Problem
Vioxx and potentially other COX-2 selective inhibitors are associated with adverse cardiovascular side effects. One year after the Food and Drug Administration approved Vioxx for the relief of arthritis symptoms, an independent research study not associated with the pharmaceutical company responsible for the production of Vioxx revealed a higher incidence of myocardial infarctions in individuals that were administered Vioxx as compared to the control group that took Naproxen. The pharmaceutical company, Merck & Co, attributed these findings to the cardioprotective effect of Naproxen. Sequential studies reported similar findings, which eventually lead to the withdrawal of Vioxx from the market. It is now clear that Vioxx causes stress on the heart that leads to a higher incidence of myocardial infarctions as compared to other nonselective COX inhibitors. In light of this information address the following:
• Describe the mechanism whereby Vioxx can relieve arthritic pain.
• Explain the process whereby which Naproxen can produce a cardioprotective effect.
• How does Vioxx cause stress on the heart leading to a myocardial infarction?