[Verse 1]
COX-1 keeps your stomach lining fed,
COX-2 fires up wherever there's inflammation spread,
Nonselective blockers hit 'em both, ibuprofen, naproxen in the lane,
Aspirin's acetyl group locks COX-1 irreversible, that's the permanent chain,
Platelets can't regenerate enzymes, so they're hobbled for their lifespan,
Celecoxib's selective, COX-2 only, that's the COX-2 selectin' plan,
Diclofenac preferential, sits between the two,
Know your spectrum front to back before you make a move
[Chorus]
COX один, COX два — запам'ятай,
GI, серце, нирки — все це знай,
Inhibez le COX, mais sachez le risque,
Sélectif ou non — choisissez dans la liste
[Verse 2]
GI toxicity, the mucosa pays the price,
When prostaglandin E2 drops, the barrier don't suffice,
Add a PPI or misoprostol if you want protection right,
H. pylori plus NSAID doubles ulcer risk overnight,
Ketorolac's potent but cap it at five days flat,
Exceed that limit and the GI bleed comes back,
Topical diclofenac for osteoarthritic knees,
Systemic sparing, local gain — evidence-based expertise
[Chorus]
COX один, COX два — запам'ятай,
GI, серце, нирки — все це знай,
Inhibez le COX, mais sachez le risque,
Sélectif ou non — choisissez dans la liste
[Verse 3]
Cardiovascular risk got complicated fast,
PRECISION trial compared celecoxib, ibuprofen, naproxen head to cast,
Celecoxib held its own, naproxen leans the safest cardiac side,
Diclofenac's the outlier, thrombotic risk runs wide,
Renal blood flow needs prostaglandins just to stay intact,
Drop 'em with an NSAID and your GFR gets cracked,
Triple whammy — NSAID plus ACE inhibitor plus a thiazide loop,
Hemodynamic AKI, hyperkalemia, papillary necrosis in the group
[Bridge]
Aspirin-exacerbated respiratory disease,
Leukotriene shunting when the COX pathway freeze,
Arachidonic acid routes itself to bronchoconstrict,
Avoid all nonselectives when that phenotype's picked,
Perioperative bleeding, hold the drug before the knife,
Bone healing controversy — osteoblasts suppressed in early life,
Anastomotic leak debated, evidence stays thin,
Pregnancy? Third trimester — ductus closes, don't begin
[Chorus]
COX один, COX два — запам'ятай,
GI, серце, нирки — все це знай,
Inhibez le COX, mais sachez le risque,
Sélectif ou non — choisissez dans la liste
[Outro]
Ibuprofen clears for pediatrics, ketorolac too in the right dose frame,
Oligohydramnios and ductus — third trimester carries all the blame,
Selective, preferential, nonselective — map the pharmacology,
COX inhibition's a calculated art, not a blanket apology