Development of highly selective COX-2 inhibitors – coxibs has proved a decreased risk of gastrointestinal toxicity, which was typical for non-selective NSAIDS, according to the evidence-based medicine. But such situation caused an imbalance in the impact on the synthesis of arachidonic acid metabolites: inhibition of COX-2 vasodilatatory prostacyclins and activation of thromboxane synthesis by platelets, which is accompanied by the increase in the frequency of thrombotic complications – myocardial infarctions and strokes. Some meta-analyses have proved this association: the higher is COX-2 inhibitors selectivity – the higher are CV-risks and cardiovascular toxicity of coxibs. Discontinuation or limitation of indications of coxibs, assessment of risk / benefit ratio is recommended in the conditions of comorbidity of CVS pathology, pain syndromes in rheumatology. Drugs of choice are moderately selective COX-2 inhibitors = meloxicam and nimesulide.

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Вісник проблем біології і медицини -2023 -Вип. 2 (169) / Bulletin of problems in biology and medicine -2023 -Issue 2 (169) 121 ОГЛЯДИ ЛІТЕРАТУРИ / LITERATURE REVIEWSSenile asthenia (SA) is the leading geriatric syndrome which characterizes the most vulnerable group of older patients. At the same time, senile asthenia is closely associated with other common geriatric syndromes, such as sarcopenia, malnutrition, reduced mobility and falls, cognitive impairment and depression. Despite widespread adoption, geriatric syndromes often remain undiagnosed. As a result, it leads to the patient functional dependence and reduced quality of life, increasing the number of hospitalizations and the risk of death.Concepts such as active longevity and healthy aging are increasingly used in society to develop action strategies aimed at supporting the elderly and senile age.Preventive and screening programs directed at preventing premature aging of the population and early detection of patients with risk factors for development of senile asthenia or its manifest signs are necessary.Conclusions. Thus, the management of elderly and senile patients with polymorbidity should take into account the presence of senile asthenia, the patient's life priorities and be focused on the optimal quality of life and supporting the patient's independence from outside assistance.