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Fiorucci S - Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for treatment of pain and inflammation, despite their association with gastrointestinal complications, including bleeding and perforation. Inhibition of cyclooxygenases (COXs), is the main mechanism of action of aspirin and NSAIDs. Inhibition of COX-1 derived prostanoids in the stomach represent the underlying mechanism involved in development of gastric and duodenal ulcers in patients taking NSAIDs. Selective COX-2 inhibitors (coxibs) spare the gastrointestinal tract, but their use increases the risk of heart attack and stroke.

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