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N the basis of the descriptions presented elsewhere in this issue, it is clear that it is difficult to identify or develop an animal model reproducing most, if not all, the features of human mild cognitive impairment MCI ; . To begin with, an animal cannot complain about memory, and it is difficult to assess whether its daily life is affected. However, correspondence between animal models and human pathology is only partial in all neurodegenerative diseases including Alzheimer's disease AD ; and Parkinson's disease. Nevertheless, even if they only partially reproduce the disease, animal models are quite useful for at least two purposes: understanding the pathogenic mechanisms of a disease; and testing the activity of new drugs to assess their potential activity prior to clinical trials. This symposium will focus on the latest option in contraception: the first monthly combination injectable contraceptive, marketed as lunella internationally and as lunelle in the united states, for instance, celecoxib renal.

NSAIDs with a lower risk of gastrointestinal adverse effects are diclofenac and ibuprofen, and the COX-2 selective NSAIDs celecoxib and lumiracoxib. COX-2 selective NSAIDs have equivalent efficacy and a similar range of adverse effects to conventional NSAIDs, so they are not preferred routinely to conventional NSAIDs. Using a COX-2 selective NSAID rather than a conventional NSAID is most justified in those with risk factors for gastrointestinal adverse effects age 65 years, history of ulcer, concomitant use of anticoagulants or corticosteroids, presence of serious comorbidity ; . Alternatively, consider adding a gastroprotective agent a proton pump inhibitor or misoprostol ; to a conventional NSAID. For more information about gastroprotective options, see NPS News 46: Proton pump inhibitors nps .au healthpro -- go to `Newsletter Index' in the left-hand panel ; . A new COX-2 selective NSAID, lumiracoxib, has recently been PBS listed. The NPS RADAR review `Lumiracoxib Prexige ; for osteoarthritis' at npsradar .au details its PBS listing and its place in therapy.
The development of only one line, the control line, in the test result window indicates a positive test screen for the targeted drug or drug metabolite the absence of a control line in the test result window indicates an invalid test result regardless of the presence of a test line in the test result window and cleocin. Medication is sometimes effective. What works for one person may not work for another. Research in this area is ongoing. There are several different types of medications that your doctor may prescribe for you.

Employee Training: An International Perspective Table A.2 Incidence of employer-supported training among employees and clomid, for instance, celecoxib versus diclofenac. Ischemia of the external carotid artery territory influences outcome in the endovascular filament model of middle cerebral artery occlusion in the rat M. Dittmar, T. Spruss, G. Schuierer, G.W. Ickenstein, M. Horn, Department of Neurology, University of Regensburg, Germany Hyperbaric Oxygenation HBO ; converts neuronal cell death from necrosis to apoptosis in transient focal cerebral ischemia in the infarct core in rats C.C. Eschenfelder, M. Lou, T. Herdegen, G. Deuschl, Christian-Albrechts University, Germany Evolving relations between cerebral blood flow and oxygen metabolism after middle cerebral artery occlusion in the porcine chronic stroke model H. Watanabe, A. Olsen, C. Bjarkam, A. Rodell, D. Zeilder, A. Blankholm, L. Ostergaard, P. Coming, A. Gjedde, Center of Functionally Integrative Neuroscience, Aarhus University, Denmark Stabilisation of cellular proliferation into steady state over the arterial filtration struts of the diverter a novel device for stroke prevention D. Tanne, O. Yodfat, D. Harris, Y. Assaf, J. Leor, D. Bushi, Y. Grad, MindGuard Medical Devices, Israel Celecoixb induces functional recovery after intracerebral hemorrhage with reduction of brain edema and perihematomal cell death K. Chu, K.H. Jung, S.W. Jeong, M. Kim, J.K. Roh, Seoul National University Hospital, South Korea. Healthy ; This 54-year-old farmer was tested for HIV because his third wife, 20 years younger than himself, recently died of AIDS. He is HIV positive, but he doesn't know what that means so far as his farming is concerned. He feels well and doesn't want to be bothered with things medical. You record his weight and persuade him to allow a CD4 count. It is 450 and the hemoglobin is 14.9 and colchicine.
Rofecoxib and celecoxib are cox-2-selective inhibitors coxibs ; with anti-inflammatory, antipyretic, and analgesic properties similar to other nsaids and are indicated for the treatment of acute pain.
