Which NSAID is a selective Cox-2 inhibitor?

Which NSAID is a selective Cox-2 inhibitor?

• A. Aspirin
• B. Fluticasone
• C. Indomethacin
• D. Celecoxib

Answer: (D)

Celecoxib is the NSAID that selectively inhibits COX-2. It’s designed so that it binds more strongly to the COX-2 enzyme than to COX-1, thanks to its chemical structure that fits a side pocket present in COX-2. This selective binding blocks COX-2–mediated prostaglandin production, giving anti-inflammatory relief while sparing COX-1, which helps protect the stomach and support platelet function. Clinically, that translates to fewer gastrointestinal side effects and less impact on platelets compared with nonselective NSAIDs. However, there’s still cardiovascular risk with COX-2 inhibitors, and celecoxib contains a sulfonamide group, so it’s avoided in sulfa allergies. By contrast, aspirin and indomethacin inhibit both COX-1 and COX-2 (nonselective), and fluticasone is a corticosteroid, not an NSAID.

Celecoxib is the NSAID that selectively inhibits COX-2. It’s designed so that it binds more strongly to the COX-2 enzyme than to COX-1, thanks to its chemical structure that fits a side pocket present in COX-2. This selective binding blocks COX-2–mediated prostaglandin production, giving anti-inflammatory relief while sparing COX-1, which helps protect the stomach and support platelet function. Clinically, that translates to fewer gastrointestinal side effects and less impact on platelets compared with nonselective NSAIDs. However, there’s still cardiovascular risk with COX-2 inhibitors, and celecoxib contains a sulfonamide group, so it’s avoided in sulfa allergies. By contrast, aspirin and indomethacin inhibit both COX-1 and COX-2 (nonselective), and fluticasone is a corticosteroid, not an NSAID.