Meloxicam is a NSAID belonging to oxicam chemical category. This drug shows anti-inflammatory actions therefore useful in the treatment of rheumatoid arthritis and osteoarthritis.
Hi everyone today in this video we are going to discuss about meloxy cam meloxicam is one of the drug which is classified as nside non-steroidal anti-inflammatory agent and among this category this drug belongs to oxycam category we can clearly observe this chemical category within the suffix of the name we can also find few of the other drugs with similar
Suffix such as pyroxycam oxycam all these are oxcam derivatives and being an ox cam derivative this drug mainly shows anti-inflammatory actions particularly this truck can reduce esr erythrocyte sedimentation rate as well as levels of crp one of the inflammatory protein so when their levels are reduced the inflammatory cascade can be reduced that’s why this drug
Is useful as anti-inflammatory agent particularly in the treatment of arthritis second important thing is that among the enercides which are non-selectively inhibiting the cox enzymes this drug is somewhat selective in the inhibition this drug shows more selectivity towards cox to enzyme compared with the cox 1 enzyme due to the select inhibition of cogs to
Enzyme this drug shows somewhat less side effects that are related with inhibition of cox 1 enzyme this drug shows somewhat less side effects such as gastrointestinal and renal side effects which are mainly produced by inhibition of cox 1 enzyme particularly this selector is observed at low dose of maloxycam but when this drug is used at high doses this electrode
Is going to be lost and it can inhibit both cause 2 as well as cox 1 enzyme now maloxycam can be used in the treatment of rheumatoid arthritis where the inflammatory response can be reduced by maloxycam similarly it cannot be used in the treatment of osteoarthritis rheumatoid arthritis is mainly produced by autoimmune disorder here maloxycom is not interfering
With the immune response but whatever the inflammatory response produced by this autoimmune activity is going to be minimized by this maloxycam similarly osteoarthritis is a degenerate to joint disorder again in such conditions maloxycam can produce anti-inflammatory effects this drug is also useful in the treatment of juvenile rheumatoid arthritis what are the
Rheumatoid arthritis observed in the children in such conditions maloxycam can be used in the children with a is greater than or equal to two years so today we will discuss how this meloxy cam acts what are the important precautions side effects doses all these things we will discuss in this video first of all it is the chemical nature of this drug so this is the
Structure of maloxycam and here we can observe the heterocycline system with sulfur and nitrogen we can start the numbering from sulphur so this is one two three four and so on now here sulfur and nitrogen are present at first and second position so we can write this suffix as one two benzyothine but at the third portion we can observe a carboxymind moiety so we
Can represent this with a suffix three carboxymile so now meloxicam is a one two benzothiazide three carboxymite derivative and it is having the other side chains fourth position hydroxy second portion methyl first portion dioxo then at the third portion on the nitrogen it is having another heterocycline system which is nothing but one three thiazole so we can
Write this as n-13 thiazole 2-isle and this digel ring is having a methyl group at the fifth portion so phi methyl that is a complete name of meloxi cam now let’s see how this truck acts just we have discussed that meloxy cam can inhibit the acute of cogswan enzyme as well as it can inhibit the cox to enzyme cox 1 enzyme is called as constitutive enzyme which
Is always present whereas cox 2 enzyme is inducible which is expressed only in the conditions of inflammatory response now cox 1 enzyme is present in the stomach where it is responsible for decreasing the gastric acid secretion and it it’s also present in the renal system where it is going to increase the glomerular filtration rate so cox 1 is having some of
The beneficial actions at the stomach as well as renal system whereas cox is inducible where it is responsible for increase of fever increase the pain as well as increase the inflammation now malloc scam can inhibit both cox 1 as well as cox to enzyme activity but it is somewhat more selective towards the cox 2 enzyme compared with the cox1 enzyme at low doses
So at low dose meloxicam will have less side effects that are related with inhibition of cox 1 enzyme now phospholipase a2 is one of the important cleavage enzyme which is going to be more expressed during the inflammatory response this phospholipid ca2 can act on the phospholipids where it can digest this phospholipids to release one of the important mediator
Arachidonic acid this arachidonic acid is a c-20 fatty acid which can be converted into various types of mediators but one of the pathways the cox pathway which produce the prostates now this erectionic acid can interact with the cox enzyme where it is going to be converted into cyclic endoperoxide such as pg g2 and pgh2 now again the psychic endo peroxides can
Interact with the cox enzyme which is having the peroxidase activity such that they are going to be converted into prostaglandins such as pge2 pgi2 and thromboxane a2 all these are responsible for setting up inflammation induction of favor precipitation of the pain at the site of inflammation now mellox come is one of the drug which is going to block this cock’s
