Scenario Celecoxib Capsules and Glucosamine

Question: Discuss about the with knee Pain Which Treatment Option is More Effective Celecoxib or Glucosamine? Answer: Many people, including the esteemed athletes are often at high risks of joint problems. These problems are often associated with the very strenuous physical activities or a sudden change in physical activity that put a continuous strain on the joints. The most common problem seen in the population is the patello-femoral pain syndrome characterized by knee pain (Patrick and Keith, 2017). Knee pain might be as a result of many underlying causes a part from just the patello-femoral syndrome. The common causes are arthritis and various knee injuries. Arthritis is a disease in which the integrity of the joints of the body is affected impairing normal function and resulting in pain (Debasis, Hiroyoshi and Siba, 2011). There are many types of arthritis; osteoarthritis, rheumatoid arthritis psoriatic arthritis, juvenile arthritis and ankylosing spondylitis and almost all types can affect the knee. The pain in the knee can be relieved by a ray of drugs that function as analgesic. These drugs may have other therapeutic uses as well and among the frequently used drugs are Celecoxib and Glucosamine. These drugs have different potency levels, half-life and therapeutic windows. This research is hence set out to identify the most effective treatment option to relieve knee pain for one Mr. Kasim between the suggested drugs: Celecoxib and Glucosamine. Celecoxib is a type of Non-Steroidal Anti-Inflammatory Drug (NSAID) (Hellen, 2014). Its brand name is Celebrex. It is often indicated in diseases like osteoarthritis, rheumatoid arthritis and ankylosing spondylitis to relieve pain and inflammation. Its mechanism of action is the blocking of the enzyme cyclo-oxygenase-2 that is involved in the formation of eicosanoids that are molecular chemicals involved in the stimulation of pain receptors and subsequent nerves stimulation to relay pain messages to the brain. This way pain receptors remain neutral despite the presence of pain at a cite, pain impulses are not generated by the nerves to relay to the brain to register pain and as such numb the pain felt in the joint. It is contraindicated in people with asthma or other allergic disorders, stomach ulcers, liver and kidney disorders, heart and circulation problems, connective tissue disorder, and those allergic to other NSAIDs and the pregnant women. Despite its good therapeutic effects, Celecoxib can also cause unwanted side effects that could include dizziness, abdominal pain and diarrhea, indigestion, high blood pressure, insomnia, urinary and/or chest infections, fluid retention and edema. Among the major concerns in using Celecoxib is its cardiovascular safety. At therapeutic doses Celecoxib does not inhibit cyclo-oxygenase-1 enzyme and as such proves disadvantageous as it predisposes one to myocardial infarction and stroke among many other serious cardiovascular disorders (Richard, 2013). It however has a large therapeutic window making its effective at various concentrations without causing any addition problems. Glucosamine can also be used to relieve mild to moderate joint pain including knee osteoarthritis. It occurs naturally in the body and it is responsible for maintaining the integrity of the cartilages in the body. Its levels however decrease with age causing the breakdown of most joints. It is also artificially produced as a supplement in two main types; hydrochloride and sulfate (Keifer, 2016). The mechanism of action of glucosamine includes the reversal of the degenerative process in osteoarthritis. It is given orally with a bioavailability of 26% after first-pass metabolism. Its side effects are always mild with most developing after an overdose of the drug. They include stomach upsets, heartburn, edema, skin rash, tachycardia and headache. It is contraindicated in people with shellfish allergies and diabetes, and those who are pregnant or breastfeeding. Despite the many good proposed advantages of using glucosamine, a limited number of studies have conducted on the safety and optimal dosage of the drug and as such it is not recommended by the Arthritis Foundation (Safran, Zachazewski and Stone, 2012) as the definitive therapeutic window is not known. It also has not been scientifically proven to have an effect on tendons, ligaments nor reverse arthritis. Therefore, in advising Mr. Kasim on the most effective drug to use in an attempt to relieve his knee pain, I would suggest Celecoxib. This is because, for starters, Celecoxib has a wider therapeutic index meaning that its toxic concentrations are not easily arrived at and as such does not prove to be that big a risk as much as minimal toxic levels are concerned. Two, studies have proven it to be effective and safe for short term treatment of arthritis unlike glucosamine that has no prior comprehensive studies nor reports done and qualified as true as far as its safety and dosage are concerned. Also, the therapeutic effects indicated for glucosamine are speculative and not a true reflection of the drugs capabilities. The drug is not even recommended by the Arthritis Foundation. As a result, Celecoxib proves to be more effective in the short term treatment of arthritis despite its many side effects, contraindications and cardiovascular safety concerns. Boolean Operators Key words/ search terms/ phrases Alternative words P Pathophysiology of Knee pain Patello-femoral pain syndrome Arthritis I Celecoxib Celebrex C Glucosamine Joint pain relievers O Arthritis Causes of knee pain I chose to use the WebMD Medical References and MedScape databases. This is because I am familiar with the use of the two databases and the search results offered by the databases are always straight to the point and very relevant to the subject in question. Database: For this demonstration I will use the WebMD database. Action Search Mode Results Limiters I first opened my browser and keyed in WebMD Medical References and clicked on the search button Google A list of possible links to the WebMD page appeared Relevance to the search word In this browser home page I chose the first link to WebMD Google The WebMD website opened. Relevance to search word In the WebMD page that opened I first logged in using my credentials then clicked on Health A-z tab. Google A refined list of common health problems appeared. of peer-reviewed journals and scholarly articles that are significant to the search key term appeared Search word Glucosamine In the list I chose arthritis Google Commonly asked questions on arthritis as well as articles on arthritis appeared. Search word In an attempt to narrow down my research, I clicked on the types of arthritis Google A list of the types of arthritis appeared in a drop down toolbox. Tab chosen From these I chose arthritis of the knee Google A brief description under the osteoarthritis health center appeared. Chosen tab The search results that I obtained from the databases were very relevant to my PICO questions with the results providing direct and straight forward solutions for the questions I had set out to answer at end of the research. It was not time consuming and very good guidelines to the pharmacology of Celecoxib and glucosamine together with the pathophysiology explanation of knee pain. References Debasis, B., Hiroyoshi, M., and Siba, P. R. (2011). Arthritis: Pathophysiology, Prevention, and Therapeutics. Print. Hellen, A. (2014). Celecoxib Capsules for Pain and Inflammation (Celebrex). Patient Platform Limited. Retrieved from https://patient.info/medicine/celecoxib-capsules-for-pain-and-inflammation-celebrex. Accessed on 5th April, 2017. Keifer, D. (2016). Is Glucosamine Good for Joint Pain? WebMD Medical Reference. Retrieved from https://www.webmd.com/vitamins-and-supplements/supplement-guide-glucosamine. Accessed on 5th April, 2017. Patrick, J. P., and Keith, A. S. (2017). Patello-femoral Syndrome. Medscape. Retrieved from https://emedicine.medscape.com/article/308471-overview. Accessed on 5th April, 2017. Richard, A. L. (2013). Pharmacology for Nursing Care. 901. Print. Safran, M., Zachazewski, J., and Stone, D. A. (2012). Instructions for Sports Medicine Patients. 2nd Edition. Elsevier Inc.429. Print.