A 30-year-old man comes to the office due to several hours of severe right elbow pain. The patient has a history of peptic ulcer disease and gastroesophageal reflux disease. His right elbow is swollen, erythematous, and tender. Arthrocentesis is performed and synovial fluid analysis shows needle-shaped, negatively birefringent crystals with many neutrophils. The medication given to this patient selectively binds to an interleukin-1 inducible enzyme that is highly expressed by inflammatory cells and undetectable in the surrounding normal tissue. Which of the following is most likely the drug used in this patient's treatment?

Question

Quizplus · Accepted Answer

Eductional Objective: Cyclooxygenase-2 (COX-2) is an inducible enzyme upregulated during inflammation by interleukin-1 and TNF-alpha.  Selective COX-2 inhibitors (eg, celecoxib) decrease inflammation by inhibiting COX-2 production of pro-inflammatory arachidonic acid metabolites.  Because they do not affect COX-1, they have minimal gastroduodenal toxicity.

A 30-Year-Old Man Comes to the Office Due to Several