RESUMEN
The interaction of celecoxib and rofecoxib with warfarin was studied. Patients stable on warfarin therapy and concurrently taking a cyclooxygenase-2 (COX-2) inhibitor comparator (traditional nonsteroidal antiinflammatory medications, salsalate, or acetaminophen) randomly received celecoxib 200 mg/day or rofecoxib 25 mg/day for three weeks. After a one-week washout period, the patients were crossed over to treatment with the opposite COX-2 inhibitor for three more weeks. The International Normalized Ratio (INR) was measured at baseline and at weeks 1, 2, and 3 of therapy with each COX-2 inhibitor by testing blood samples obtained by finger stick. Data for 16 patients were analyzed. The INR increased by 13%, 6%, and 5% on average in patients taking celecoxib at weeks 1, 2, and 3, respectively, and by 5%, 9%, and 5% in patients taking rofecoxib. Changes in the INR were statistically significant at week 1 for celecoxib and at week 2 for rofecoxib. Of the 12 subjects who had a clinically significant > or = 15% change in the INR while receiving either COX-2 inhibitor, 4 showed this change for both agents. Adverse drug reactions were similar for each COX-2 inhibitor, but the rate of edema requiring medical intervention was higher in the rofecoxib group. Significant increases in the INR were observed in patients who were stable on warfarin therapy after the addition of therapy with rofecoxib or celecoxib.
Asunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Anticoagulantes/efectos adversos , Inhibidores de la Ciclooxigenasa/efectos adversos , Lactonas/efectos adversos , Sulfonamidas/efectos adversos , Warfarina/efectos adversos , Anciano , Antiinflamatorios no Esteroideos/farmacología , Celecoxib , Estudios Cruzados , Ciclooxigenasa 2 , Inhibidores de la Ciclooxigenasa 2 , Inhibidores de la Ciclooxigenasa/farmacología , Sinergismo Farmacológico , Femenino , Humanos , Relación Normalizada Internacional , Isoenzimas/antagonistas & inhibidores , Lactonas/farmacología , Masculino , Proteínas de la Membrana , Estudios Prospectivos , Prostaglandina-Endoperóxido Sintasas , Pirazoles , Sulfonamidas/farmacología , SulfonasAsunto(s)
Agonistas de Dopamina/efectos adversos , Narcolepsia/inducido químicamente , Enfermedad de Parkinson/tratamiento farmacológico , Síndrome de las Piernas Inquietas/tratamiento farmacológico , Anciano , Benzotiazoles , Agonistas de Dopamina/uso terapéutico , Femenino , Humanos , Indoles/efectos adversos , Indoles/uso terapéutico , Masculino , Persona de Mediana Edad , Pergolida/efectos adversos , Pergolida/uso terapéutico , Pramipexol , Tiazoles/efectos adversos , Tiazoles/uso terapéuticoAsunto(s)
Isoenzimas/antagonistas & inhibidores , Isoxazoles/uso terapéutico , Lactonas/uso terapéutico , Sulfonamidas/uso terapéutico , Anciano , Anciano de 80 o más Años , Artritis Reumatoide/tratamiento farmacológico , Celecoxib , Enfermedad Crónica , Ahorro de Costo , Ciclooxigenasa 2 , Revisión de la Utilización de Medicamentos , Determinación de Punto Final , Femenino , Hospitales de Veteranos , Humanos , Isoxazoles/economía , Isoxazoles/farmacocinética , Lactonas/economía , Lactonas/farmacocinética , Masculino , Proteínas de la Membrana , Osteoartritis/tratamiento farmacológico , Dolor/tratamiento farmacológico , Prostaglandina-Endoperóxido Sintasas , Pirazoles , Sulfonamidas/economía , Sulfonamidas/farmacocinética , Sulfonas , Equivalencia TerapéuticaAsunto(s)
Bencimidazoles/farmacología , Digoxina/sangre , Inhibidores de la Bomba de Protones , 2-Piridinilmetilsulfinilbencimidazoles , Anciano , Bencimidazoles/uso terapéutico , Digoxina/uso terapéutico , Interacciones Farmacológicas , Formularios de Hospitales como Asunto , Humanos , Lansoprazol , Masculino , Omeprazol/análogos & derivados , Omeprazol/uso terapéutico , Estudios Prospectivos , RabeprazolRESUMEN
In an attempt to determine the association of potential risk factors and an increase in the rate of Clostridium difficile-associated diarrhea (CDAD) at a tertiary teaching institution in the Midwest United States, all CDAD cases among admissions from a period of 20 consecutive months were analyzed. A retrospective chart review was performed on 4992 admissions from this period. Logistic regression analysis suggested a correlation between CDAD and multiple factors.