach from ulceration. COX-2 drugs would
only selectively
block certain prostaglandins, thereby sparing the gut and lowering
that side effect.
Because of the way they worked, these COX-2 drugs did not
"thin the blood" like Aspirin
and Motrin typically did. This also had advantages for people who
were already on blood
thinners like Coumadin, and for those in whom blood thinning drugs
were
contraindicated.
When Vioxx came out, Merck disclosed to
physicians that there was a slightly higher
risk of stroke and heart attack in older patients on this drug as
opposed to a control group.
Their "theory" was that this was because their drug did
not thin blood, like older antiinflammatory drugs. It made sense,
but that doesn't mean it was correct. As a rule, I only
had used Vioxx for the treatment of acute pain for no more than
5-10 days, and never for
chronic pain. Celebrex and Bextra did not show similar increased
risk in their initial prerelease
studies.
Recently, Merck own continued studies
confirmed that the risk is above and beyond
what was expected. It appears that Vioxx, unlike blood thinning
anti inflammatories, does
not only not thin the blood, but makes it more likely to encourage
clot formation at the
site of inflammation, hence a stroke or heart attack. It also
appears that the other 2 drugs
may also increase the risk, but not to the same degree.
With the advent of strong acid blockers
like Prilosec, we can prevent a lot of the
ulceration and bleeding that occurred with older anti-inflammatory
drugs. If you need
strong anti-inflammatory pain medication for a long period of
time, check with your
doctor, take tried and true Motrin, and pop a Zantac or Prilosec
along the way. It is safer
than long term use of these COX-2's for now.
When you see these pharmaceutical ads on
TV, harken back to an old and new cliche:
"Buyer beware!" and "Be an informed consumer!"
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