Enzyme activity thereby can reduce the sins of prostaglandins so that you can control pain fever and inflammation within the body that’s why meloxy camp can be used in the treatment of chromatid arthritis as well as osteoarthritis now let’s see the precautions of maloxycam this drug meloxicam can increase the risk of cardiovascular disorders so in the patients
With pre-existing cardiovascular disease this maloxycam should be carefully given particularly the risk is increased with thrombotic events produced by this maloxycam one of the important prostaglandin pg i2 is responsible for vasodilation now it can act on ip receptors which are expressed on the vascular smooth muscle when this prostaglandin i2 binds to the ip
Receptors it produces vasodilation but in prince of meloxycam this pgi 2 biosensory is going to be inhibited such that the pgi2 levels are reduced which results in vasoconstriction now because of vasoconstriction the platelets come nearer and they can be more aggregated so maloxycam can increase the risk of platelet aggregation which further increase the risk of
Stroke as well as myocardial infarction in the patients so the patients with cardiovascular disorders this meloxy camp should be carefully given similarly this truck can increase the liver enzymes particularly alt alanine transaminase and ast aspartate transformance levels can be increased up to three times and rarely this drug can produce some jaundice and any
Fuminating hepatitis in the patients so these side effects are rarely observed with this male oxycam similarly this stuff can increase the inflammation of stomach as well as intestine again this is because of reduced production due to inhibition of cox-1 enzyme activity so this results in the ulceration of stomach as well as intestine and increased perforation
Finally it can also lead to some gastrointestinal bleeding so all these side effects are observed with meloxicam particularly high dose when it is prescribed for chronic periods normally at the intestine gastric acid is going to be released from the gastric parietal cells which is controlled by prostaglandins so erectinic acid can be converted into prostaglandins
Such as pg i2 and pce2 which are hang some protective action and this conversion is mediated by the enzyme cox one now these prostaglandins can act on the prostate receptors so that they can inhibit the release of gastric acid but in place of meloxicam particularly at high dose it can inhibit the cox 1 enzyme activity so that it can inhibit the sins of protective
Prostaglandins and when these are not synthesized the gastric acid secretion is not controlled so that more gastric acid is released which results in the increased ulceration perforation or even gastrointestinal bleeding within the patients so any symptoms of severe abdominal pain anemia and any other symptoms of gastric ulceration are observed then this drug
Should be carefully used similar to the renal system again this cox pathway is important where cox 1 enzyme is involved in the sense of pgi 2 and pge2 now these prostaglandins can act on the renal system which is again expressed with the prostate receptors so when these prostaglandins bind to these prosthetic receptors they can increase the different vasodilation
Resulting in the increased grammar filtration so they can increase the filtration rate by the renal system but when this maloxycam is used it can inhibit this cox 1 enzyme activity so that it can reduce glomerular filtration rate so when this filtration rate is reduced it can reduce the renal functionality finally it can lead to the renal failure which may result
In the liver dysfunction and fluid retention so case should be taken when this maloxycam is used at a high dose in the patients with any renal dysfunction similarly meloxicam can also increase the blood pressure resulting in the hypertension and it can also increase the bronchospasm in the patients which is particularly more important the patients with asthma
And it can also prescribe fear of the skin reactions such as pruritus or even it can produce stevens johnson syndrome due to any hypersensitive reaction what are the side effects the important side effects of meloxicam mainly include abdominal pain dyspepsia diarrhea flatulence and even it can produce central side effects such as dizziness headache pharyngitis
And some edema anemia and any skin rashes can be observed with this maloxycam how it is given this drug is available as tablet as well as oral suspension it’s also available as iv injection the initial dose of the drug is started at low dose particularly it is given as 7.5 mg given once daily but the dose can be increased up to 15 mg based on the conditions of the
Patients in the children this drug is given based on the body weight so it can be started at 0.125 mg per kg and the recommended dose is again 7.5 mg given once daily so that’s about this drug maloxycam which is a aux cam derivative and is a non-steroidal anti-inflammatory agent since this drug produce anti-inflammatory actions it can be used in the treatment of
Osteoarthritis as well as rheumatoid arthritis and it can also be used in the juvenile rheumatoid arthritis in the children with is greater than two years so this drug may increase the cardiovascular disorder such as stroke and myocardial infarction because of any thrombotic events and it can also increase the gas rotational side effects resulting in ulceration
Perforation and bleeding and these side effects are particularly absurd at high dose of maloxycan at a low dose this drug is somewhat more selective towards the cox to enzyme therefore it shows less gastrointestinal and cardiovascular side effects that’s why this truck is initiated at a low dose of 7.5 mg and the dose can be increased up to 15 mg so that’s about
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Transcribed from video
Meloxicam – Mechanism, precautions, side effects & uses By egpat