Eventually George Philip seems to have realised that he had no legal leg to stand on. First he sent me a message saying that I could put my blog back up again but only once he had given me permission. A few days later he grudgingly acknowledged that I had the right to maintain my own blog on my own webspace. Instead of trying to close down the blog, they tried to dig up dirt on me in preparation for some kind of process. Apparently George Philip was convinced I had gone mad, and rumours to that effect started circulating in the department. One day a motorcycle courier delivered a confidential invitation for me to go medical leave. Needless to say I declined. One of my teaching assistants reported: you might be interested to know that I recently received an email from [the Government Department] asking me the way to provide them with feedback about the way you were supervising undergraduate teaching how often you met with me, whether you monitored me, etc. ; . I don't know if it is regular procedure or a way of trying to intimidate you, but I made sure that nothing of what I replied could be held against you. This kind of behaviour is threatening and intimidating. Although the LSE has stopped trying to close down my blog, neither George Philip nor Howard Davies has retracted their threats and I have not been given an apology. Clearly I still under surveillance. There is one computer at the LSE that has checked out my blog over 850 times, and there are several other computers that have clocked up many hundreds of hits. These could of course be fans, but somehow I doubt it. This is not free speech as it usually is understood. For one thing it means that LSE staff has to devote time to the reading and censoring of blogs. It also means that blog authors can be subject to arbitrary treatment and harassment by people with repressive inclinations. Free speech requires the freedom from fear. At the LSE that cannot be guaranteed under present conditions. The only satisfactory long-term solution is that the LSE institutes that which Howard Davies explicitly denied the need for a policy on blogging which acknowledges the general right of staff and students to write freely about whatever topics they choose and doxycycline. 196. Petitioner's Brief, supra note 90, at 26 n.15. 197. Iafelice v. Luchs, 501 A.2d 1040, 1046 N.J. 1985 ; quoting In re Quinlan, 355 A.2d 647, 663 N.J. 1976 . 198. See id. 199. 355 A.2d 647 N.J. 1976 ; . 200. Menninger, supra note 88, 2 discussing several court decisions allowing someone to act on behalf of an incompetent patient in order to refuse life-sustaining medical treatment ; . A distinguishing factor from the Millers' case is that In re Quinlan involved a patient in a persistent vegetative state who was presumed to be kept alive by a respirator. See id. 201. Petitioner's Brief, supra note 90, at 27. 202. See Cruzan v. Dir., Mo. Dep't of Health, 497 U.S. 261, 27879 1990 ; . 203. Petitioner's Brief, supra note 90, at 27. 204. Professor, University of Texas School of Law. 205. Borges, supra note 7, at 36.
Likewise, higher reaction rates have been observed with amoxicillin and cefadroxil ~32% ; , imipenem and penicillin, ampicillin and cephalexin with identical thiophene-2-acetic acid side chains ~31% ; , and aztreonam and ceftazidime, with identical aminothiazolyl side chains. Studies have also shown that agents with markedly different side chains have much lower cross reactivity rates, as with aztreonam and penicillins 1% ; , and ceftazidime and benzyl penicillin ~2-3% ; . Published data also indicates a lower incidence of reactions with second and third generation cephalosporins in penicillin allergic patients, again due to altered side chain structure. There is often confusion surrounding the term "sulfa allergy." Sulfa allergy strictly refers to those patients who have a history of hypersensitivity to sulfonamides. Sulfonamide agents all contain structurally similar paminobenzoic acid rings, and include: antimicrobials trimethoprim sulfamethoxazole, dapsone ; , sulfonylureas, furosemide, thiazide diuretics, chlorthalidone, sulfasalazine, diazoxide, and the new COX-2 selective inhibitor celecoxib. Cross reactivity between these compounds is uncommon, but may occur. The most common adverse reaction to sulfonamide compounds is a generalized maculopapular rash. Urticaria, erythema multiforme, and potentially life threatening reactions like Stevens-Johnson syndrome or toxic epidermal necrolysis may occasionally occur. It appears that metabolism of these agents by cytochrome P450 catalyzed N-oxidation may result in the formation of hapten-carrier complexes, stimulating an immune response. Genetically slow acetylators the major route of sulfonamide metabolism ; are more likely to metabolize through the N-oxidation pathway, and therefore generate these complexes. Allergic reactions to sulfa containing compounds have become an even greater concern in HIV positive patients, since there is an increased incidence of rash 50% vs. ~3.5% in HIV negative populations ; . Multiple desensitization protocols and erythromycin. H celecoxib in a clinical trial for colorectal adenoma prevention. Through a caspase dependent pathway, 12, 26 but only recently has Jendrossek and colleagues fully investigated this.27 In a study utilizing Jurkat cell lines with defective caspase-8 activity, they demonstrated complete independence from the extrinsic pathway of apoptosis. Celecodib activates the caspase-9 pathway of apoptosis and could be prevented by inactivating this caspase, implicating mitochondria disruption in the celecoxib-mediated cytotoxic effect. In addition, inhibition with the broad caspase and exelon.

