oxicam
{{Short description|Drug class}}
File:Piroxicam.svg, the most popular drug of the oxicam class.]]
Oxicam is a class of non-steroidal anti-inflammatory drugs (NSAIDs),{{Cite journal|vauthors=Ivanova D, Deneva V, Nedeltcheva D, Kamounah FS, Gergov G, Hansen PE, Kawauchi S, Antonov L|date=March 2015|title=Tautomeric transformations of piroxicam in solution: a combined experimental and theoretical study|journal=RSC Advances|publisher=Royal Society of Chemistry|location=England, UK|volume=5|pages=31852–31860|issue=40|doi=10.1039/c5ra03653d|bibcode=2015RSCAd...531852I |doi-access=free}} meaning that they have anti-inflammatory, analgesic, and antipyretic therapeutic effects. Oxicams bind closely to plasma proteins.{{Cite journal|vauthors=Olkkola KT, Brunetto AV, Mattila MJ|date=February 1994|title=Pharmacokinetics of oxicam nonsteroidal anti-inflammatory agents|journal=Clinical Pharmacokinetics|volume=26|issue=2|pages=107–20|pmid=8162655|doi=10.2165/00003088-199426020-00004|s2cid=13300943 }} Most oxicams are unselective inhibitors of the cyclooxygenase (COX) enzymes. The exception is meloxicam with a slight (10:1) preference for COX-2, which, however, is only clinically relevant at low doses.{{Cite book|last=Mutschler|first=Ernst|author2=Gerd Geisslinger|author3=Heyo K. Kroemer|author4=Monika Schäfer-Korting|date=2001|title=Mutschler Arzneimittelwirkungen: Lehrbuch der Pharmakologie und Toxikologie ; mit einführenden Kapiteln in die Anatomie, Physiologie und Pathophysiologie|language=German|trans-title=Mutster medicine effects: Textbook of pharmacology and toxicology; with introductory chapters in anatomy, physiology and pathophysiology|publisher=Wissenschaftliche Verlagsgesellschaft|location=Stuttgart, Germany|edition=8|page=233|isbn=3-8047-1763-2|ol=12928661M|oclc=48723029}}
The most popular drug of the oxicam class is piroxicam. Other examples include: ampiroxicam, droxicam, pivoxicam, tenoxicam, lornoxicam, and meloxicam.
Isoxicam has been suspended as a result of fatal skin reactions.
Chemistry
The physico-chemical characteristics of these molecules vary greatly depending upon the environment.{{Cite journal|vauthors=Banerjee R, Chakraborty H, Sarkar M|date=April 2003|title=Photophysical studies of oxicam group of NSAIDs: piroxicam, meloxicam and tenoxicam|journal=Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy|publisher=Elsevier|volume=59|issue=6|pages=1213–22|bibcode=2003AcSpA..59.1213B|doi=10.1016/S1386-1425(02)00300-1|pmid=12659890}}
In contrast to most other NSAIDs, oxicams are not carboxylic acids. They are tautomeric, and can exist as a number of tautomers (keto-enol tautomerism), here exemplified by piroxicam:
Side effects
{{Unreferenced-medical section|date=February 2022}}
The oxicams are associated with drug-related erythema multiforme (EM), Stevens–Johnson syndrome, and toxic epidermal necrolysis (TEN). This association is one of the reasons oxicams are not regularly prescribed.
References
{{Anti-inflammatory products}}
{{Prostanoid signaling modulators}}
Category:Nonsteroidal anti-inflammatory drugs
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