This invention describes novel compounds that are cyclooxygenase 2 (COX-2) selective inhibitors and novel compositions comprising at least one cyclooxygenase 2 (COX-2) selective inhibitor, and, optionally, at least one compound that donates, transfers or releases nitric oxide, stimulates endogenous synthesis of nitric oxide, elevates endogenous levels of endothelium-derived relaxing factor or is a substrate for nitric oxide synthase, and/or, optionally, at least one therapeutic agent. The invention also provides novel kits comprising at least one COX-2 selective inhibitor, and, optionally, at least one nitric oxide donor, and/or, optionally, at least one therapeutic agent. The novel cyclooxygenase 2 selective inhibitors of the invention can be optionally nitrosated and/or nitrosylated. The invention also provides methods for treating inflammation, pain and fever; for treating and/or improving the gastrointestinal properties of COX-2 selective inhibitors; for facilitating wound healing; for treating and/or preventing renal toxicity or other toxicities; for treating and/or preventing other disorders resulting from elevated levels of cyclooxygenase-2; and for improving the cardiovascular profile of COX-2 selective inhibitors.
Description
FIELD OF THE INVENTION [0002] The invention describes novel compounds that are cyclooxygenase 2 (COX-2) selective inhibitors and novel compositions comprising at least one cyclooxygenase 2 (COX-2) selective inhibitor, and, optionally, at least one compound that donates, transfers or releases nitric oxide, stimulates endogenous synthesis of nitric oxide, elevates endogenous levels of endothelium-derived relaxing factor or is a substrate for nitric oxide synthase, and/or, optionally, at least one therapeutic agent. The invention also provides novel kits comprising at least one COX-2 selective inhibitor, and, optionally, at least one nitric oxide donor, and/or, optionally, at least one therapeutic agent. The novel cyclooxygenase 2 selective inhibitors of the invention can be optionally nitrosated and/or nitrosylated. The invention also provides methods for treating inflammation, pain and fever; for treating and/or improving the gastrointestinal properties of COX-2 selective inhibitors; for facilitating wound healing; for treating and/or preventing renal toxicity or other toxicities; for treating and/or preventing other disorders resulting from elevated levels of cyclooxygenase-2; and for improving the cardiovascular profile of COX-2 selective inhibitors.
BACKGROUND OF THE INVENTION [0003] Nonsteroidal anti-inflammatory compounds (NSAIDs) are widely used for the treatment of pain, inflammation, and acute and chronic inflammatory disorders such as osteoarthritis and rheumatoid arthritis. These compounds inhibit the activity of the enzyme cyclooxygenase (COX), also known as prostaglandin G/H synthase, which is the enzyme that converts arachidonic acid into prostanoids. The NSAIDs also inhibit the production of other prostaglandins, especially prostaglandin G2, prostaglandin H2 and prostaglandin E2, thereby reducing the prostaglandin-induced pain and swelling associated with the inflammation process. The chronic use of NSAIDs has been associated with adverse effects, such as gastrointestinal ulceration and renal toxicity. The undesirable side effects are also due to the inhibition of prostaglandin in the affected organ. [0004] Recently two isoforms of cyclooxygenase, encoded by two distinct genes (Kujubu et al, J. Biol. Chem., 266, 12866-12872 (1991)), have been identified—a constitutive form, cyclooxygenase-1 (COX-1), and an inductive form, cyclooxygenase-2 (COX-2). It is thought that the antiinflammatory effects of NSAIDs are mediated by the inhibition of COX-2, whereas the side effects seem to be caused by the inhibition of COX-1. The NSAIDs currently on the market either inhibit both isoforms of COX with little selectivity for either isoform or are COX-1 selective. Recently compounds that are COX-2 selective inhibitors have been developed and marketed. These COX-2 selective inhibitors have the desired therapeutic profile of an antiinflammatory drug without the adverse effects commonly associated with the inhibition of COX-1. However, these compounds can result in dyspepsia and can cause gastropathy (Mohammed et al, N. Engl. J. Med., 340(25) 2005 (1999)). Additionally the COX-2 selective inhibitors can increase the risk of cardiovascular events in a patient (Mukherjee et al., JAMA 286(8)9-54-959 (2001)); Hennan et al., Circulation, 104:820-825 (2001)). [0005] There is still a need in the art for novel COX-2 selective inhibitor compounds that have gastroprotective properties, facilitate wound healing, decreased renal toxicity and dyspepsia, improved cardiovascular profile and that can be used at low dosages. The invention is directed to these, as well as other, important ends.
SUMMARY OF THE INVENTION [0006] The invention provides novel compounds that are COX-2 selective inhibitors. These compounds are potent analgesics, have antiinflammatory properties and have an unexpected potential for facilitating wound healing. The novel compounds also have unexpected properties in the treatment and/or prevention of renal toxicity and for improving the cardiovascular profile of COX-2 selective inhibitors. The invention also provides compositions comprising the novel compounds described herein in a pharmaceutically acceptable carrier. [0007] The invention is also based on the discovery that administering at least one COX-2 selective inhibitor, and, optionally, at least one nitric oxide donor reduces the gastrointestinal distress induced by COX-2 selective inhibitors. A nitric oxide donor is a compound that contains a nitric oxide moiety and which releases or chemically transfers nitric oxide to another molecule. [0008] Nitric oxide donors include, for example, S-nitrosothiols, nitrites, nitrates, N-oxo-N-nitrosamines, SPM 3672, SPM 5185, SPM 5186 and analogues thereof, and substrates of the various isozymes of nitric oxide synthase. Thus, another aspect of the invention provides compositions comprising at least one COX-2 selective inhibitor, and at least one compound that donates, transfers or releases nitric oxide as a charged species, i.e., nitrosonium (NO+) or nitroxyl (NO—), or as the neutral species, nitric oxide (NO.), and/or stimulates endogenous production of nitric oxide or EDRF in vivo and/or is a substrate for nitric oxide synthase. [0009] Yet another aspect of the invention provides compositions comprising at least one COX-2 selective inhibitor that is substituted with at least one nitrogen monoxide group (NO), and/or at least one nitrogen dioxide group (NO2) (i.e., nitrosylated and/or nitrosated). The COX-2 selective inhibitors can be nitrosated and/or nitrosylated through one or more sites such as oxygen (hydroxyl condensation), sulfur (sulfhydryl condensation) and/or nitrogen. The invention also provides compositions comprising a therapeutically effective amount of such compounds in a pharmaceutically acceptable carrier. [0010] Another aspect of the invention provides compositions comprising a therapeutically effective amount of at least one COX-2 selective inhibitor that is substituted with at least one NO and/or NO2 group (i.e., nitrosylated and/or nitrosated), and at least one compound that donates, transfers or releases nitrogen monoxide as a charged species, i.e., nitrosonium (NO+) or nitroxyl (NO—), or as the neutral species, nitric oxide (NO.), and/or stimulates endogenous production of nitric oxide or EDRF in vivo and/or is a substrate for nitric oxide synthase. The invention also provides for such compositions in a pharmaceutically acceptable carrier. [0011] Yet another aspect of the invention provides compositions comprising at least one COX-2 selective inhibitor, that is optionally substituted with at least one NO and/or NO2 group (i.e., nitrosylated and/or nitrosated), and, optionally, at least one compound that donates, transfers or releases nitric oxide as a charged species, i.e., nitrosonium (NO+) or nitroxyl (NO—), or as the neutral species, nitric oxide (NO.), and/or stimulates endogenous production of nitric oxide or EDRF in vivo and/or is a substrate for nitric oxide synthase, and/or, optionally, at least one therapeutic agent, including but not limited to, steroids, nonsteroidal antiinflammatory compounds (NSAID), 5-lipoxygenase (5-LO) inhibitors, leukotriene B4 (LTB4) receptor antagonists, leukotriene A4 (LTA4) hydrolase inhibitors, 5-HT agonists, HMG CoA inhibitors, H2 antagonists, antineoplastic agents, antiplatelet agents, thrombin inhibitors, thromboxane inhibitors, decongestants, diuretics, sedating or non-sedating anti-histamines, inducible nitric oxide synthase inhibitors, opioids, analgesics, Helicobacter pylori inhibitors, proton pump inhibitors, isoprostane inhibitors, and the like. [0012] Yet another aspect of the invention provides methods for treating and/or preventing inflammation, pain and fever; for treating and/or improving gastrointestinal properties of COX-2 selective inhibitors; for facilitating wound healing; for treating and/or preventing renal toxicity; and for treating and/or preventing COX-2 mediated disorders (i.e., disorders resulting from elevated levels of COX-2) in a patient in need thereof which comprises administering to the patient a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally substituted with at least one NO and/or NO2 group (i.e., nitrosylated and/or nitrosated), and, optionally, at least one compound that donates, transfers or releases nitric oxide as a charged species, i.e., nitrosonium (NO+) or nitroxyl (NO—), or as the neutral species, nitric oxide (NO.), and/or stimulates endogenous production of nitric oxide or EDRF in vivo and/or is a substrate for nitric oxide synthase and/or stimulates endogenous production of NO or EDRF in vivo and/or is a substrate for nitric oxide synthase (i.e. NO donor). The methods can optionally further comprise the administration of at least one therapeutic agent, such as, for example, steroids, nonsteroidal antiinflammatory compounds (NSAID), 