A patient comes to the clinic complaining of seasonal rhinitis. What adrenergic agonist will be prescribed for seasonal rhinitis?

A) Increased intraocular pressure: Sympathomimetic drugs stimulate the sympathetic nervous system and promote "fight or flight" responses, often resulting in vasoconstriction and other effects. Some sympathomimetics, especially those that affect alpha-adrenergic receptors, can lead to increased intraocular pressure, which is a concern in conditions like glaucoma.

B) Decreased blood pressure: Sympathomimetic drugs generally increase blood pressure by stimulating alpha and beta receptors that cause vasoconstriction and increased heart rate. In contrast, drugs that would decrease blood pressure are usually parasympathomimetics or other agents designed to block sympathetic responses.

C) Decreased heart rate: Sympathomimetic drugs typically increase heart rate by stimulating beta-1 adrenergic receptors in the heart. These drugs are used in situations requiring increased cardiac output or to counteract bradycardia. Decreased heart rate would typically occur with parasympathomimetic drugs or medications that block sympathetic activity (e.g., beta blockers).

D) Increased respiration: Sympathomimetic drugs can increase respiratory rate by promoting bronchodilation through beta-2 adrenergic receptor activation in the lungs. However, "increased respiration" as a general effect is not as specific or consistent as the other cardiovascular and ocular effects of these drugs. The primary and most prominent physiological change would be related to the cardiovascular effects.

A) Celecoxib (Celebrex):
Celecoxib is a selective COX-2 inhibitor that targets the cyclooxygenase-2 enzyme, which is primarily responsible for inflammation, pain, and fever. COX-2 inhibitors tend to cause less gastrointestinal irritation compared to nonselective NSAIDs like aspirin, which block both COX-1 and COX-2 enzymes. Because aspirin is causing gastrointestinal upset, switching to Celecoxib, which is less likely to irritate the stomach lining, may be an appropriate option to prevent myocardial infarction while minimizing gastrointestinal discomfort.

B) Enteric-coated aspirin:
Enteric-coated aspirin is designed to dissolve in the small intestine rather than the stomach, which may reduce some gastrointestinal irritation. However, it does not eliminate the risk entirely, and it still functions as a COX-1 inhibitor. If the patient is already experiencing gastrointestinal upset, simply switching to enteric-coated aspirin may not be sufficient to alleviate the discomfort, and other options should be considered.

C) Nabumetone (Relafen):
Nabumetone is a nonsteroidal anti-inflammatory drug (NSAID) with some COX-2 selectivity. While it may cause less gastrointestinal upset than non-selective NSAIDs like aspirin, it is still an NSAID and carries a risk of gastrointestinal side effects, especially with prolonged use.
D) A COX-2 inhibitor:
While COX-2 inhibitors, including Celecoxib, are typically effective in reducing inflammation and pain with fewer gastrointestinal side effects than traditional NSAIDs, the term "a COX-2 inhibitor" could refer to various drugs, and Celecoxib (Celebrex) is the most commonly used.