Advance Pharmacology Discussion 7 Sally is a 50-year-old female who has been a jogger for several years. She has recently been diagnosed with osteoarthritis. She has been taking ibuprofen for 3 months but states that “it does not help” and hurts her stomach. The health care provider prescribes celecoxib (Celebrex) 100 mg orally twice a day. What is the first-line therapy for osteoarthritis and the mechanism of action? Sally expresses concern about all the recent news about heart problems and celecoxib (Celebrex). What information should be included in a teaching plan to help her understand about taking celecoxib and the benefits and risks? Ibuprofen and celecoxib are both nonsteroidal anti-inflammatory drugs. Explain how they are similar and different Online Materials & Resources Schneider, M., & Krüger, K. (2013). Rheumatoid Arthritis--Early Diagnosis and Disease Management. Deutsches Aerzteblatt International, 110(27/28), 477-484. doi:10.3238/arztebl.2013.0477 Magennis, B., Lynch, T., & Corry, M. (2014). Current trends in the medical management of Parkinson's disease: implications for nursing practice. British Journal of Neuroscience Nursing, 10(2), 67-74. Larsen, M., Rosholm, J., & Hallas, J. (2014). The influence of comprehensive geriatric assessment on drug therapy in elderly patients. European Journal of Clinical Pharmacology, 70(2), 233-239. doi:10.1007/s00228-013-1601-x. REPLY TO  Concerning Sally's case study, the first-line therapy for osteoarthritis varies with the treatment modalities to substantiate the action plan. The effective action plan for osteoarthritis based on the background diagnosis of Sally, cyclooxygenase-2 (COX-2) inhibitors, acetaminophen (APAP), and nonsteroidal anti-inflammatory drugs (NSAIDs) could be the primary option for the treatment. Osteoarthritis is one of the most prevalent diseases in society that affects mostly the elderly population, such as Sally, who is 50 years old. The leading cause of osteoarthritis is wear and tear of the cartilage over a low repair capacity. The APAP enhances relief from mild to moderate pain, inhibiting the COX-3 activity and synthesizing prostaglandin. NSAIDs also have mild and moderate pain relief that inhibits cyclooxygenase enzymes and prostaglandin synthesis (Medline Plus, 2016). NSAIDs have a low benefit/risk ratio and can be used for short term use with minimum effective dose. On the other hand, the APAP is recommended for long-term use, but it has side effects and should be used strictly. Like any other drug used for diagnosis purposes, there are benefits and risks involved. This case study of Sally taking Celebrex with her heart problems conditions should enhance a plan for diagnosis. Medical specialists need to note that Celebrex is a selective cyco-oxygenase-2 (COX-2) inhibitor-associated with fewer risks of gastrointestinal bleeding contrary to non-selective NSAIDs of the benefits of using Celebrex drug (Falla, 2016). Some of the risks involved while using Celebrex are it increases cardiovascular, kidney risks, and liver complications linked with non-selective NSAIDs. Moreover, Celebrex or Celecoxib's use has other side effects such as heart-related risks like stroke and heart attack among individuals. These risks may be severe liver problems, serious skin reactions, dizziness, difficulty breathing or shortness of breathing (dyspnea), kidney issues, hypertension or high blood pressure, and difficulty swallowing (Falla, 2016). Some of the merits and benefits of using Celebrex or Celecoxib are liver impairment where it small dosage enhanced dismal or moderate hepatic impairment, is used to relieve pain, swelling and stiffness of osteoarthritis, tenderness, rheumatoid arthritis, and ankylosing spondylitis that affects the joints and spine respectively. The drug is also used to treat painful menstrual periods among female patients and enhance relief and other short-term pain such as injuries for both males and females (Medline Plus, 2016). Another benefit of Celebrex is that; it is used to treat migraine headaches due to severe throbbing. There are similarities and differences between ibuprofen and celecoxib drug base on a nonsteroidal anti-inflammatory. Celebrex is known as a selective COX-2 inhibitor. While it is still an NSAID like ibuprofen, Celebrex only blocks COX-2 instead of ibuprofen, which blocks both COX-1 and COX-2. A COX-2 inhibitor can be more comfortable on the stomach, with a lower risk of causing stomach ulcers (Berger, 2019). Celebrex and ibuprofen have many of the same interactions with other prescription drugs. Both medications interact with blood thinners such as Coumadin (warfarin), certain blood pressure medications (Berger, 2019). Alcohol should be avoided when taking Celebrex or ibuprofen. Using either of these medications with alcohol can increase the risk of GI (stomach) bleeding or inflammation. Both drugs have similar side effects such as abdominal pain, headache dyspepsia, diarrhoea with varying frequency to a patient.