5-lipoxygenase (5-LO) inhibitors, leukotriene B4 (LTB4) receptor antagonists, leukotriene A4 (LTA4) hydrolase inhibitors, 5-HT agonists, 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) inhibitors, H2 antagonists, antineoplastic agents, antiplatelet agents, thrombin inhibitors, thromboxane inhibitors, decongestants, diuretics, sedating or non-sedating anti-histamines, inducible nitric oxide synthase inhibitors, opioids, analgesics, Helicobacter pylori inhibitors, proton pump inhibitors, isoprostane inhibitors, and mixtures thereof. In this aspect of the invention, the methods can involve administering the COX-2 selective inhibitors, that are optionally nitrosated and/or nitrosylated, administering the COX-2 selective inhibitors, that are optionally nitrosated and/or nitrosylated, and NO donors, administering the COX-2 selective inhibitors, that are optionally nitrosated and/or nitrosylated, and therapeutic agents, or administering the COX-2 selective inhibitors, that are optionally nitrosated and/or nitrosylated, NO donors, and therapeutic agents. [0013] Yet another aspect of the invention provides methods for improving the cardiovascular profile of COX-2 selective inhibitors in a patient in need thereof which comprises administering to the patient a therapeutically effective amount of at least one COX-2 selective inhibitor, substituted with at least one NO and/or NO2 group (i.e., nitrosylated and/or nitrosated), and, optionally, at least one compound that donates, transfers or releases nitric oxide as a charged species, i.e., nitrosonium (NO+) or nitroxyl (NO—), or as the neutral species, nitric oxide (NO.), and/or stimulates endogenous production of nitric oxide or EDRF in vivo and/or is a substrate for nitric oxide synthase and/or stimulates endogenous production of NO or EDRF in vivo and/or is a substrate for nitric oxide synthase (i.e. NO donor). The methods can optionally further comprise the administration of at least one of 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) inhibitors, antiplatelet agents, thrombin inhibitors, thromboxane inhibitors, and mixtures thereof. In this aspect of the invention, the methods can involve administering the nitrosated and/or nitrosylated COX-2 selective inhibitors, administering the COX-2 selective inhibitors, that are optinally nitrosated and/or nitrosylated, and NO donors, administering the COX-2 selective inhibitors, that are optinally nitrosated and/or nitrosylated, and at least one of 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) inhibitors, antiplatelet agents, thrombin inhibitors or thromboxane inhibitors, or administering the COX-2 selective inhibitors, that are optinally nitrosated and/or nitrosylated, NO donors, and at least one of 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) inhibitors, antiplatelet agents, thrombin inhibitors or thromboxane inhibitors. [0014] In yet another aspect the invention provides kits comprising at least one COX-2 selective inhibitor, that is optionally substituted with at least one NO and/or NO2 group (i.e., nitrosylated and/or nitrosated), and, optionally, at least one compound that donates, transfers or releases nitric oxide as a charged species, i.e., nitrosonium (NO+) or nitroxyl (NO—), or as the neutral species, nitric oxide (NO.), and/or stimulates endogenous production of nitric oxide or EDRF in vivo and/or is a substrate for nitric oxide synthase. The kit can further comprise at least one therapeutic agent, such as, for example, steroids, nonsteroidal antiinflammatory compounds (NSAID), 5-lipoxygenase (5-LO) inhibitors, leukotriene B4 (LTB4) receptor antagonists, leukotriene A4 (LTA4) hydrolase inhibitors, 5-HT agonists, 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) inhibitors, H2 antagonists, antineoplastic agents, antiplatelet agents, thrombin inhibitors, thromboxane inhibitors, decongestants, diuretics, sedating or non-sedating anti-histamines, inducible nitric oxide synthase inhibitors, opioids, analgesics, Helicobacter pylori inhibitors, proton pump inhibitors, isoprostane inhibitors, and mixtures thereof. The COX-2 selective inhibitor, the nitric oxide donor and/or therapeutic agent, can be separate components in the kit or can be in the form of a composition in one or more pharmaceutically acceptable carriers.
DETAILED DESCRIPTION OF THE INVENTION [0015] As used throughout the disclosure, the following terms, unless otherwise indicated, shall be understood to have the following meanings. [0016] “NSAID” refers to a nonsteroidal anti-inflammatory compound or a nonsteroidal anti-inflammatory drug. NSAIDs inhibit cyclooxygenase, the enzyme responsible for the biosyntheses of the prostaglandins and certain autocoid inhibitors, including inhibitors of the various isozymes of cyclooxygenase (including but not limited to cyclooxygenase-1 and -2), and as inhibitors of both cyclooxygenase and lipoxygenase. [0017] “Cyclooxygenase-2 (COX-2) inhibitor” refers to a compound that selectively inhibits the cyclooxygenase-2 enzyme over the cyclooxygenase-1 enzyme. Preferably, the compound has a cyclooxygenase-2 IC50 of less than about 0.5 μM, and also has a selectivity ratio of cyclooxygenase-2 inhibition over cyclooxygenase-1 inhibition of at least 50, and more preferably of at least 100. Even more preferably, the compound has a cyclooxygenase-1 IC50 of greater than about 1 μM, and more preferably of greater than 20 μM. The compound can also inhibit the enzyme, lipoxygenase and/or phosphodiestase. Such preferred selectivity may indicate an ability to reduce the incidence of common NSAID-induced side effects. [0018] “Parent COX-2 inhibitor” refers to a non-nitrosated and/or non-nitrosylated COX-2 inhibitor and includes those described in the prior art, including those described in the patents and publications cited herein, as well as the novel compounds described herein. “Parent COX-2 inhibitor” includes the compounds of Formulas I to X before they are nitrosated and/or nitrosylated by the methods described herein. [0019] “Therapeutic agent” includes any therapeutic agent that can be used to treat or prevent the diseases described herein. “Therapeutic agents” include, for example, steroids, nonsteroidal antiinflammatory compounds, 5-lipoxygenase inhibitors, leukotriene B4 receptor antagonists, leukotriene A4 hydrolase inhibitors, 5-HT agonists, 3-hydroxy-3-methylglutaryl coenzyme A inhibitors, H2 antagonists, antineoplastic agents, antiplatelet agents, decongestants, diuretics, sedating or non-sedating anti-histamines, inducible nitric oxide synthase inhibitors, opioids, analgesics, Helicobacter pylori inhibitors, proton pump inhibitors, isoprostane inhibitors, and the like. Although NO donors have therapeutic activity, the term “therapeutic agent” does not include the NO donors described herein, since NO donors are separately defined. [0020] “Patient” refers to animals, preferably mammals, most preferably humans, and includes males and females, and children and adults. [0021] “Cardiovascular disease or disorder” refers to any cardiovascular disease or disorder known in the art, including, but not limited to, restenosis, atherosclerosis, atherogenesis, angina, (particularly chronic, stable angina pectoris), ischemic disease, congestive heart failure or pulmonary edema associated with acute myocardial infarction, thrombosis, controlling blood pressure in hypertension (especially hypertension associated with cardiovascular surgical procedures), thromboemboembolic events, platelet aggregation, platelet adhesion, smooth muscle cell proliferation, vascular complications associated with the use of medical devices, wounds associated with the use of medical devices, cerebrovascular ischemic events, and the like. Complications associated with the use of medical devices may occur as a result of increased platelet deposition, activation, thrombus formation or consumption of platelets and coagulation proteins. Such complications, which are within the definition of “cardiovascular disease or disorder,” include, for example, myocardial infarction, ischemic stroke, transient ischemic stroke, thromboemboembolic events, pulmonary thromboembolism, cerebral thromboembolism, thrombophlebitis, thrombocytopenia, bleeding disorders and/or any other complications which occur either directly or indirectly as a result of the foregoing disorders. [0022] “Restenosis” is a cardiovascular disease or disorder that refers to the closure of a peripheral or coronary artery following trauma to the artery caused by an injury such as, for example, angioplasty, balloon dilation, atherectomy, laser ablation treatment or stent insertion. For these angioplasty procedures, restenosis occurs at a rate of about 30-60% depending upon the vessel location, lesion length and a number of other variables. Restenosis can also occur following a number of invasive surgical techniques, such as, for example, transplant surgery, vein grafting, coronary artery bypass surgery, endarterectomy, heart transplantation, balloon angioplasty, atherectomy, laser ablation, endovascular stenting, and the like. [0023] “Atherosclerosis” is a form of chronic vascular injury in which some of the normal vascular smooth muscle cells in the artery wall, which ordinarily control vascular tone regulating blood flow, change their nature and develop “cancer-like” behavior. These vascular smooth muscle cells become abnormally proliferative, secreting substances such as growth factors, tissue-degradation enzymes and other proteins, which enable them to invade and spread into the inner vessel lining, blocking blood flow and making that vessel abnormally susceptible to being completely blocked by local blood clotting, resulting in the death of the tissue served by that artery. Atherosclerotic cardiovascular disease, coronary heart disease (also known as coronary artery disease or ischemic heart disease), cerebrovascular disease and peripheral vessel disease are all common manifestations of atherosclerosis and are therefore encompassed by the terms “atherosclerosis” and “atherosclerotic disease”. [0024] “Improving the cardiovascular