1. Wolfe MM, Lichtenstein DR, Singh G. Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs. N Engl J Med 1999; 340: 18881899. Vane JR. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat New Biol 1971; 231: 232235. Crofford LJ, Lipsky PE, Brooks P, Abramson SB, Simon LS, van de Putte LBA. Basic biology and clinical application of specific cyclooxygenase-2 inhibitors. Arthritis Rheum 2000; 43: 413. FitzGerald GA, Patrono C. The coxibs, selective inhibitors of cyclooxygenase-2. N Engl J Med 2001; 345: 433442. Emery P, Zeidler H, Kvien TK, et al. Celeocxib versus diclofenac in long-term management of rheumatoid arthritis: randomised doubleblind comparison. Lancet 1999; 354: 21062111. Simon LS, Weaver AL, Graham DY, et al. Anti-inflammatory and upper gastrointestinal effects of celecoxib in rheumatoid arthritis: a randomized controlled trial. JAMA 1999; 282: 19211928. Laine L, Harper S, Simon T, et al, for the Rofecoxib Osteoarthritis Endoscopy Study Group. A randomized trial comparing the effect of rofecoxib, a cyclooxygenase 2specific inhibitor, with that of ibuprofen on the gastroduodenal mucosa of patients with osteoarthritis. Gastroenterology 1999; 117: 776783. Goldstein JL, Silverstein FE, Agrawal NM, et al. Reduced risk of upper gastrointestinal ulcer complications with celecoxib, a novel COX-2 inhibitor. J Gastroenterol 2000; 95: 16811690. Lipsky PE, Abramson SB, Crofford L, DuBois RN, Simon LS, van de Putte LBA. The classification of cyclooxygenase inhibitors. J Rheumatol 1998; 25: 22982303. Singh G. Recent considerations in nonsteroidal anti-inflammatory drug gastropathy. J Med 1998; 105: 31S38S. Bombardier C, Laine L, Reicin A, et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. N Engl J Med 2000; 343: 15201528. Silverstein FE, Faich G, Goldstein JL, et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study--a randomized controlled trial. JAMA 2000; 284: 12471255. Reicin A. VIOXX Gastrointestinal Outcomes Research VIGOR ; . Merck & Co., Inc; West Point, PA. FDA Arthritis Advisory Committee; February 8, 2001. 14. Laine L, Bombardier C, Ramey DR, Watson DJ, Pellissier JM, Reicin A. Less use of gastrointestinal GI ; protective agents and GI. Celecoxib is highly protein bound with the clinical dose range, with in vitro studies indicating that albumin and alpha 1 -acid glycoprotein being the major bound species and floxin.
Figure 2. Summary of Efficacy Results during the Three-Year Post-Randomization Period. For the 2035 patients who underwent randomization, Panel A represents the estimated cumulative incidence of adenomas or advanced adenomas detected during the three years after randomization. The highest point of each bar indicates the proportion of patients with any adenoma detected, and the lower section of each bar indicates the proportion with advanced adenomas. For all adenomas, P 0.001 for the comparison with placebo for both drug doses. Advanced lesions were identified in 17.2 percent of patients taking placebo, 7.8 percent of patients taking 200 mg of celecoxib twice daily, and 6.3 percent of patients taking 400 mg of celecoxib twice daily. Panel B shows the mean SE ; treatment-associated reduction in adenoma burden defined as the sum of the diameter of all adenomas ; among all 819 patients in whom recurrent adenomas were detected during the three years after randomization.15. We therefore observed the effect of modest weight loss on serum adipocytokines and their relationship with changes in anthropometric and metabolic parameters within a period of 6 months in the setting of a routine obesity hospital clinic after various medical treatments and fluoxetine. You have told me stories of both men and women falling victim to this drug.

