A 54-year-old woman with knee osteoarthritis comes to the physician for a follow-up examination. She reports significantly improved pain control since starting celecoxib 1 month ago. A history involving which of the following conditions is most likely to explain the administration of this drug instead of another nonsteroidal anti-inflammatory drug?

Question

Quizplus · Accepted Answer

Eductional Objective: If a patient with Glanzmann thrombasthenia (GT) requires treatment with an NSAID, a selective COX-2 inhibitor, such as celecoxib, would be the best choice. In GT, deficient glycoprotein IIb/IIIa on the surface of platelets impairs proper fibrinogen binding and predisposes patients to bleeding. Thromboxane, whose formation is catalyzed by COX-1, is especially important in GT as a factor that enhances platelet aggregation. Nonselective COX inhibitors (e.g., aspirin, ibuprofen) would inhibit COX-1 and thromboxane formation, thereby increasing the risk of bleeding, whereas celecoxib has no effect on platelets and would thus be the preferred agent for patients with GT.

A 54-Year-Old Woman with Knee Osteoarthritis Comes to the Physician