profile” refers to and includes reducing the risk of thromboembolic events, reducing the risk of developing atherosclerosis and atherosclerotic diseases, and inhibiting platelet aggregation. [0025] “Thromboemboembolic events” includes, but is not limited to, ischemic stroke, transient ischemic stroke, myocardial infarction, angina pectoris, thrombosis, thromboembolism, thrombotic occlusion and reocclusion, acute vascular events, restenosis, transient ischemic attacks, and first and subsequent thrombotic stroke. Patients who are at risk of developing thromboembolic events, may include those with a familial history of, or genetically predisposed to, thromboembolic disorders, who have had ischemic stroke, transient ischemic stroke, myocardial infarction, and those with unstable angina pectoris or chronic stable angina pectoris and patients with altered prostacyclin/thromboxane A2 homeostasis or higher than normal thromboxane A2 levels leading to increase risk for thromboembolism, including patients with diabetes and rheumatoid arthritis. [0026] “Thromboxane inhibitor” refers to any compound that reversibly or irreversibly inhibits thromboxane synthesis, and includes compounds which are the so-called thromboxane A2 receptor antagonists, thromboxane A2 antagonists, thromboxane A2/prostaglandin endoperoxide antagonists, thromboxane receptor (TP) antagonists, thromboxane antagonists, thromboxane synthase inhibitors, and dual acting thromboxane synthase inhibitors and thromboxane receptor antagonists. The characteristics of the preferred thromboxane inhibitor should include the suppression of thromboxane A2 formation (thromboxane synthase inhibitors) and/or blockade of thromboxane A2 and prostaglandin H2 platelet and vessel wall (thromboxane receptor antagonists). The effects should block platelet activation and therefore platelet function. [0027] “Thromboxane A2 receptor antagonist” refers to any compound that reversibly or irreversibly blocks the activation of any thromboxane A2 receptor. [0028] “Thromboxane synthase inhibitor” refers to any compound that reversibly or irreversibly inhibits the enzyme thromboxane synthesis thereby reducing the formation of thromboxane A2. Thromboxane synthase inhibitors may also increase the synthesis of antiaggregatory prostaglandins including prostacyclin and prostaglandin D2. Thromboxane A2 receptor antagonists and thromboxane synthase inhibitors and can be identified using the assays described in Tai, Methods of Enzymology, Vol. 86, 110-113 (1982); Hall, Medicinal Research Reviews, 11:503-579 (1991) and Coleman et al., Pharmacol Rev., 46: 205-229 (1994) and references therein, the disclosures of which are incorporated herein by reference in its entirety. [0029] “Dual acting thromboxane receptor antagonist and thromboxane synthase inhibitor” refers to any compound that simultaneously acts as a thromboxane A2 receptor antagonist and a thromboxane synthase inhibitor. [0030] “Thrombin inhibitors” refers to and includes compounds that inhibit hydrolytic activity of thrombin, including the catalytic conversion of fibrinogen to fibrin, activation of Factor V to Va, Factor VIII to VIIIa, Factor XIII to XIIIa and platelet activation. Thrombin inhibitors may be identified using assays described in Lewis et at., Thrombosis Research. 70: 173-190 (1993). [0031] “Platelet aggregation” refers to the binding of one or more platelets to each other. Platelet aggregation is commonly referred to in the context of generalized atherosclerosis, not with respect to platelet adhesion on vasculature damaged as a result of physical injury during a medical procedure. Platelet aggregation requires platelet activation which depends on the interaction between the ligand and its specific platelet surface receptor. [0032] “Platelet activation” refers either to the change in conformation (shape) of a cell, expression of cell surface proteins (e.g., the IIb/IIIa receptor complex, loss of GPIb surface protein), and secretion of platelet derived factors (e.g., serotonin, growth factors). [0033] “Patient” refers to animals, preferably mammals, most preferably humans, and includes males and females, and children and adults. [0034] “Therapeutically effective amount” refers to the amount of the compound and/or composition that is effective to achieve its intended purpose. [0035] “Transdermal” refers to the delivery of a compound by passage through the skin and into the blood stream. [0036] “Transmucosal” refers to delivery of a compound by passage of the compound through the mucosal tissue and into the blood stream. [0037] “Penetration enhancement” or “permeation enhancement” refers to an increase in the permeability of the skin or mucosal tissue to a selected pharmacologically active compound such that the rate at which the compound permeates through the skin or mucosal tissue is increased. [0038] “Carriers” or “vehicles” refers to carrier materials suitable for compound administration and include any such material known in the art such as, for example, any liquid, gel, solvent, liquid diluent, solubilizer, or the like, which is non-toxic and which does not interact with any components of the composition in a deleterious manner. [0039] “Nitric oxide adduct” or “NO adduct” refers to compounds and functional groups which, under physiological conditions, can donate, release and/or directly or indirectly transfer any of the three redox forms of nitrogen monoxide (NO+, NO−, NO.), such that the biological activity of the nitrogen monoxide species is expressed at the intended site of action. [0040] “Nitric oxide releasing” or “nitric oxide donating” refers to methods of donating, releasing and/or directly or indirectly transferring any of the three redox forms of nitrogen monoxide (NO+, NO—, NO.), such that the biological activity of the nitrogen monoxide species is expressed at the intended site of action. [0041] “Nitric oxide donor” or “NO donor” refers to compounds that donate, release and/or directly or indirectly transfer a nitrogen monoxide species, and/or stimulate the endogenous production of nitric oxide or endothelium-derived relaxing factor (EDRF) in vivo and/or elevate endogenous levels of nitric oxide or EDRF in vivo. “NO donor” also includes compounds that are substrates for nitric oxide synthase. [0042] “Alkyl” refers to a lower alkyl group, a haloalkyl group, a hydroxyalkyl group, an alkenyl group, an alkynyl group, a bridged cycloalkyl group, a cycloalkyl group or a heterocyclic ring, as defined herein. An alkyl group may also comprise one or more radical species, such as, for example a cycloalkylalkyl group or a heterocyclicalkyl group. [0043] “Lower alkyl” refers to a branched or straight chain acyclic alkyl group comprising one to about ten carbon atoms (preferably one to about eight carbon atoms, more preferably one to about six carbon atoms). Exemplary lower alkyl groups include methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, t-butyl, pentyl, neopentyl, iso-amyl, hexyl, octyl, and the like. [0044] “Substituted lower alkyl” refers to a lower alkyl group, as defined herein, wherein one or more of the hydrogen atoms have been replaced with one or more R100 groups, wherein each R100 is independently a hydroxy, an oxo, a carboxyl, a carboxamido, a halo, a cyano or an amino group, as defined herein. [0045] “Haloalkyl” refers to a lower alkyl group, an alkenyl group, an alkynyl group, a bridged cycloalkyl group, a cycloalkyl group or a heterocyclic ring, as defined herein, to which is appended one or more halogens, as defined herein. Exemplary haloalkyl groups include trifluoromethyl, chloromethyl, 2-bromobutyl, 1-bromo-2-chloro-pentyl, and the like. [0046] “Alkenyl” refers to a branched or straight chain C2-C10 hydrocarbon (preferably a C2-C8 hydrocarbon, more preferably a C2-C6 hydrocarbon) which can comprise one or more carbon-carbon double bonds. Exemplary alkenyl groups include propylenyl, buten-1-yl, isobutenyl, penten-1-yl, 2,2-methylbuten-1-yl, 3-methylbuten-1-yl, hexan-1-yl, hepten-1-yl, octen-1-yl, and the like. [0047] “Lower alkenyl” refers to a branched or straight chain C2-C4 hydrocarbon which can comprise one or two carbon-carbon double bonds. [0048] “Substituted alkenyl” refers to a branched or straight chain C2-C10 hydrocarbon (preferably a C2-C8 hydrocarbon, more preferably a C2-C6 hydrocarbon) which can comprise one or more carbon-carbon double bonds, wherein one or more of the hydrogen atoms have been replaced with one or more R100 groups, wherein each R100 is independently a hydroxy, an oxo, a carboxyl, a carboxamido, a halo, a cyano or an amino group, as defined herein. [0049] “Alkynyl” refers to an unsaturated acyclic C2-C10 hydrocarbon (preferably a C2-C8 hydrocarbon, more preferably a C2-C6 hydrocarbon) which can comprise one or more carbon-carbon triple bonds. Exemplary alkynyl groups include ethynyl, propynyl, butyn-1-yl, butyn-2-yl, pentyl-1-yl, pentyl-2-yl, 3-methylbutyn-1-yl, hexyl-1-yl, hexyl-2-yl, hexyl-3-yl, 3,3-dimethyl-butyn-1-yl, and the like. [0050] “Bridged cycloalkyl” refers to two or more cycloalkyl groups, heterocyclic groups, or a combination thereof fused via adjacent or non-adjacent atoms. Bridged cycloalkyl groups can be unsubstituted or substituted with one, two or three substituents independently selected from alkyl, alkoxy, amino, alkylamino, dialkylamino, hydroxy, halo, carboxyl, alkylcarboxylic acid, aryl, amidyl, ester, alkylcarboxylic ester, carboxamido, alkylcarboxamido, oxo and nitro. Exemplary bridged cycloalkyl groups include adamantyl, decahydronapthyl, quinuclidyl, 2,6-dioxabicyclo[3.3.0]octane, 7-oxabycyclo[2.2.1]heptyl, 8-azabicyclo[3,2,1]oct-2-enyl and the like. [0051] “Cycloalkyl” refers to a saturated or unsaturated cyclic hydrocarbon comprising from about 3 to about 10 carbon atoms. Cycloalkyl groups can be unsubstituted or substituted with one, two or three substituents independently selected from alkyl, alkoxy, amino, alkylamino, dialkylamino, arylamino, diarylamino, alkylarylamino, aryl, amidyl, ester, hydroxy, halo, carboxyl, alkylcarboxylic acid, alkylcarboxylic ester, carboxamido, alkylcarboxamido, oxo, alkylsulfinyl, and