Nonsteroidal anti-inflammatory drugs case study

COX-2 Inhibitor Celecoxib (Celebrex, Pfizer) inhibits the enzyme COX-2, which is involved in pain and inflammation, but it has no effect on the COX-1 enzyme, which helps to maintain stomach lining. It is prescribed for the relief of pain and symptoms of osteoarthritis and rheumatoid arthritis. Previously, nonsteroidal anti-inflammatory drugs (NSAIDs) were used. NSAIDs inhibit both COX-1 and COX-2 enzymes and cause stomach bleeding (see Case Study 2). 

Aalykke C, Lauritsen JM, Hallas J, Remholdt S, Krogfelt K, Lauritsen K. Helicobacter pylori and risk of ulcer bleeding among users of nonsteroidal anti-inflammatory drugs a case-control study. Gastroenterology 1999 116(6) 1305-9. 

Evans JM, McMahon AD, McGilchrist MM, White G, Murray FE, McDevitt DG, MacDonald TM. Topical nonsteroidal anti-inflammatory drugs and admission to hospital for upper gastrointestinal bleeding and perforation a record linkage case-control study. BMJ 1995 311(6996) 22-6. 

On page 299, A Word About... Green Chemistry and Ibuprofen A Case Study showed how efficiently ibuprofen can be prepared on a large scale. Another nonsteroidal, anti-inflammatory drug (NSAID) is acetaminophen. Suggest a short synthesis of acetaminophen from p-hydroxyaniline. 

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