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Analyses of serious CV events were performed from studies comparing celecoxib with placebo, from studies comparing celecoxib with combined nonselective NSAIDs naproxen, ibuprofen, diclofenac, ketoprofen, and loxoprofen at any dose ; , and from studies comparing celecoxib with the individual NSAIDs naproxen, ibuprofen, and diclofenac ; . For validation purposes, an additional meta-analysis including all patients randomized to either of the 3 treatment arms celecoxib, placebo, or NSAIDs ; in any clinical trial containing 2 of the 3 arms was also conducted. Analyses of CV events were performed for all patients and for the following subgroups: 1 ; users versus nonusers of low-dose aspirin at baseline; 2 ; celecoxib dosage groups of 200, 400, and 800 mg day as well as all doses combined; and 3 ; therapeutic indications of osteoarthritis and rheumatoid arthritis and the combined subgroup of patients with osteoarthritis and rheumatoid arthritis. In addition, analyses were performed for subgroups with or without CV risk and metformin and celecoxib.
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Here we summarise data on the prevalence of current asthma among children aged up to 17 years. Among girls aged 0 to 17 years, the prevalence of current asthma in 200405 increased with age. The prevalence among boys was higher than girls up to age 11 years, with the highest being among boys of primary school age 5 to 11 years ; Figure 2.4 ; . In this age group, the prevalence of current asthma was 15.1% in boys compared with 11.0% in girls. Between 2001 and 200405, the prevalence of current asthma among children aged 0 to 17 years fell significantly, from 15.5% to 12.2% p 0.0001 ; , for boys and, to a lesser extent, from 12.2% to 10.3% p 0.0122 ; for girls. While the prevalence of current asthma did not change for children aged 0 to 1 year between 2001 and 200405 Figure 2.5 ; , the prevalence rates among older children were lower in 200405, notably among those aged 5 to 17 years. If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.
50first senior membership program: good health for life. Boks AL, Brommer EJP, Schalm SW, et al. Hemostasis and fibrinolysis in severe liver failure and their relation to hemorrhage. Hepatology. 1986; 6: 79-86. Lisman T, Leebeek FWG, Mosnier LO, et al. Thrombin-activatable fibrinolysis inhibitor deficiency in cirrhosis is not associated with increased plasma fibrinolysis. Gastroenterology. 2001; 121: 131-139, for example, celeccoxib rofecoxib. The Birmingham Hip, established in the early nineties, has provided an alternative to standard total hip arthroplasty in young active patients. It consists of a metal on metal hip resurfacing which has been purported to eliminate the problems of proximal femoral stress-shielding and osteolysis caused by plastic wear debris associated with traditional hips. In addition to this, there are significantly less bending and torque forces applied to the femoral component in the Birmingham Hip compared to that of the conventional hip replacement, due to the fact that the point of loading is coincident with the point of fixation. The distribution of the elastic energy is transferred through the cortices in such a way as to mimic a natural healthy hip and thereby preventing the formation of stress protection osteopaenia. The documented benefit of resurfacing arthroplasty, is the ease with which one can convert to a standard total hip arthroplasty at a later stage due to the quality of the residual femoral bone. In this study, using dual-energy X-ray absorptiometry DEXA ; , we determined periprosthetic bone mineral density in 15 patients two years post-Birmingham Hip Replacement. The purpose of the study was to elucidate any evidence of stress-shielding or osteopaenia around the femoral component of the prosthesis and cleocin.