nitro. Exemplary cycloalkyl groups include cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cyclohexenyl, cyclohepta, 1,3-dienyl, and the like. [0052] “Heterocyclic ring or group” refers to a saturated or unsaturated cyclic hydrocarbon group having about 2 to about 10 carbon atoms (preferably about 4 to about 6 carbon atoms) where 1 to about 4 carbon atoms are replaced by one or more nitrogen, oxygen and/or sulfur atoms. Sulfur maybe in the thio, sulfinyl or sulfonyl oxidation state. The heterocyclic ring or group can be fused to an aromatic hydrocarbon group. Heterocyclic groups can be unsubstituted or substituted with one, two or three substituents independently selected from alkyl, alkoxy, amino, alkylthio, aryloxy, arylthio, arylalkyl, hydroxy, oxo, thial, halo, carboxyl, carboxylic ester, alkylcarboxylic acid, alkylcarboxylic ester, aryl, arylcarboxylic acid, arylcarboxylic ester, amidyl, ester, alkylcarbonyl, arylcarbonyl, alkylsulfinyl, carboxamido, alkylcarboxamido, arylcarboxamido, sulfonic acid, sulfonic ester, sulfonamido and nitro. Exemplary heterocyclic groups include pyrrolyl, 3-pyrrolinyl, 4,5,6-trihydro-2H-pyranyl, pyridinyl, 1,4-dihydropyridinyl, pyrazolyl, triazolyl, pyrimidinyl, pyridazinyl, oxazolyl, thiazolyl, imidazolyl, indolyl, thiophenyl, furanyl, tetrhydrofuranyl, tetrazolyl, pyrrolinyl, pyrrolindinyl, oxazolindinyl 1,3-dioxolanyl, imidazolinyl, imidazolindinyl, pyrazolinyl, pyrazolidinyl, isoxazolyl, isothiazolyl, 1,2,3-oxadiazolyl, 1,2,3-triazolyl, 1,3,4-thiadiazolyl, 2H-pyranyl, 4H-pyranyl, piperidinyl, 1,4-dioxanyl, morpholinyl, 1,4-dithianyl, thiomorpholinyl, pyrazinyl, piperazinyl, 1,3,5-triazinyl, 1,3,5-trithianyl, benzo(b)thiophenyl, benzimidazolyl, benzothiazolinyl, quinolinyl, and the like. [0053] “Heterocyclic compounds” refer to mono- and polycyclic compounds comprising at least one aryl or heterocyclic ring. [0054] “Aryl” refers to a monocyclic, bicyclic, carbocyclic or heterocyclic ring system comprising one or two aromatic rings. Exemplary aryl groups include phenyl, pyridyl, napthyl, quinoyl, tetrahydronaphthyl, furanyl, indanyl, indenyl, indoyl, and the like. Aryl groups (including bicyclic aryl groups) can be unsubstituted or substituted with one, two or three substituents independently selected from alkyl, alkoxy, alkylthio, amino, alkylamino, dialkylamino, arylamino, diarylamino, alkylarylamino, halo, cyano, alkylsulfinyl, hydroxy, carboxyl, carboxylic ester, alkylcarboxylic acid, alkylcarboxylic ester, aryl, arylcarboxylic acid, arylcarboxylic ester, alkylcarbonyl, arylcarbonyl, amidyl, ester, carboxamido, alkylcarboxamido, carbomyl, sulfonic acid, sulfonic ester, sulfonamido and nitro. Exemplary substituted aryl groups include tetrafluorophenyl, pentafluorophenyl, sulfonamide, alkylsulfonyl, arylsulfonyl, and the like. [0055] “Cycloalkenyl” refers to an unsaturated cyclic C2-C10 hydrocarbon (preferably a C2-C8 hydrocarbon, more preferably a C2-C6 hydrocarbon) which can comprise one or more carbon-carbon triple bonds. [0056] “Arylalkyl” refers to an aryl radical, as defined herein, attached to an alkyl radical, as defined herein. Exemplary arylalkyl groups include benzyl, phenylethyl, 4-hydroxybenzyl, 3-fluorobenzyl, 2-fluorophenylethyl, and the like. [0057] “Arylalkenyl” refers to an aryl radical, as defined herein, attached to an alkenyl radical, as defined herein. Exemplary arylalkenyl groups include styryl, propenylphenyl, and the like. [0058] “Cycloalkylalkyl” refers to a cycloalkyl radical, as defined herein, attached to an alkyl radical, as defined herein. [0059] “Cycloalkylalkoxy” refers to a cycloalkyl radical, as defined herein, attached to an alkoxy radical, as defined herein. [0060] “Cycloalkylalkylthio” refers to a cycloalkyl radical, as defined herein, attached to an alkylthio radical, as defined herein. [0061] “Heterocyclicalkyl” refers to a heterocyclic ring radical, as defined herein, attached to an alkyl radical, as defined herein. [0062] “Arylheterocyclic ring” refers to a bi- or tricyclic ring comprised of an aryl ring, as defined herein, appended via two adjacent carbon atoms of the aryl ring to a heterocyclic ring, as defined herein. Exemplary arylheterocyclic rings include dihydroindole, 1,2,3,4-tetra-hydroquinoline, and the like. [0063] “Alkoxy” refers to R50O—, wherein R50 is an alkyl group, as defined herein (preferably a lower alkyl group or a haloalkyl group, as defined herein). Exemplary alkoxy groups include methoxy, ethoxy, t-butoxy, cyclopentyloxy, trifluoromethoxy, and the like. [0064] “Aryloxy” refers to R55O—, wherein R55 is an aryl group, as defined herein. Exemplary aryloxy groups include napthyloxy, quinolyloxy, isoquinolizinyloxy, and the like. [0065] “Alkylthio” refers to R50S—, wherein R50 is an alkyl group, as defined herein. [0066] “Arylalkoxy or alkoxyaryl” refers to an alkoxy group, as defined herein, to which is appended an aryl group, as defined herein. Exemplary arylalkoxy groups include benzyloxy, phenylethoxy, chlorophenylethoxy, and the like. [0067] “Alkoxyalkyl” refers to an alkoxy group, as defined herein, appended to an alkyl group, as defined herein. Exemplary alkoxyalkyl groups include methoxymethyl, methoxyethyl, isopropoxymethyl, and the like. [0068] “Alkoxyhaloalkyl” refers to an alkoxy group, as defined herein, appended to a haloalkyl group, as defined herein. Exemplary alkoxyhaloalkyl groups include 4-methoxy-2-chlorobutyl and the like. [0069] “Cycloalkoxy” refers to R54O—, wherein R54 is a cycloalkyl group or a bridged cycloalkyl group, as defined herein. Exemplary cycloalkoxy groups include cyclopropyloxy, cyclopentyloxy, cyclohexyloxy, and the like. [0070] “Cycloalkylthio” refers to R54S—, wherein R54 is a cycloalkyl group or a bridged cycloalkyl group, as defined herein. Exemplary cycloalkylthio groups include cyclopropylthio, cyclopentylthio, cyclohexylthio, and the like. [0071] “Haloalkoxy” refers to an alkoxy group, as defined herein, in which one or more of the hydrogen atoms on the alkoxy group are substituted with halogens, as defined herein. [0072] Exemplary haloalkoxy groups include 1,1,1-trichloroethoxy, 2-bromobutoxy, and the like. [0073] “Hydroxy” refers to —OH. [0074] “Oxo” refers to ═O. [0075] “Oxy” refers to —O−R77+ wherein R77 is an organic or inorganic cation. [0076] “Organic cation” refers to a positively charged organic ion. Exemplary organic cations include alkyl substituted ammonium cations, and the like. [0077] “Inorganic cation” refers to a positively charged metal ion. Exemplary inorganic cations include Group I metal cations such as for example, sodium, potassium, and the like. [0078] “Hydroxyalkyl” refers to a hydroxy group, as defined herein, appended to an alkyl group, as defined herein. [0079] “Nitrate” refers to —O— NO2. [0080] “Nitrite” refers to —O— NO. [0081] “Thionitrate” refers to —S—NO2. [0082] “Thionitrite” and “nitrosothiol” refer to —S—NO. [0083] “Nitro” refers to the group —NO2 and “nitrosated” refers to compounds that have been substituted therewith. [0084] “Nitroso” refers to the group —NO and “nitrosylated” refers to compounds that have been substituted therewith. [0085] “Nitrile” and “cyano” refer to —CN. [0086] “Halogen” or “halo” refers to iodine (I), bromine (Br), chlorine (Cl), and/or fluorine (F). [0087] “Amino” refers to —NH2, an alkylamino group, a dialkylamino group, an arylamino group, a diarylamino group, an alkylarylamino group or a heterocyclic ring, as defined herein. [0088] “Alkylamino” refers to R50NH—, wherein R50 is an alkyl group, as defined herein. Exemplary alkylamino groups include methylamino, ethylamino, butylamino, cyclohexylamino, and the like. [0089] “Arylamino” refers to R55NH—, wherein R55 is an aryl group, as defined herein. [0090] “Dialkylamino” refers to R52R53N—, wherein R52 and R53 are each independently an alkyl group, as defined herein. Exemplary dialkylamino groups include dimethylamino, diethylamino, methyl propargylamino, and the like. [0091] “Diarylamino” refers to R55R60N—, wherein R55 and R60 are each independently an aryl group, as defined herein. [0092] “Alkylarylamino or arylalkylamino” refers to R52R55N—, wherein R52 is an alkyl group, as defined herein, and R55 is an aryl group, as defined herein. [0093] “Alkylarylalkylamino” refers to R52R79N—, wherein R52 is an alkyl group, as defined herein, and R79 is an arylalkyl group, as defined herein. [0094] “Alkylcycloalkylamino” refers to R52R80N—, wherein R52 is an alkyl group, as defined herein, and R80 is an cycloalkyl group, as defined herein. [0095] “Aminoalkyl” refers to an amino group, an alkylamino group, a dialkylamino group, an arylamino group, a diarylamino group, an alkylarylamino group or a heterocyclic ring, as defined herein, to which is appended an alkyl group, as defined herein. Exemplary aminoalkyl groups include dimethylaminopropyl, diphenylaminocyclopentyl, methylaminomethyl, and the like. [0096] “Aminoaryl” refers to an aryl group to which is appended an alkylamino group, a arylamino group or an arylalkylamino group. Exemplary aminoaryl groups include anilino, N-methylanilino, N-benzylanilino, and the like. [0097] “Thio” refers to —S—. [0098] “Sulfinyl” refers to —S(O)—. [0099] “Methanthial” refers to —C(S)—. [0100] “Thial” refers to ═S. [0101] “Sulfonyl” refers to —S(O)2−. [0102] “Sulfonic acid” refers to —S(O)2OR76, wherein R76 is a hydrogen, an organic cation or an inorganic cation, as defined herein. [0103] “Alkylsulfonic acid” refers to a sulfonic acid group, as defined herein, appended to an alkyl group, as defined herein. [0104] “Arylsulfonic acid” refers to an sulfonic acid group, as defined herein, appended to an aryl group, as defined herein [0105] “Sulfonic ester” refers to —S(O)2OR58, wherein R58 is an alkyl group, an aryl group or an aryl heterocyclic ring, as defined herein. [0106] “Sulfonamido” refers to —S(O)2—N(R51)(R57), wherein R51 and R57 are each independently a hydrogen atom, an alkyl group, an aryl group or an arylheterocyclic ring, as defined herein, or R51 and R57 when taken together are a heterocyclic ring, a cycloalkyl group or a bridged cycloalkyl group, as