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BMJ 1999; 318 doi: (Published 19 June 1999) Cite this as: BMJ 1999;318:1706
  1. Christopher Martyn (
  1. BMJ
    • Non-steroidal anti-inflammatory drugs work their magic by inhibiting cyclo-oxygenase, an enzyme vital to the synthesis of prostaglandins. Actually, there are two isoforms of the enzyme:cyclo-oxygenase-1, which has a physiological role in many tissues, including protection of the gastric mucosa, and cyclo-oxygenase-2, which is induced by proinflammatory stimuli. The older generations of non-steroidal anti-inflammatory drugs inhibited both isoforms, so it is not surprising that adverse effects are common. Selective cyclo-oxygenase-2 …

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