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From:  norma bowen <normasings2000@y...>
Date:  Sat Nov 30, 2002  11:35 am
Subject:  RE: [vocalist] Osteoarthritis drugs and voice


What is the effect of aspirin on the mucosal tissue of the stomach and the vocal
fold?
"John Messmer, M.D." <jjm23@p...> wrote:NSAID's work by inhibiting an
enzyme, cycloxygenase (COX for short -
it's also easier to say.) There are two forms (that we know of) of COX:
COX-1 and COX-2. COX-1 is involved in the production of chemicals in
platelets that make them stick together and a chemical in the stomach
that protects it from its own acid (and some other things, but I don't
want this to be a hematology lecture). COX-2 helps produce the
chemicals that cause pain and inflammation.

The original bunch of NSAID's inhibited both COX's and thus were called
nonselective COX inhibitors. They could cause bleeding and ulcers since
platelets were inhibited and the stomach was not protected due to COX-1
being blocked while treating inflammation by blocking COX-2. (We are
constantly having little hemorrhages and blood vessel leaks if we
traumatize some area, but platelets plug the leaks very quickly so we
mostly don't notice it. If we abuse our voices we can get microscopic
hemorrhages that can be bigger if our platelets are inhibited.)

COX-2 selective NSAID's block MOSTLY COX-2. The effect on COX-1 is
clinically irrelevant for the most part. Thus for all practical
purposes, they should not cause bleeding. They will still protect one
from inflammation so one might abuse one's voice and not realize it due
to the reduced edema from the NSAID. To date I am not aware of any data
on singers in particular however.

John

John Messmer, M.D.
Assistant Professor, Family and Community Medicine
Penn State Hershey Medical Center



> -----Original Message-----
> From: Candace Magner [mailto:magner@l...]
> Sent: Tuesday, November 05, 2002 12:34 PM
> We have had some recent discussion about NSAIDs (ibuprofin,
> aspirin, etc) and their effect on the mucosal tissues of
> stomach and vocal folds. The newer meds for arthritis
> [celecoxib (Celebrex), rofecoxib (Vioxx) and valdecoxib
> (Bextra)] are of a slightly different formula (COX-2
> inhibitors) and are said to be less problematic.







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  Replies Name/Email Yahoo! ID Date  
21185 Re: Osteoarthritis drugs and voiceJohn Messmer, M.D. singdoc_1 Sat  11/30/2002  

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