defined herein. [0107] “Alkylsulfonamido” refers to a sulfonamido group, as defined herein, appended to an alkyl group, as defined herein. [0108] “Arylsulfonamido” refers to a sulfonamido group, as defined herein, appended to an aryl group, as defined herein. [0109] “Alkylthio” refers to R50S—, wherein R50 is an alkyl group, as defined herein (preferably a lower alkyl group, as defined herein). [0110] “Arylthio” refers to R55S—, wherein R55 is an aryl group, as defined herein. [0111] “Arylalkylthio” refers to an aryl group, as defined herein, appended to an alkylthio group, as defined herein. [0112] “Alkylsulfinyl” refers to R50—S(O)—, wherein R50 is an alkyl group, as defined herein. [0113] “Alkylsulfonyl” refers to R50—S(O)2—, wherein R50 is an alkyl group, as defined herein. [0114] “Alkylsulfonyloxy” refers to R50—S(O)2—O—, wherein R50 is an alkyl group, as defined herein. [0115] “Arylsulfinyl” refers to R55—S(O)—, wherein R55 is an aryl group, as defined herein. [0116] “Arylsulfonyl” refers to R55—S(O)2—, wherein R55 is an aryl group, as defined herein. [0117] “Arylsulfonyloxy” refers to R55—S(O)2—O—, wherein R55 is an aryl group, as defined herein. [0118] “Amidyl” refers to R51C(O)N(R57)— wherein R51 and R57 are each independently a hydrogen atom, an alkyl group, an aryl group or an arylheterocyclic ring, as defined herein. [0119] “Ester” refers to R51C(O)O— wherein R51 is a hydrogen atom, an alkyl group, an aryl group or an arylheterocyclic ring, as defined herein. [0120] “Carbamoyl” refers to —O—C(O)N(R51)(R57), wherein R51 and R57 are each independently a hydrogen atom, an alkyl group, an aryl group or an arylheterocyclic ring, as defined herein, or R51 and R57 taken together are a heterocyclic ring, a cycloalkyl group or a bridged cycloalkyl group, as defined herein. [0121] “Carboxyl” refers to —C(O)OR76, wherein R76 is a hydrogen, an organic cation or an inorganic cation, as defined herein. [0122] “Carbonyl” refers to —C(O)—. [0123] “Alkylcarbonyl” refers to R52—C(O)—, wherein R52 is an alkyl group, as defined herein. [0124] “Arylcarbonyl” refers to R55—C(O)—, wherein R55 is an aryl group, as defined herein. [0125] “Arylalkylcarbonyl” refers to R55—R52—C(O)—, wherein R55 is an aryl group, as defined herein, and R52 is an alkyl group, as defined herein. [0126] “Alkylarylcarbonyl” refers to R52—R55—C(O)—, wherein R55 is an aryl group, as defined herein, and R52 is an alkyl group, as defined herein. [0127] “Heterocyclicalkylcarbonyl” refer to R78C(O)— wherein R78 is a heterocyclicalkyl group, as defined herein. [0128] “Carboxylic ester” refers to —C(O)OR58, wherein R58 is an alkyl group, an aryl group or an aryl heterocyclic ring, as defined herein. [0129] “Alkylcarboxylic acid” and “alkylcarboxyl” refer to an alkyl group, as defined herein, appended to a carboxyl group, as defined herein. [0130] “Alkylcarboxylic ester” refers to an alkyl group, as defined herein, appended to a carboxylic ester group, as defined herein. [0131] “Arylcarboxylic acid” refers to an aryl group, as defined herein, appended to a carboxyl group, as defined herein. [0132] “Arylcarboxylic ester” and “arylcarboxyl” refer to an aryl group, as defined herein, appended to a carboxylic ester group, as defined herein. [0133] “Carboxamido” refers to —C(O)N(R51)(R57), wherein R51 and R57 are each independently a hydrogen atom, an alkyl group, an aryl group or an arylheterocyclic ring, as defined herein, or R51 and R57 when taken together are a heterocyclic ring, a cycloalkyl group or a bridged cycloalkyl group, as defined herein. [0134] “Alkylcarboxamido” refers to an alkyl group, as defined herein, appended to a carboxamido group, as defined herein. [0135] “Arylcarboxamido” refers to an aryl group, as defined herein, appended to a carboxamido group, as defined herein. [0136] “Urea” refers to —N(R59)—C(O)N(R51)(R57) wherein R51, R57, and R59 are each independently a hydrogen atom, an alkyl group, an aryl group or an arylheterocyclic ring, as defined herein, or R51 and R57 taken together are a heterocyclic ring, a cycloalkyl group or a bridged cycloalkyl group, as defined herein. [0137] “Phosphoryl” refers to —P(R70)(R71)(R72), wherein R70 is a lone pair of electrons, thial or oxo, and R71 and R72 are each independently a covalent bond, a hydrogen, a lower alkyl, an alkoxy, an alkylamino, a hydroxy, an oxy or an aryl, as defined herein. [0138] “Silyl” refers to —Si(R73)(R74)(R75), wherein R73, R74 and R75 are each independently a covalent bond, a lower alkyl, an alkoxy, an aryl or an arylalkoxy, as defined herein. [0139] Compounds that donate, transfer or release nitric oxide species in vivo have been recognized as having a wide spectrum of advantages and applications. The present invention is based on the unexpected discovery of the effects of such compounds alone and together with one or more COX-2 inhibitors. Treatment or prevention of inflammation, pain and fever; treatment and/or improvement of the gastrointestinal properties of COX-2 inhibitors; facilitation of wound healing; and treatment and/or prevention of renal toxicity and cyclooxygenase-2 mediated disorders can be obtained by the use of COX-2 inhibitors of the present invention; or by the use of COX-2 inhibitors in conjunction with one or more compounds that donate, release or transfer nitric oxide and/or stimulate endogenous production of NO and/or EDRF in vivo and/or is a substrate for nitric oxide synthase, and, optionally, with one or more therapeutic agents. [0140] In one embodiment, the present invention describes nitrosated and/or nitrosylated COX-2 inhibitors of Formula (I): 1 [0141] wherein: [0142] when side b is a double bond, and sides a and c are single bonds, —X1—Y1—Z1— is: [0143] (a) —CR4(R5)—CR5(R5)—CR4(R5)—; [0144] (b) —C(O)—CR4(R4′)—CR5(R5′)—; [0145] (c) —CR4(R4′)—CR5(R5′)—C(O)—; [0146] (d) —(CR5(R5′))k—O—C(O)—; [0147] (e) —C(O)—O—(CR5(R5′))k—; [0148] (f) —CR4(R4′)—NR3—CR5(R5′)—; [0149] (g) —CR5(R5′)—NR3—C(O)—; [0150] (h) —CR4═CR4′—S—; [0151] (i) —S—CR4═CR4′—; [0152] (j) —S—N═CR4—; [0153] (k) —CR4═N—S—; [0154] (l) —N═CR4—O—; [0155] (m) —O—CR4═N—; [0156] (n) —NR3—CR4═N—; [0157] (O) —N═CR4 S; [0158] (p) —S—CR4═N—; [0159] (q) —C(O)—NR3—CR5′(R5′)—; [0160] (r) —R3N—CR5═C R5′—; [0161] (s) —CR4═CR5—NR3—; [0162] (t) —O—N═CR4—; [0163] (u) —CR4═N—O—; [0164] (v) —N═N—S—; [0165] (w) —S—N═N—; [0166] (x) —R3N—CR4═N—; [0167] (y) —N═CR4—NR3—; [0168] (z) —R3N—N═N—; [0169] (aa) —N═N—NR3—; [0170] (bb) —CR4(R4)—O—CR5(R5′)—; [0171] (cc) —CR4(R4)—S—CR5(R5′)—; [0172] (dd) —CR4(R4′)—C(O)—CR5(R5′)—; [0173] (ee) —CR4(R4)—CR5(R5′)—C(S)—; [0174] (ff) —(CR5(R5′))k—O—C(S)—; [0175] (gg) —C(S)—O—(CR5(R5′))k—; [0176] (hh) —(CR5(R5′))k—NR3—C(S)—; [0177] (ii) —C(S)—NR3—(CR5(R5′))k—; [0178] (jj) —(CR5(R5′))k—S—C(O)—; [0179] (kk) —C(O)—S—(CR5(R5′))k—; [0180] (ll) —O—CR═CR5—; [0181] (mm) —CR4═CR5—O—; [0182] (nn) —C(O)—NR3—S—; [0183] (oo) —S—NR3—C(O)—; [0184] (pp) —C(O)—NR3—O—; [0185] (qq) —O—NR3—C(O)—; [0186] (rr) —NR3—CR4═CR5—; [0187] (ss) —CR4═N—NR3—; [0188] (tt) —NR3—N═CR4—; [0189] (uu) —C(O)—NR3—NR3—; [0190] (vv) —NR3—NR3—C(O)—; [0191] (ww) —C(O)—O—NR3—; [0192] (xx) —NR3—O—C(O)—; [0193] (yy) —CR4R4—CR5R5; [0194] (zz) —C(O)—CR4R4′— [0195] (aaa) —CR4R4′—C(O)—; [0196] (bbb) —C(S)—CR4R4′—; [0197] (ccc) —CR4R4′—C(S)—; [0198] (ddd) —C(═NR3)—CR4R4′—; [0199] (eee) —CR4R4′—C(═NR3)—; [0200] (fff) —O—CR4R4′—C(S)—; or [0201] (ggg) —O—CR4R4′—C(O)—; [0202] when sides a and c are double bonds and side b is a single bond, —X1—Y1—Z1— is: [0203] (a) ═CR4—O—CR5═; [0204] (b) ═CR4—NR3—CR5═; [0205] (c) ═N—S—CR4═; [0206] (d) ═CR4—S—N═; [0207] (e) ═N—O—CR4═; [0208] (f) ═CR4—O—N═; [0209] (g) ═N—S—N═; [0210] (h) ═N—O—N═; [0211] (i) ═N—NR3—CR4═; [0212] (j) ═CR4—NR3—N═; [0213] (k) ═N—NR3—N═; [0214] (l) ═CR4—S—CR5═; or [0215] (m) ═CR4—CR4(R4′)—CR5═; [0216] R1 is: [0217] (a) —S(O)2—C(XRjRk); or [0218] (b) —S(O)—C(XRjRk); [0219] R1′ is: [0220] (a) hydrogen; [0221] (b) halogen; [0222] (c) methyl; or [0223] (d) CH2OH; [0224] R2 is: [0225] (a) lower alkyl; [0226] (b) cycloalkyl; [0227] (c) mono-, di- or tri-substituted phenyl or naphthyl, wherein the substituents are each independently: [0228] (1) hydrogen; [0229] (2) halo; [0230] (3) alkoxy; [0231] (4) alkylthio; [0232] (5) CN; [0233] (6) haloalkyl, preferably CF3; [0234] (7) lower alkyl; [0235] (8) N3; [0236] (9) —CO2D1; [0237] (10) —CO2-lower alkyl; [0238] (11) —(C(R5)(R6))z—OD1; [0239] (12) —(C(R5)(R6))z—O-lower alkyl; [0240] (13) lower alkyl-CO2—R5; [0241] (14) —OD1; [0242] (15) haloalkoxy; [0243] (16) amino; [0244] (17) nitro; [0245] (18) alkylsulfinyl; or [0246] (19) heteroaryl; [0247] (d) mono-, di- or tri-substituted heteroaryl, wherein the heteroaryl is a monocyclic aromatic ring of 5 atoms, said ring having one heteroatom which is S, O, or N, and, optionally, 1, 2, or 3 additional N atoms; or the heteroaryl is a monocyclic ring of 6 atoms, said ring having one heteroatom which is N, and, optionally, 1, 2, 3, or 4 additional N atoms; wherein the substituents are each independently: [0248] (1) hydrogen; [0249] (2) halo; [0250] (3) lower alkyl; [0251] (4) alkoxy; [0252] (5) alkylthio; [0253] (6) CN; [0254] (7) haloalkyl, preferably CF3; [0255] (8) N3; [0256] (9) —C(R5)(R6)—OD1; [0257] (10) —C(R5)(R6)—O-lower alkyl; or [0258] (11) alkylsulfinyl; [0259] (e) benzoheteroaryl which includes the benzo fused analogs of (d); [0260] (f) —NR10 R11; [0261] (g) —SR11; [0262] (h) —OR11; [0263] (i) —R11; [0264] (j) alkenyl; [0265] (k) alkynyl; [0266] (l) unsubstituted, mono-, di-, tri- or tetra-substituted cycloalkenyl, wherein the substituents are each independently: [0267] (1) halo; [0268] (2) alkoxy; [0269] (3) alkylthio; [0270] (4) CN; [0271] (5) haloalkyl, preferably CF3; [0272] (6) lower alkyl; [0273] (7) N3; [0274] (8) —CO2D1; [0275] (9) —CO2-lower alkyl; [0276] (10) —C(R12)(R13)—OD1; [0277] (11) —C(R12)(R13)—O-lower alkyl; [0278] (12) lower alkyl-CO2—R12; [0279] (13) benzyloxy; [0280] (14) —O-(lower alkyl)-CO2R [0281] (15) —O-(lower alkyl)-NR12R13; or [0282] (16) alkylsulfinyl; [0283] (m) mono-, di-, tri- or tetra-substituted heterocycloalkyl group of 5, 6 or 7 members, or a benzoheterocycle, wherein said heterocycloalkyl or benzoheterocycle