Perbandingan Keamanan Obat Golongan Penghambat COX-1 dan COX-2

Oleh :

dr.Trisni Untari Dewi Sp.FK

Obat antiinflamasi nonsteroid (OAINS) dapat dibagi menjadi golongan penghambat siklooksigenase 1 (COX-1) seperti aspirin dan indomethacin, serta penghambat COX-2 seperti celecoxib dan etoricoxib. Penghambat COX-2 dianggap lebih aman dibandingkan OAINS non-selektif yang lebih dominan menghambat COX-1, karena memiliki efek samping gastrointestinal minimal. Namun, beberapa studi melaporkan bahwa COX-2 dapat meningkatkan efek samping kardiovaskular, termasuk infark miokard dan kematian kardiovaskular.[1-6]

Ketidakseimbangan antara prostaglandin I2 (PGI2) dan tromboksan A2 (TXA2) diduga menyebabkan efek buruk kardiovaskular terkait konsumsi OAINS. Penghambatan COX-2 selektif menyebabkan berkurangnya PGI2 dari endotel pembuluh darah, sehingga efek perlindungan PGI2 hilang. Di sisi lain, produksi TXA2 oleh trombosit tidak dihambat, yang menyebabkan keadaan protrombotik.[1,2,7-11]

Mekanisme Kerja Penghambat Siklooksigenase (COX)

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Referensi

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