الكاتب: Multiple References

Pharmacology/Pharmacokinetics Mechanism of action/Effect: Anti-inflammatory— Inhibition of cyclooxygenase (COX) occurs with etodolac administration.{R-1} COX-1, present in most cells and tissues, is believed to produce cytoprotective prostaglandins active in maintaining normal gastrointestinal and renal function in mammals while COX-2 produces prostaglandins involved in inflammation.{R-1} Although in vitro studies of human enzymes show etodolac selectively inhibiting COX-2 over COX-1, one in vitro experiment using canine cells demonstrated a fairly equal inhibition of COX-1 and COX-2.{R-5} Another study reported a 7- fold selectivity of etodolac for COX-2 over COX-1 using a canine whole blood assay. {R-18} The roles of COX-1 and COX-2 in normal physiological function and in production of inflammation are not yet completely defined. Based on early evidence that their effects may overlap, some authors have stated that, at certain dosages, a finely balanced partial inhibition of both COX-1 and COX-2 may be preferred to maximize the inhibition of inflammation and protection of gastrointestinal mucosa; more research is necessary.{R-19} It may be that COX inhibition by etodolac is not the predominant mechanism in its production of anti-inflammatory effects.{R-12} Etodolac also inhibits macrophage chemotaxis in vivo and in vitro. {R-1}