contains 1 or 2 heteroatoms selected from O, S, or N and, optionally, contains a carbonyl group or a sulfonyl group, and wherein said substituents are each independently: [0284] (1) halo; [0285] (2) lower alkyl; [0286] (3) alkoxy; [0287] (4) alkylthio; [0288] (5) CN; [0289] (6) haloalkyl, preferably CF3; [0290] (7) N3; [0291] (8) —C(R2)(R13)—OD1; [0292] (9) —C(R12)(R3)—O-lower alkyl; or [0293] (10) alkylsulfinyl; [0294] (n) styryl, mono or di-substituted styryl, wherein the substituent are each independently: [0295] (1) halo; [0296] (2) alkoxy; [0297] (3) alkylthio; [0298] (4) CN; [0299] (5) haloalkyl, preferably CF3; [0300] (6) lower alkyl; [0301] (7) N3; [0302] (8) —CO2D1; [0303] (9) —CO2-lower alkyl; [0304] (10) —C(R12)(R13)—OD1; [0305] (11) —C(R12)(R13)—O-lower alkyl; [0306] (12) lower alkyl-CO2—R12; [0307] (13) benzyloxy; [0308] (14) —O-(lower alkyl)-CO2R12; or [0309] (15) —O-(lower alkyl)-NR12R13; [0310] (o) phenylacetylene, mono- or di-substituted phenylacetylene, wherein the substituents are each independently: [0311] (1) halo; [0312] (2) alkoxy; [0313] (3) alkylthio; [0314] (4) CN; [0315] (5) haloalkyl, preferably CF3; [0316] (6) lower alkyl; [0317] (7) N3; [0318] (8) —CO2D1; [0319] (9) —CO2-lower alkyl; [0320] (10) —C(R2)(R13)—OD1; [0321] (11) —C(R2)(R13)—O-lower alkyl; [0322] (12) lower alkyl-CO2—R12; [0323] (13) benzyloxy; [0324] (14) —O-(lower alkyl)-CO2R12; or [0325] (15) —O-(lower alkyl)-NR12R13; [0326] (p) fluoroalkenyl; [0327] (q) mono-or di-substituted bicyclic heteroaryl of 8, 9 or 10 members, containing 2, 3, 4 or 5 heteroatoms, wherein at least one heteroatom resides on each ring of said bicyclic heteroaryl, said heteroatoms are each independently O, S and N and said substituents are each independently: [0328] (1) hydrogen; [0329] (2) halo; [0330] (3) lower alkyl; [0331] (4) alkoxy; [0332] (5) alkylthio; [0333] (6) CN; [0334] (7) haloalkyl, preferably CF3; [0335] (8) N3; [0336] (9) —C(R5)(R6)—OD1; or [0337] (10) —C(R5)(R6)—O-lower alkyl; [0338] (r) K; [0339] (s) aryl; [0340] (t) arylalkyl; [0341] (u) cycloalkylalkyl; [0342] (v) —C(O)R11; [0343] (u) hydrogen; [0344] (v) arylalkenyl; [0345] (w) arylalkoxy; [0346] (x) alkoxy; [0347] (y) aryloxy; [0348] (z) cycloalkoxy; [0349] (aa) arylthio; [0350] (bb) alkylthio; [0351] (cc) arylalkylthio; or [0352] (dd) cycloalkylthio; [0353] R3 is: [0354] (a) hydrogen; [0355] (b) haloalkyl, preferably CF3; [0356] (c) CN; [0357] (d) lower alkyl; [0358] (e) —(C(Re)(Rf))p—U—V; [0359] (f) K; [0360] (g) unsubstituted or substituted: [0361] (1) lower alkyl-Q; [0362] (2) lower alkyl-O— lower alkyl-Q; [0363] (3) lower alkyl-S-lower alkyl-Q; [0364] (4) lower alkyl-O—Q; [0365] (5) lower alkyl-S—Q; [0366] (6) lower alkyl-O—V; [0367] (7) lower alkyl-S—V; [0368] (8) lower alkyl-O—K; or [0369] (9) lower alkyl-S—K; [0370] wherein the substituent(s) reside on the lower alkyl group; [0371] (h) Q; [0372] (i) alkylcarbonyl; [0373] (j) arylcarbonyl; [0374] (k) alkylarylcarbonyl; [0375] (l) arylalkylcarbonyl; [0376] (m) carboxylic ester; [0377] (n) carboxamido; [0378] (o) cycloalkyl; [0379] (p) mono-, di- or tri-substituted phenyl or naphthyl, wherein the substituents are each independently: [0380] (1) hydrogen; [0381] (2) halo; [0382] (3) alkoxy; [0383] (4) alkylthio; [0384] (5) CN; [0385] (6) haloalkyl, preferably CF3; [0386] (7) lower alkyl; [0387] (8) N3; [0388] (9) —CO2D1; [0389] (10) —CO2-lower alkyl; [0390] (11) —(C(R5)(R6))z—OD1; [0391] (12) —(C(R5)(R6))z—O-lower alkyl; [0392] (13) lower alkyl-CO2—R5 [0393] (14) —OD1; [0394] (15) haloalkoxy; [0395] (16) amino; [0396] (17) nitro; or [0397] (18) alkylsulfinyl; [0398] (q) alkenyl; [0399] (r) alkynyl; [0400] (s) arylalkyl; [0401] (t) lower alkyl-OD1; [0402] (u) alkoxyalkyl; [0403] (v) aminoalkyl; [0404] (w) lower alkyl-CO2R10; [0405] (x) lower alkyl-C(O)NR10(R10′); [0406] (y) heterocyclicalkyl; or [0407] (z) heterocyclic ring-C(O)—; [0408] R4, R4′, R5 and R5′ are each independently: [0409] (a) hydrogen; [0410] (b) amino; [0411] (c) CN; [0412] (d) lower alkyl; [0413] (e) haloalkyl; [0414] (f) alkoxy; [0415] (g) alkylthio; [0416] (h) Q; [0417] (i) —O—Q; [0418] (j) —S—Q; [0419] (k) K; [0420] (l) cycloalkoxy; [0421] (m) cycloalkylthio; [0422] (n) unsubstituted, mono-, or di-substituted phenyl or unsubstituted, mono-, or di-substituted benzyl, wherein the substituents are each independently: [0423] (1) halo; [0424] (2) lower alkyl; [0425] (3) alkoxy; [0426] (4) alkylthio; [0427] (5) CN; [0428] (6) haloalkyl, preferably CF3; [0429] (7) N3; [0430] (8) Q; [0431] (9) nitro; or [0432] (10) amino; [0433] (o) unsubstituted, mono-, or di-substituted heteroaryl or unsubstituted, mono-, or di-substituted heteroarylmethyl, wherein the heteroaryl is a monocyclic aromatic ring of 5 atoms, said ring having one heteroatom which is S, O, or N, and, optionally, 1, 2, or 3 additional N atoms; or the heteroaryl is a monocyclic ring of 6 atoms, said ring having one heteroatom which is N, and, optionally, 1, 2, 3, or 4 additional N atoms; said substituents are each independently: [0434] (1) halo; [0435] (2) lower alkyl; [0436] (3) alkoxy; [0437] (4) alkylthio; [0438] (5) CN; [0439] (6) haloalkyl, preferably CF3; [0440] (7) N3; [0441] (8) —C(R6)(R7)—OD1; [0442] (9) —C(R6)(R7)—O-lower alkyl; or [0443] (10) alkylsulfinyl [0444] (p) —CON(R8)(R8); [0445] (q) —CH2OR8; [0446] (r) —CH2OCN; [0447] (s) unsubstituted or substituted: [0448] (1) lower alkyl-Q; [0449] (2) —O-lower alkyl-Q; [0450] (3) —S-lower alkyl-Q; [0451] (4) lower alkyl-O-lower alkyl-Q; [0452] (5) lower alkyl-S-lower alkyl-Q; [0453] (6) lower alkyl-O—Q; [0454] (7) lower alkyl-S—Q; [0455] (8) lower alkyl-O—K; [0456] (9) lower alkyl-S—K; [0457] (10) lower alkyl-O—V; or [0458] (11) lower alkyl-S—V; [0459] wherein the substituent(s) resides on the lower alkyl; [0460] (t) cycloalkyl; [0461] (u) aryl; [0462] (v) arylalkyl; [0463] (w) cycloalkylalkyl; [0464] (x) aryloxy; [0465] (y) arylalkoxy; [0466] (z) arylalkylthio; [0467] (aa) cycloalkylalkoxy; [0468] (bb) heterocycloalkyl; [0469] (cc) alkylsulfonyloxy; [0470] (dd) alkylsulfonyl; [0471] (ee) arylsulfonyl; [0472] (ff) arylsulfonyloxy; [0473] (gg) —C(O)R10; [0474] (hh) nitro; [0475] (ii) amino; [0476] (jj) aminoalkyl; [0477] (kk) —C(O)-alkyl-heterocyclic ring; [0478] (ll) halo; [0479] (mm) heterocyclic ring; [0480] (nn) —CO2D1; [0481] (oo) carboxyl; [0482] (pp) amidyl; or [0483] (qq) alkoxyalkyl; [0484] alternatively, R4 and R5 together with the carbons to which they are attached are: [0485] (a) cycloalkyl; [0486] (b) aryl; or [0487] (c) heterocyclic ring; [0488] alternatively, R4 and R4′ or R5 and R5′ taken together with the carbon to which they are attached are: [0489] (a) cycloalkyl; or [0490] (b) heterocyclic ring; [0491] alternatively, R4 and R5, R4′ and R5′, R4 and R5′, or R4′ and R5 when substituents on adjacent carbon atoms taken together with the carbons to which they are attached are: [0492] (a) cycloalkyl; [0493] (b) heterocyclic ring; or [0494] (c) aryl; [0495] R6 and R7 are each independently: [0496] (a) hydrogen; [0497] (b) unsubstituted, mono- or di-substituted phenyl; unsubstituted, mono- or di-substituted benzyl; unsubstituted, mono- or di-substituted heteroaryl; mono- or di-substituted heteroarylmethyl, wherein said substituents are each independently: [0498] (1) halo; [0499] (2) lower alkyl; [0500] (3) alkoxy; [0501] (4) alkylthio; [0502] (5) CN; [0503] (6) haloalkyl, preferably CF3; [0504] (7) N3; [0505] (8) —C(R14)(R15)—OD1; or [0506] (9) —C(R14)(R15)—O-lower alkyl; [0507] (c) lower alkyl; [0508] (d) —CH2OR8; [0509] (e) CN; [0510] (f) —CH2CN; [0511] (g) haloalkyl, preferably fluoroalkyl; [0512] (h) —CON(R8)(R8); [0513] (i) halo; or [0514] (j) —OR8; [0515] R8 is: [0516] (a) hydrogen; [0517] (b) K; or [0518] (c) R9; [0519] alternatively, R5 and R5′, R6 and R7 or R7 and R8 together with the carbon to which they are attached form a saturated monocyclic ring of 3, 4, 5, 6 or 7 atoms; optionally containing up to two heteroatoms selected from oxygen, S(O)o or NR1; [0520] R9 is: [0521] (a) lower alkyl; [0522] (b) lower alkyl-CO2D1; [0523] (c) lower alkyl-NHD1; [0524] (d) phenyl or mono-, di- or tri-substituted phenyl, wherein the substituents are each independently: [0525] (1) halo; [0526] (2) lower alkyl; [0527] (3) alkoxy; [0528] (4) alkylthio; [0529] (5) lower alkyl-CO2D1; [0530] (6) lower alkyl-NHD1; [0531] (7) CN; [0532] (8) CO2D1; or [0533] (9) haloalkyl, preferably fluoroalkyl; [0534] (e) benzyl, mono-, di- or tri-substituted benzyl, wherein the substituents are each independently: [0535] (1) halo; [0536] (2) lower alkyl; [0537] (3) alkoxy; [0538] (4) alkylthio; [0539] (5) lower alkyl-CO2D1; [0540] (6) lower alkyl-NHD1; [0541] (7) CN; [0542] (8) —CO2D1; or [0543] (9) haloalkyl, preferably CF3; [0544] (f) cycloalkyl; [0545] (g) K; or [0546] (h) benzoyl, mono-, di-, or trisubstituted benzoyl, wherein the substituents are each independently: [0547] (1) halo; [0548] (2) lower alkyl; [0549] (3) alkoxy; [0550] (4) alkylthio; [0551] (5) lower alkyl-CO2D1; [0552] (6) lower alkyl-NHD1; [0553] (7) CN; [0554] (8) —CO2D1; or [0555] (9) haloalkyl, preferably CF3; [0556] R10 and R10′ are each independently: [0557] (a) hydrogen; or [0558] (b) R11; [0559] R11 is: [0560] (a) lower alkyl; [0561] (b) cycloalkyl; [0562] (c) unsubstituted, mono-, di- or tri-substituted phenyl or naphthyl, wherein the substituents are each independently: [0563] (1) halo; [0564] (2) alkoxy; [0565] (3) alkylthio; [0566] (4) CN; [0567] (5) haloalkyl, preferably CF3; [0568] (6) lower alkyl; [0569] (7) N3; [0570] (8) —CO2D1; [0571] (9) —CO2-lower alkyl; [0572] (10) —C(R12)(R13)—OD; [0573] (11) —C(R12)(R13)—O-lower alkyl; [0574] (12) lower alkyl-CO2D1; [0575] (13) lower alkyl-CO2R12; [0576] (14) benzyloxy; [0577] (15) —O-(lower alkyl)-CO2D1; 12 [0578] (16) —O-(lower alkyl)-CO2R12; or [0579] (17) —O-(lower alkyl)-NR12R13; [0580] (d) unsubstituted, mono-, di- or tri-substituted heteroaryl, wherein the heteroaryl is a monocyclic aromatic ring of 5 atoms, said ring having one heteroatom which is S, O, or N, and, optionally, 1, 2, or 3 additional N atoms; or said heteroaryl is a monocyclic ring of 6 atoms, said ring having one heteroatom