In the clinical management of arthritis, the choice of nonsteroidal anti inflammatory drug (NSAID) remains confusing and controversial. A common practice on the choice of NSAID in clinical management of arthritis is the risk benefit ratio. The main objective of this review is to addresses the main arguments for the pharmacological and clinical use of COX-2 inhibitors in relation to nonselective NSAIDs for the clinical management of arthritis. This review concluded that, both NSAIDs and COX-2 inhibitors are equally effective and are associated with increased risk of GI, renal, and CV, adverse effects. Complete understanding of the patient's comorbid conditions and concomitant medications, coupled with precise monitoring during the treatment, may help to decrease the threat of adverse effects induced by nonselective NSAIDs and selective COX-2 inhibitors.

Antiplatelet therapy, which reduces platelet activation and aggregation, is the corner stone of treatment for patients undergoing percutaneous coronary intervention (PCI). Clopidogrel is an established oral antiplatelet medication of thienopyridine class, which inhibits blood clots in coronary artery disease, peripheral vascular disease, and cerebrovascular disease. Many studies have revealed that high loading dose clopidogrel in patients undergoing PCI. This review article investigates the rationale and role of high loading dose clopidogrel in patients undergoing PCI.