1 a certain selective Cox-2-inhibitor was considered to have a higher reporting risk for "potential fatal thrombotic vascular events" or death than other drugs. A higher reporting risk might be indicative for a higher risk for "potential fatal thrombotic vascular events"or death. Results of Analysis 1. Overview reports of "thrombotic vascular events" We received 541 reports of which the suspect drug concerned a selective Cox-2-inhibitor, of which 389 reports concerned rofecoxib table 1 ; . Of the 541 reports on selective Cox-2-inhibitors 78 reports matched the selected preferred terms. Of these 78 reports 46 reports were excluded for further analysis because they did not match the inclusion criteria "thrombotic vascular events". Three reports considered the same patient, namely 29787 29788 both reported by the pharmaceutical company and report 29517 reported by the general practitioner. Finally, 30 reports were selected for further analysis table 2 , appendix 1 ; . Of these 30 reports 23 reports 77.4% ; concerned rofecoxib, 3 9.68% ; celecoxib, 4 etoricoxib 12.9% ; . None of the reports concerned valdecoxib. Table 1. Reports on Cox-2-selective inhibitors selective date of total number cox-2-inhibitor marketing of reports celscoxib 04-05-2000 94 rofecoxib 02-11-1999 389 etoricoxib 09-07-2002 57 valdecoxib 27-03-2003 1 total 541.

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Activity in rats. We have also shown for the first time that the coadministration of an iNOS inhibitor and a COX-2 inhibitor in the diet significantly suppresses AOM-induced colonic ACF formation. An important finding of this study is that celeccoxib and SC-51, when administered together, were more effective in inhibiting ACF formation than was administration of the same doses of these agents individually. Importantly, the administration of an iNOS inhibitor plus a COX-2 inhibitor also suppressed AOM-induced colonic mucosal inducible isoforms of NOS 25% ; and COX 45% ; activities to a greater degree than when the inhibitors were given individually. The correlation of inhibition of crypt formation with the reduction in both COX-2 and iNOS enzymatic activities suggests their important role in AOM-induced tumorigenesis. It is known that expression of the inducible isoforms of NOS and COX is increased in human colorectal tumors, as well as in carcinogen-induced colon tumors in laboratory rats 24 26 ; . The precise pathobiological functions of both iNOS and COX-2 activities in colorectal carcinogenesis are not clearly understood. Recent reports suggest that iNOS may contribute to colon tumor development or acceleration of the progression of colon carcinogenesis. Importantly, only iNOS produces sustained NO concentrations in the micromolar range, and this inducible isoform is specifically associated with neoplastic tissue. The demonstration of inhibition of early stages of colon carcinogenesis by iNOS selective inhibitors, such as AG and SC-51, further supports the hypothesis that iNOS appears to play a significant role in tumorigenesis. The results of the present study also support our previous finding with the selective iNOS inhibitor, S, S -1, 4-phenylene-bis 1, 2-ethanediyl ; bisisothiourea, which we found also suppresses AOM-induced colonic ACF and activities of inducible NOS and COX 19 ; . The precise mechanisms involved in the suppression of AOMinduced colonic ACF by selective iNOS inhibitors are also not yet fully understood and are most likely multiple in nature, as diagramed in Fig. 3. Previous reports indicated that iNOS is associated with the modulation of COX-2 activity in colorectal cancer 23, 38, 39 ; . NO has been found to enhance the activity of COX-2 in a variety of cell types. In addition, increased COX-2 expression and activity in colorectal tumors in humans and rodents have been reported 40, 41 ; . Overexpression of COX-2 may increase the production of several mitogenic eicosanoids, particularly the type-2 series PGs that are involved in antiapoptotic activity in epithelial tumors 42 ; . Previously, we demonstrated that the COX-2 inhibitor, celecoxib, suppressed AOM-induced colonic ACF and adenocarcinomas in this model 9.
Abstract 1101 THE PROFILE OF SF-36 IN A COMMUNITY-DWELLING ELDERLY SAMPLE: HIGH VS LOW FUNCTIONED FEMALE ELDERLY Beeto, Wai-Chung Leung, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China The SF-36 has been used as a generic measure of health-related quality of life in general populations and in a variety of patient groups. However, few studies have focused at investigating the profile of healthy elderly who are without any disease or impairment.The purpose of the present preliminary study was to compare the profile of SF-36 between healthy elderly with high and low functioning. Forty-eight female participants aged from 65 to 79 mean age 72.25; S.D. 4.21 ; was recruited in a community elderly center. Face-to-face interviews were conducted and SF-36, MMSE and IADL were administered as part of a comprehensive battery. Those have scored in the upper quartile in their age- and education- adjusted MMSE and reported no disability in IADL were defined as high functioned while others, not meeting the above criteria, were defined as low functioned. Significant difference were found between RP, RE and MH scores which indicated that elderly with high functioning tended to have less role limitations in carrying out daily activities due to their physical and emotional problems and they tended to have better mental health. Also, elderly defined as high functioned seemed to have better physical functioning, less bodily pain and better social functioning measured by PF, BP and SF respectively although the differences were not significant. In general, elderly defined as high functioned by MMSE & IADL ; tended to have better score in SF-36. Individual scale scores of SF-36 may be useful in predicting the functioning level of healthy elderly. Further studies on the effect of aging on SF-36 were suggested. Scale scores with * indicate a sign. difference; p .05!