which is N, and, optionally 1, 2, or 3 additional N atoms, and wherein said substituents are each independently: [0581] (1) halo; [0582] (2) lower alkyl; [0583] (3) alkoxy; [0584] (4) alkylthio; [0585] (5) CN; [0586] (6) haloalkyl, preferably CF3; [0587] (7) N3; [0588] (8) —C(R12)(R13)—OD1; or [0589] (9) —C(R12)(R13)—O-lower alkyl; [0590] (e) unsubstituted, mono- or di-substituted benzoheterocycle, wherein the benzoheterocycle is a 5, 6, or 7-membered ring which contains 1 or 2 heteroatoms independently selected from O, S, or N, and, optionally, a carbonyl group or a sulfonyl group, wherein said substituents are each independently: [0591] (1) halo; [0592] (2) lower alkyl; [0593] (3) alkoxy; [0594] (4) alkylthio; [0595] (5) CN; [0596] (6) haloalkyl, preferably CF3; [0597] (7) N3; [0598] (8) —C(R12)(R13)—OD1; or [0599] (9) —C(R12)(R13)—O-lower alkyl; [0600] (f) unsubstituted, mono- or di-substituted benzocarbocycle, wherein the carbocycle is a 5, 6, or 7-membered ring which optionally contains a carbonyl group, wherein said substituents are each independently: [0601] (1) halo; [0602] (2) lower alkyl; [0603] (3) alkoxy; [0604] (4) alkylthio; [0605] (5) CN; [0606] (6) haloalkyl, preferably CF3; [0607] (7) N3; [0608] (8) —C(R12)(R13)—OD1; or [0609] (9) —C(R12)(R13)—O-lower alkyl; [0610] (g) hydrogen; or [0611] (h) K [0612] R12 and R13 are each independently: [0613] (a) hydrogen; [0614] (b) lower alkyl; or [0615] (c) aryl; or [0616] R12 and R13 together with the atom to which they are attached form a saturated monocyclic ring of 3, 4, 5, 6 or 7 atoms; [0617] R14 and R15 are each independently: [0618] (a) hydrogen; or [0619] (b) lower alkyl; or [0620] R14 and R15 together with the atom to which they are attached form a carbonyl, a thial, or a saturated monocyclic ring of 3, 4, 5, 6 or 7 atoms; [0621] Rj and Rk are each independently: [0622] (a) hydrogen; or [0623] (b) halogen, preferably flourine; [0624] X is halogen; [0625] D1 is: [0626] (a) hydrogen or [0627] (b) D; [0628] D is: [0629] (a) V; or [0630] (b) K; [0631] U is: [0632] (a) oxygen; [0633] (b) sulfur; or [0634] (c) —N(Ra)(R1)—; [0635] V is: [0636] (a) —NO; [0637] (b) —NO2; or [0638] (c) hydrogen [0639] K is —Waa—Eb—(C(Re)(Rf))p—Ec—(C(Re)(Rf))x—Wd—(C(Re)(Rf))y—Wi—Ej—Wg—(C(Re)(Rf))z—U—V; wherein aa, b, c, d, g, i and j are each independently an integer from 0 to 3; [0640] p, x, y and z are each independently an integer from 0 to 10; [0641] W at each occurrence is independently: [0642] (a) —C(O)—; [0643] (b) —C(S)—; [0644] (c) —T—; [0645] (d) —(C(Re)(Rf))h—; [0646] (e) alkyl; [0647] (f) aryl; [0648] (g) heterocyclic ring; [0649] (h) arylheterocyclic ring, or [0650] (i) —(CH2CH2O)q—; [0651] E at each occurrence is independently: [0652] (a) —T—; [0653] (b) alkyl; [0654] (c) aryl; [0655] (d) —(C(Re)(Rf))h—; [0656] (e) heterocyclic ring; [0657] (f) arylheterocyclic ring; or [0658] (g) —(CH2CH2O)q—; [0659] h is an integer form 1 to 10; [0660] q is an integer from 1 to 5; [0661] Re and Rf are each independently: [0662] (a) hydrogen; [0663] (b) alkyl; [0664] (c) cycloalkoxy; [0665] (d) halogen; [0666] (e) hydroxy; [0667] (f) hydroxyalkyl; [0668] (g) alkoxyalkyl; [0669] (h) arylheterocyclic ring; [0670] (i) cycloalkylalkyl; [0671] (j) heterocyclicalkyl; [0672] (k) alkoxy; [0673] (l) haloalkoxy; [0674] (m) amino; [0675] (n) alkylamino; [0676] (o) dialkylamino; [0677] (p) arylamino; [0678] (q) diarylamino; [0679] (r) alkylarylamino; [0680] (s) alkoxyhaloalkyl; [0681] (t) haloalkoxy; [0682] (u) sulfonic acid; [0683] (v) alkylsulfonic acid; [0684] (w) arylsulfonic acid; [0685] (x) arylalkoxy; [0686] (y) alkylthio; [0687] (z) arylthio; [0688] (aa) cyano; [0689] (bb) aminoalkyl; [0690] (cc) aminoaryl; [0691] (dd) alkoxy; [0692] (ee) aryl; [0693] (ff) arylalkyl; [0694] (gg) carboxamido; [0695] (hh) alkylcarboxamido; [0696] (ii) arylcarboxamido; [0697] (jj) amidyl; [0698] (kk) carboxyl; [0699] (ll) carbamoyl; [0700] (mm) alkylcarboxylic acid; [0701] (nn) arylcarboxylic acid; [0702] (oo) alkylcarbonyl; [0703] (pp) arylcarbonyl; [0704] (qq) ester; [0705] (rr) carboxylic ester; [0706] (ss) alkylcarboxylic ester; [0707] (tt) arylcarboxylic ester; [0708] (uu) haloalkoxy; [0709] (vv) sulfonamido; [0710] (ww) alkylsulfonamido; [0711] (xx) arylsulfonamido; [0712] (yy) alkylsulfonyl, [0713] (zz) alkylsulfonyloxy, [0714] (aaa) arylsulfonyl, [0715] (bbb) arylsulphonyloxy [0716] (ccc) sulfonic ester; [0717] (ddd) carbamoyl; [0718] (eee) urea; [0719] (fff) nitro; or [0720] (ggg) —U—V; or [0721] Re and Rf taken together are: [0722] (a) oxo; [0723] (b) thial; or [0724] Re and Rf taken together with the carbon to which they are attached are: [0725] (a) heterocyclic ring; [0726] (b) cycloalkyl group; or [0727] (c) bridged cycloalkyl group; [0728] k is an integer from 1 to 2; [0729] T at each occurrence is independently: [0730] (a) a covalent bond, [0731] (b) carbonyl, [0732] (c) an oxygen, [0733] (d) —S(O)o—; or [0734] (e) —N(Ra)(R1)—; [0735] o is an integer from 0 to 2; [0736] Q is: [0737] (a) —C(O)—U—D1; [0738] (b) —CO2-lower alkyl; [0739] (c) tetrazolyl-5-yl; [0740] (d) —C(R7)(R8)(S—D1); [0741] (e) —C(R7)(R8)(O—D1); or [0742] (f) —C(R7)(R8)(O-lower alkyl); [0743] Ra is: [0744] (a) a lone pair of electron; [0745] (b) hydrogen; or [0746] (c) lower alkyl; [0747] Ri is: [0748] (a) hydrogen; [0749] (b) alkyl; [0750] (c) aryl; [0751] (d) alkylcarboxylic acid; [0752] (e) arylcarboxylic acid; [0753] (f) alkylcarboxylic ester; [0754] (g) arylcarboxylic ester; [0755] (h) alkylcarboxamido; [0756] (i) arylcarboxamido; [0757] (j) alkylsulfinyl; [0758] (k) alkylsulfonyl; [0759] (l) alkylsulfonyloxy, [0760] (m) arylsulfinyl; [0761] (n) arylsulfonyl; [0762] (o) arylsulphonyloxy; [0763] (p) sulfonamido; [0764] (q) carboxamido; [0765] (r) carboxylic ester; [0766] (s) aminoalkyl; [0767] (t) aminoaryl; [0768] (u) —CH2—C(U—V)(Re)(Rf); [0769] (v) a bond to an adjacent atom creating a double bond to that atom; or [0770] (w) —(N2O2—)−.M+, wherein M+ is an organic or inorganic cation. [0771] In cases where Re and Rf are a heterocyclic ring or Re and Rf taken together with the carbon atoms to which they are attached are a heterocyclic ring, then R1 can be a substituent on any disubstituted nitrogen contained within the radical where Ri is as defined herein. [0772] In cases where multiple designations of variables which reside in sequence are chosen as a “covalent bond” or the integer chosen is 0, the intent is to denote a single covalent bond connecting one radical to another. For example, E0 would denote a covalent bond, while E2 denotes (E-E) and (C(Re)(Rf))2 denotes —C(Re)(Rf)—C(Re)(Rf)—. [0773] Another embodiment of the present invention provides nitrosated and/or nitrosylated compounds of Formula (II): 2 [0774] wherein: [0775] A—B is: [0776] (a) N—C; [0777] (b) C—N; or [0778] (c) N—N; [0779] when sides d and f are double bonds, and sides e and g are single bonds, —X2—Y2—Z2— is: [0780] (a) ═CR4—CR4′═CR5—; [0781] (b) ═N—CR4═CR4′—; [0782] (c) ═N—CR4═N—; [0783] (d) ═CR4—N═CR4′; [0784] (e) ═CR4—N═N—; [0785] (f) ═N—N═CR4—; [0786] (g) ═N—N═N—; [0787] (h) ═CR4—CR5═N—; or [0788] (i) ═CR2—CR5═N—; [0789] R2 and R2′ taken together are: 3 [0790] or R2′ and R5 taken together with the carbon atoms to which they are attached are: [0791] (a) cycloalkyl; or [0792] (b) heterocyclic ring; [0793] R97 is: [0794] (a) hydrogen; [0795] (b) alkylthio; [0796] (c) alkylsulfinyl; [0797] (d) alkylsulfonyl; [0798] (e) cyano; [0799] (f) carboxyl; [0800] (g) amino; [0801] (h) lower alkyl; [0802] (i) haloalkyl; [0803] (j) hydroxy; [0804] (k) alkoxy; [0805] (l) haloalkoxy; [0806] (m) alkylarylalkylamino; [0807] (n) aminoalkyl; [0808] (o) aminoaryl; [0809] (p) sulfonamido; [0810] (q) alkylsulfonamido; [0811] (r) arylsulfonamido; [0812] (s) heterocyclic ring; [0813] (t) hydroxyalkyl; or [0814] (u) nitro; [0815] a is an integer from 1 to 3; [0816] when sides e and g are double bonds, and sides d and f are single bonds, —X2—Y2—Z2— is: [0817] (a) —CR4═N—N═; [0818] (b) —N═N—CR4═; [0819] (c)—CR4═N—CR4′═; [0820] (d) —N═CR4—N═; [0821] (e) —CR4═CR4′—N═; [0822] (f) —N═CR4—CR5═; [0823] (g) —CR4═CR5—CR5′═; or [0824] (h) —N═N—N═; [0825] when side g is a double bond, and sides d, e and f are single bonds, —X2—Y2—Z2— is: [0826] (a) —C(O)—O—CR4═; [0827] (b) —C(O)—NR3—CR4═; [0828] (c) —C(O)—S—CR4═; or [0829] (d) —C(H)R4—C(OH)R5—N═; [0830] when sides d is a double bond, and sides e, f and g are single bonds, —X2—Y2—Z2— is: [0831] (a) =CR4—O—C(O)—; [0832] (b) =CR4—NR3—C(O)—; [0833] (c) =CR4—S—C(O)—; or [0834] (d) ═N—C(OH)R4—C(H)R5—; [0835] when sides f is a double bond, and sides d, e and g are single bonds, —X2—Y2—Z2— is: [0836] (a) —CH(R4)—CR5═N—; or [0837] (b) —C(O)—CR4═CR5—; [0838] when sides e is a double bond, and sides d, f and g are single bonds, —X2—Y2—Z2— is: [0839] (a) —N═CR4—CH(R5)—; or [0840] (b) —CR4═CR5C(O)—; [0841] when sides d, e, f and g are single bonds, —X2—Y2—Z2— is: [0842] (a) —C(O)—CR4(R4′)—C(O)—; [0843] R1, R1′, R2, R3, R4, R4′, R5 and R5′ are as defined herein. [0844] Another embodiment of the present invention provides nitrosated and/or nitrosylated compounds of Formula (III): 4 [0845] wherein: [0846] X3 is: [0847] (a) —C(O)—U—D1; [0848] (b) —CH2—U—D1; [0849] (c) —CH2—C(O)—CH3; [0850] (d) —CH2—CH2—C(O)—U—D1; [0851] (e) —CH2—O—D1; or [0852] (f) —C(O)H [0853] Y3 is: [0854] (a) —(CR5(R5′))k—U—D1; [0855] (b) —CH3; [0856] (c) —CH2OC(O)R6; or [0857] (d) —C(O)H; [0858] alternatively, X3 and Y3 taken together are —CR82(R83)—CR82′(R83′)—; [0859] R82, R82′, R83 and R83′ are each independently: [0860] (a) hydrogen; [0861] (b) hydroxy; [0862] (c) alkyl; [0863] (d) alkoxy; [0864] (e) lower alkyl-OD1; [0865] (f) alkylthio; [0866] (g) CN; [0867] (h) —C(O)R84; or [0868] (i) —OC(O)R85; [0869] R84 is: [0870] (a) hydrogen; [0871] (b) lower alkyl; or [0872] (c) alkoxy; [0873] R85 is: [0874] (a) lower alkyl; [0875] (b) alkoxy [0876] (c) unsubstituted, mono-, di- or tri-substituted phenyl or pyridyl, wherein the substituents are each independently: [0877] (1) halo; [0878] (2) alkoxy; [0879] (3) haloalkyl; [0880] (4) CN; [0881] (5) —C(O)R84; [0882] (6) lower alkyl; [0883] (7) —S(O)o-lower alkyl; or [0884] (8)—OD1; [0885] alternatively, R82 