1. Presentation On Non-Steroidal Anti-Inflammatory Drugs
Presented by: Mahwish Nasir

2. DRUG CATEGORY : Coxib(cox-2-inhibitor)
CELECOXIB
DRUG CATEGORY : Coxib(cox-2-inhibitor)
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3. KETOROLAC TROMETHAMINE Nonselective Cox inhibitor
DRUG CATEGORY : NSAID
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4. Celecoxib Drug Description Indication & Dosage Pharmacology
Contra-Indications & Precautions
Interactions
Side effects
Available Brands & Prices

5. Celecoxib Main Menu DRUG DESCRIPTION: MECHANISM OF ACTION:
Celecoxib is chemically designated as 4-[5-(4-methylphenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl] benzene sulfonamide and is a diaryl-substituted pyrazole. It has the following chemical structure:
MECHANISM OF ACTION:
Celecoxib is a highly selective COX-2inhibitor , about 10 – 20 times more selective for COX -2 than for COX-1 .
COX-2 selective inhibitors , were developed in an attempt to inhibit prostacyclin synthesis.
It is done by COX-2 ISO enzyme Induced at sites of inflammation without affecting the action of the constitutively active “house keeping” COX-1 ISO enzyme found in the GI tract, kidneys, and platelets.
COX-2 inhibitors have analgesic, anti-pyretic, and anti-inflammatory effects similar to those of non-selective NSAIDs.
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6. Celecoxib Main Menu INDICATIONS: Rheumatoid arthritis Osteoarthritis
DOSAGE:
Osteoarthritis (adults): 200mg capsule once daily or in two divided doses.
Increase to 200mg twice daily if necessary. Maximum 400mg daily.
CHILDREN: not recommended.
Rheumatoid arthritis (adults): 200 to 400mg daily.
CHILDERN: not recommended.
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7. Celecoxib PHARMACOLOGY: Main Menu Pharmacokinetics: Pharmacodynamics:
HALF-LIFE(hours): 11
URINARY EXCRETION: 27%
Pharmacodynamics:
The Coxib continue to be investigated to determine whether their effects on prostacyclin production could lead to a prothrombotic state.
It causes no more edema or renal effects than other members of NSAIDs group.
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8. Celecoxib CONTRA-INDICATION:
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Celecoxib
CONTRA-INDICATION:
History of hypersensitivity to sulphonamides or NSAIDs.
Active peptic ulceration or GI bleeding.
Severe renal or hepatic impairment.
Severe congestive heart failure.
Safe-use during pregnancy or lactation is not advisable.
Precautions:
Risk of hypovolaemia in elderly patient ( > 65 yrs).
Left ventricular dysfunction.
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9. Celecoxib INTERACTIONS: Diuretics Anti-hypertensive ACE inhibitors
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Celecoxib
INTERACTIONS:
Diuretics
Anti-hypertensive
ACE inhibitors
Anti-coagulants
Lithium
Cyclosporine
Rifampicin
Barbiturates
Fluconazole
Methotrexate
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10. Celecoxib SIDE-EFFECTS: Fluid retention GI upset Dizziness Insomnia
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Celecoxib
SIDE-EFFECTS:
Fluid retention
GI upset
Dizziness
Insomnia
Skin rash
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11. AVAILABLE BRANDS AND PRICES:
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Celecoxib
AVAILABLE BRANDS AND PRICES:
CELART(Hilton)
Price:
Caps 100mg:10’s: 97.75
Caps 200mg:10’s:
CELBEXX (Getz-pharma)
Caps: 100mg: 20’s :102.00
Caps: 200mg: 20’s:

12. KETOROLAC TROMETHAMINE
Drug Description
Indication & Dosage
Contra-Indications
Pharmacology & Precautions
Interactions
Side effects
Available Brands & Prices

13. KETOROLAC TROMETHAMINE
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KETOROLAC TROMETHAMINE
DRUG DESCRIPTION:
Ketorolac is potent analgesic but only a moderately effective anti-inflammatory drug. It is one of the few NSAIDs approved for Perenteral administration.
Mechanism of action:
It is an NSAID promoted for systemic use.
It inhibits prostaglandin biosynthesis.
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14. KETOROLAC TROMETHAMINE
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KETOROLAC TROMETHAMINE
Indications:
Short -term management of moderate to severe post- operative pain.
Available dosage forms:
Oral:
10mg tablets
Perenteral:
10-30mg per ml for IM or Iv injection.
Ophthalmic:
0.5 % solution.
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15. KETOROLAC TROMETHAMINE
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KETOROLAC TROMETHAMINE
Dosage regimen:
Adults:
Initially 10mg by IM or bolus IV daily for upto2 days.
Maximum 90mg daily for up to 2 days.
Elderly:
Initially 10mg by IM or bolus Iv injection then 10-30mg every 4-6 hours.
Maximum 60mg daily for 2 days.
Children:
Under 16 yrs, not recommended.
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16. KETOROLAC TROMETHAMINE
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KETOROLAC TROMETHAMINE
Contra-indication:
Peptic ulcer
GI or cerebrovascular bleeding
Coagulation disorders
Asthma
Renal impairment
Hypovolaemia during dehydration
Pregnancy & Lactation:
Safe use during pregnancy and lactation is not advisable.
( NOTE: unless expected benefit outweighs potential risk.)
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17. KETOROLAC TROMETHAMINE
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KETOROLAC TROMETHAMINE
PHARMACOLOGY:
Pharmacokinetics:
HALF-LIFE(hours): 4-10
URINARY EXCRETION: 58%
Pharmacodynamics:
The drug does appear to have significant analgesic efficacy and has been used successfully to replace morphine in some situations involving mild to moderate post surgical pain.
When used with an opioid, it may decrease the opioid requirement by 25 to 50%.
Precautions:
Homeostasis
Allergic disease
Cardiac dysfunction
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18. KETOROLAC TROMETHAMINE
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KETOROLAC TROMETHAMINE
Interaction:
Anticoagulants
Lithium
Frusemide
Oxypentifylline
NSAIDs
Methotrexate
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19. KETOROLAC TROMETHAMINE
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KETOROLAC TROMETHAMINE
Side effects:
Abnormal liver function tests
Acute renal failure
Bronchospasm
Anaphylaxis
Pain at injection site
Ulcers
Wound hemorrhage
GI disturbances
Dizziness
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20. KETOROLAC TROMETHAMINE
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KETOROLAC TROMETHAMINE
AVAILABLE BRANDS AND PRICES:
TORADOL(Roche)
Price:
Inj 30mg :5×1ml :
TORAPAN (Duopharma)
Inj 30mg :10×1ml :
References

21. Main Menu
REFRENCES:
Katzung
Pharma guide
Goodman Gilman