27 conditions. This probably reflects a lack of awareness about potential drug degradation problems, and the perceived inability to improve conditions. The daily reading and charting of temperatures as indicated by thermometers placed in drug storage areas is possible, but places additional task and documentation requirements on personnel who are already overworked in many services. While electronic temperature logging devices are initially more expensive approximately $125 - $150 per device, with necessary software and cables included ; , they can be programmed once, placed in the apparatus, and connected to a computer on a weekly or monthly basis to download a graph of temperature conditions present. The devices are small enough about the size of a package of cigarettes ; to be placed anywhere that drugs are stored. Some devices can even be programmed to sound an alarm if certain temperature parameters are exceeded. As no survey respondents reported using color change indicators, and many did not even provide thermometers to verify storage temperatures, it appears that the cost of the temperature monitoring device was not as important as the staff time involved for services that did no regular monitoring of storage areas. By using electronic data logging devices services can provide constant monitoring with minimal staff time requirements. The downloading of data to a computer will also provide an ongoing record that can be maintained either for review by inspecting agencies or to defend against claims of improper drug storage. With respect to physical security of medications, the Sun-Sentinel article O'Boye, 2001 ; suggests that even reasonable levels of physical security will not deter those employees who are desperate to obtain controlled substances. Measures that provide for easy identification of tampering may be more effective than secure storage. The DEA 2001 ; regulations require that controlled substances be stored "in a securely locked, substantially constructed cabinet. CBD Article 2: "Biological resources" includes genetic resources, organisms or parts thereof, populations, or any other biotic component of ecosystems with actual or potential use or value for humanity" Does this exclude toxic plants, disease-caused microorganisms e.g.Pseudomonas exotoxin ; , viruses etc.? Three objectives of Article 1, CBD should be interpreted cumulatively: 1 ; conservation of biological diversity, 2 ; sustainable use of its components and 3 ; fair and equitable sharing of benefits arising out of the utilization of genetic resources, which are accomplished, inter alia, by the "appropriate transfer of relevant technology, taking into account all rights over those resources and to technologies" as stipulated in the CBD. They could contradict each other, if they are interpreted as independent, for example, celecoxib drug.
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Control: a special situation in research where no drug is given or no test is done. For example, a control group that gets a sugar pill might be compared to an experimental group that gets a real medication to see what are the effects of the medication. Cross-resistance: the ability of a virus or bacteria to overcome the effects of more than one drug at a time. For example, if an infection was resistant to antibiotic A and cross-resistant to B and C, then a different antibiotic D ; would be needed. Hemophilia: a disease that interferes with blood clotting and can result in uncontrolled bleeding. Hepatitis: inflammation of the liver that can have a variety of causes including viruses, medications, etc. HIV-associated dementia: a progressive brain problem that causes confusion, loss of memory, problems thinking, and trouble keeping balanced. Lactic acidosis: accumulation of lactic acid in the body. Lactic acid is a substance in blood and muscle tissue pro.
INTRODUCTION Nonsteroidal anti-inflammatory drugs NSAIDs ; are often the first choice of treatment for acute myalgias, orthopedic injuries, postoperative pain, chronic rheumatoid arthritis, and osteoarthritis.1 The newest class of NSAIDs, cyclooxygenase COX ; inhibitors, is being promoted heavily by the pharmaceutical industry. By the end of 1999, their first year on the market, sales in the United States skyrocketed to $472 million for rofecoxib and $1.4 billion for celecoxib. As newer NSAIDs and other alternatives become available, the practicing clinician needs to be fully aware of the therapeutic choices in specific applications. The purpose of this review is to provide a brief overview of COX-2 inhibitors that target the modulation of prostaglandin levels, especially in reference to gynecological applications.

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