and R83 or R82′ and R83′ taken together are: [0886] (a) oxo; [0887] (b) thial; [0888] (c) ═CR86R87; or [0889] (d) ═NR88; [0890] R86 and R87 are each independently: [0891] (a) hydrogen; [0892] (b) lower alkyl; [0893] (c) lower alkyl-OD1; [0894] (d) CN; or [0895] (e)—C(O)R84; [0896] R88 is: [0897] (a) OD1; [0898] (b) alkoxy; [0899] (c) lower alkyl; or [0900] (d) unsubstituted, mono-, di- or tri-substituted phenyl or pyridyl, wherein the substituents are each independently: [0901] (1) halo; [0902] (2) alkoxy; [0903] (3) haloalkyl; [0904] (4) CN; [0905] (5) —C(O)R84; [0906] (6) lower alkyl; [0907] (7) —S(O)o-lower alkyl; or [0908] (8) —OD1; [0909] R1, R1′, R2, R5, R5′, R6, U, D1, o and k are as defined herein. [0910] Another embodiment of the present invention provides nitrosated and/or nitrosylated compounds of Formula (IV) 5 [0911] wherein: [0912] X4 and Z4 are each independently: [0913] (a) N; or [0914] (b) CR21; [0915] R20 is: [0916] (a) —S(O)2—CH3; [0917] (b) —S(O)2—NR8(D1); or [0918] (c) —S(O)2—N(D1)—C(O)—CF3; [0919] R21 and R21′ are each independently: [0920] (a) hydrogen; [0921] (b) lower alkyl; [0922] (c) alkoxy; [0923] (d) alkylthio; [0924] (e) haloalkyl, preferably fluoroalkyl; [0925] (f) haloalkoxy, preferably fluoroalkoxy; [0926] (g) CN; [0927] (h) —CO2D1; [0928] (i) —CO2R14; [0929] (j) lower alkyl-O—D1; [0930] (k) lower alkyl-CO2D1; [0931] (l) lower alkyl-CO2R14; [0932] (m) halo; [0933] (n) —O—D1; [0934] (O)—N3; [0935] (p) —NO2; [0936] (q) —NR14D1; [0937] (r) —N(D1)C(O)R14; [0938] (s) —NHK; [0939] (t) aryl; [0940] (u) arylalkylthio; [0941] (v) arylalkoxy; [0942] (w) alkylamino; [0943] (x) aryloxy; [0944] (y) alkylarylalkylamino; [0945] (z) cycloalkylalkylamino; or [0946] (aa) cycloalkylalkoxy; [0947] R22 is: [0948] (a) mono-, di- or tri-substituted phenyl or pyridinyl (or the N-oxide thereof), wherein the substituent are each independently: [0949] (1) hydrogen; [0950] (2) halo; [0951] (3) alkoxy; [0952] (4) alkylthio; [0953] (5) CN; [0954] (6) lower alkyl; [0955] (7) haloalkyl, preferably fluoroalkyl; [0956] (8) N3; [0957] (9) —CO2D1; [0958] (10) —CO2-lower alkyl; [0959] (11) —C(R4)(R15)—OD; [0960] (12) —OD1; [0961] (13) lower alkyl-CO2—R14; or [0962] (14) lower alkyl-CO2—D1; [0963] (b) —T—C(R23)(R24)—(C(R25)(R26))o—C(R27)(R28)—U—D1; [0964] (c) 6 [0965] (d) arylalkyl; or [0966] (e) cycloalkylalkyl; [0967] wherein: [0968] R14 and R15 are each independently: [0969] (a) hydrogen; or [0970] (b) lower alkyl; [0971] R23, R24, R25, R26, R27, R28 are each independently: [0972] (a) hydrogen; or [0973] (b) lower alkyl; or [0974] R23 and R27, or R27 and R28 together with the atoms to which they are attached form a carbocyclic ring of 3, 4, 5, 6 or 7 atoms, or R23 and R25 are joined to form a covalent bond; [0975] Y5 is: [0976] (a) CR29R30; [0977] (b) oxygen; or [0978] (c) sulfur; [0979] R29 and R30 are each independently: [0980] (a) hydrogen; [0981] (b) lower alkyl; [0982] (c) (CH2)o—OD1; [0983] (d) halo; or [0984] R29 and R30 taken together are an oxo group; [0985] s is an integer from 2 to 4; [0986] R1, R1′, R8, D1, T, U, K and o are as defined herein. [0987] Another embodiment of the present invention provides nitrosated and/or nitrosylated compounds of Formula (V): 7 [0988] wherein: [0989] X7 is: [0990] (a) oxygen; [0991] (b) sulfur; [0992] (c) —NR51; [0993] (d) —N—O—R52; or [0994] (e) —N—NR52R53; [0995] Y7 is: [0996] (a) hydrogen; [0997] (b) halo; [0998] (c) lower alkyl; [0999] (d) alkenyl; or [1000] (e) alkynyl; [1001] Z7 is: [1002] (a) —C(O)—; [1003] (b) oxygen; [1004] (c) —S(O)o—; [1005] (d) —NR93; or [1006] (e) covalent bond; [1007] R49 is: [1008] (a) R3; or [1009] (b) R4; [1010] R50 and R50′ are each independently: [1011] (a) hydrogen; [1012] (b) halo; [1013] (c) lower alkyl; [1014] (d) aryl; [1015] (e) arylalkyl; [1016] (f) cycloalkyl; [1017] (g) cycloalkylalkyl; [1018] (h) —OD1; [1019] (i) lower alkyl-OD1; [1020] (j) carboxamido; [1021] (k) amidyl; or [1022] (l) K; [1023] R51 is: [1024] (a) lower alkyl; [1025] (b) alkenyl; [1026] (c) cycloalkyl; [1027] (d) cycloalkylalkyl; [1028] (e) aryl; [1029] (f) arylalkyl; [1030] (g) heterocyclic ring; or [1031] (h) lower alkyl-heterocyclic ring; [1032] R52 and R53 are each independently: [1033] (a) lower alkyl; [1034] (b) cycloalkyl; [1035] (c) cycloalkylalkyl; [1036] (d) aryl; [1037] (e) arylalkyl; [1038] (f) heterocyclic ring; or [1039] (g) heterocyclicalkyl; [1040] R93 is: [1041] (a) hydrogen; or [1042] (b) lower alkyl; [1043] R1, R3, R4, K, D1 and o are as defined herein. [1044] Another embodiment of the present invention provides nitrosated and/or notrosylated compounds of Formula (VI): 8 [1045] wherein: [1046] X9 is —C(O)—U—D1 and Y9 is —CH2—CR5(R5′)—U—D1; or [1047] X9 is —CH2—CR5(R5′)—U—D1 and Y9 is —C(O)—U—D1; or [1048] X9 and Y9 taken together are: [1049] (a) —C(O)—O—CR4(R4′)—CR5(R5′)—; [1050] (b) —(CR4(R4′))k—CR5(R5′)—CR5(R5′)—; [1051] (c) —C(O)—(CR4(R4′))k—CR5(R5′)—; [1052] (d) —(CR4(R4′))k—CR5(R5′)—C(O)—; or [1053] (e) —C(O)—CR4(R4′)—CR5(R5′)—; [1054] wherein X9 is the first carbon atom of a, b, c, d and e; [1055] R1, R2, R4, R4′, R5, R5′, U, D1 and k are as defined herein. [1056] Another embodiment of the present invention provides nitro sated and/or notrosylated compounds of Formula (VII): 9 [1057] wherein: [1058] when side h, k, and j are single bonds, and side i and l are a double bond, —X10—Y10—Z10— is: 10 [1059] when sides i, k and l are single bonds, and sides h and j are double bonds, —X10—Y10—Z10— 11 [1060] when side h and j are single bonds, and side k and i is a single or a double bond, —X10—Y10— 12 [1061] P10 is: [1062] (a) —N═; [1063] (b) —NR3—; [1064] (c) —O—; or [1065] (d) —S—; [1066] Q10 and Q10′ are each independently: [1067] (a) CR60; or [1068] (b) nitrogen; [1069] A10-—B10—C10-—D10— is: [1070] (a) —CR4═CR4′—CR5═CR5′—; [1071] (b) —CR4(R4′)—CR5(R5′)—CR4(R4′)—C(O)—; [1072] (c) —CR4(R4′)—CR5(R5)—C(O)—CR4(R4′)—; [1073] (d) —CR4(R4′)—C(O)—CR4(R4′)—CR5(R5′)—; [1074] (e) —C(O)—CR4(R4′)—CR5(R5′)—CR4(R4′)—; [1075] (f) —CR4(R4′)—CR5(R5′)—C(O)—; [1076] (g) —CR4(R4′)—C(O)—CR5(R5′)—; [1077] (h) —C(O)—CR4(R4′)—CR5(R5′)—; [1078] (i) —CR4(R4′)—CR5(R5′)—O—C(O)—; [1079] (l) —CR4(R4′)—O—C(O)—CR5(R5′); [1080] (k) —O—C(O)—CR4(R4′)—CR5(R5′); [1081] (l) —CR4(R4′)—CR5(R5′)—C(O)—O—; [1082] (m) —CR4(R4′)—C(O)—O—CR5(R5′)—; [1083] (n) —C(O)—O—CR4(R4′)—CR5(R5′)—; [1084] (o) —CR12(R13)—O—C(O)—; [1085] (p) —C(O)—O—CR12(R13)—; [1086] (q) —O—C(O)—CR2(R3)—; [1087] (r) —CR12(R13)—C(O)—O—; [1088] (s) —N═CR4—CR4′═CR5—; [1089] (t) —CR4═N—CR4′═CR5—; [1090] (u) —CR4═CR4—N═CR5—; [1091] (v) —CR4═CR5—CR5═N—; [1092] (w) —N═CR4—CR4′═N—; [1093] (x) —N═CR4—N═CR4′—; [1094] (y) —CR4═N—CR4═N—; [1095] (z) —S—CR4═N—; [1096] (aa) —S—N═CR4—; [1097] (bb) —N═N—NR3 [1098] (cc) —CR4═N—S—; [1099] (dd) —N═CR4—S—; [1100] (ee) —O—CR4—N—; [1101] (ff) —O—N═CR4—; or [1102] (gg) —N═CR4—O—; [1103] —A10′—B10′—D10′— is: [1104] (a) —CR4═CR5—CR5′═ [1105] (b) —CR4(R4′)—CR5(R5′)—CR4(R4′)—; [1106] (c) —C(O)—CR4(R4′)—CR5(R5′)—; [1107] (d) —CR4(R4)—CR5(R5′)—C(O)—; [1108] (e) —N═CR4—CR5═; [1109] (g) —N═N—CR4═; [1110] (h) —N═N—NR3—; [1111] (i) —N═N—N═; [1112] (l) —N═CR4—NR3—; [1113] (k) —N═CR4—N═; [1114] (l) —CR4═N—NR3—; [1115] (m) —CR4═N—N═; [1116] (n) —CR4═N—CR5═; [1117] (o) —CR4═CR5—NR3—; [1118] (p) —CR4═CR5—N═; [1119] (q) —S—CR4═CR5—; [1120] (r) —O—CR4═CR5; [1121] (s) —CR4═CR—O—; [1122] (t) —CR4═CR5—S—; [1123] (u) —CR4═N—S—; [1124] (v) —CR4═N—O—; [1125] (w) —N═CR4—S—; [1126] (x) —N═CR4—O—; [1127] (y) —S—CR4═N—; [1128] (z) —O—CR4═N—; [1129] (aa) —N═N—S—; [1130] (bb) —N═N—O—; [1131] (cc) —S—N═N—; [1132] (dd) —O—N═N—; [1133] (ee) —CR4═CR5—S; [1134] (ff) —CR4(R4′)—CR5(R5′)—S—; [1135] (gg) —CR4(R4′)—CR5(R5′)—O—; [1136] (hh) —S—CR4(R4′)—CR5(R5′)—; or [1137] (ii) —O—CR4(R4′)—CR5(R5′)—; [1138] R60 and R61 are each independently: [1139] (a) lower alkyl; [1140] (b) haloalkyl, preferably fluoroalkyl; [1141] (c) alkoxy; [1142] (d) alkylthio; [1143] (e) lower alkyl-OD1; [1144] (f) —C(O)H; [1145] (h) —(CH2)q—CO2-lower alkyl; [1146] (i) —(CH2)q—CO2D1; [1147] (j) —O—(CH2)q—S-lower alkyl; [1148] (k) —(CH2)q—S-lower alkyl; [1149] (l) —S(O)2-lower alkyl; [1150] (m) —(CH2)q—NR12R13; or [1151] (n) —C(O)N(R8)(R8); [1152] R1, R1′, R2, R3, R4, R4′, R5, R5′, R8, R12, R13 T, D1 and q are as defined herein. [1153] Another embodiment of the present invention provides nitrosated and/or Nitrosylated compounds of the Formula (VIII): 13 [1154] wherein: [1155] X13 and Y13 are each independently: [1156] (a) ═C(H)—; or [1157] (b) ═N—; [1158] R90 is: [1159] (a) lower alkyl; [1160] (b) lower alkyl-OD1; [1161] (c) alkenyl; [1162] (d) lower alkyl-CN; [1163] (e) lower alkyl-CO2D1; [1164] (f) aryl; [1165] (g) heterocyclic ring; or [1166] (i) heterocyclicalkyl; [1167] R91 is: [1168] (a) mono-, di- or tri-substituted phenyl, wherein the substituents are each independently: [1169] (1) hydrogen; [1170] (2) halo; [1171] (3) alkoxy; [1172] (4) alkylthio; [1173] (5) CN; [1174] (6) haloalkyl; [1175] (7) lower alkyl; [1176] (8) —CO2D1; [1177] (9) —CO2-lower alkyl; [1178] (10) lower alkyl-OD1; [1179] (11) lower alkyl-NR2R13; [1180] (12) lower alkyl-CO2D1; or [1181] (13) —OD1; [1182] (b) mono-, di- or tri-substituted heteroaryl, wherein the heteroaryl is a monocyclic aromatic ring of 5 atoms, said ring having one heteroatom which is S, O, or N, and, optionally, 1, 2, or 3 additional N atoms; or the heteroaryl is a monocyclic ring of 6 atoms, said ring having one heteroatom which is N, and, optionally, 1, 2, 3, or 4 additional N atoms; wherein the substituents are each independently: [1183] (1) hydrogen; [1184] (2) halo; [1185] (3) alkoxy; [1186] (4) alkylthio; [1187] (5) CN; [1188] (6) haloalkyl; [1189] (7) lower alkyl; [1190] (8) —CO2D1; [1191] (9) —CO2-lower alkyl; [1192] (10) lower alkyl-OD1; [1193] (11) lower alkyl-NR12R13; [1194] (12) lower alkyl-CO2D1; or [1195] (13) —OD1; [1196] D1, R1, R12, and R13, are as defined herein. [1197] Another embodiment of the present invention provides nitrosated and/or nitrosylated compounds of Formula (IX): 14 [1198] wherein: [1199] X14 is: [1200] (a) —C(O)—; or [1201] (b) —C(S)—; [1202] Y14 is: [1203] (a) —O—; or [1204] (b) —S—; [1205] A14—B14—D14 is: [1206] (a) —CR4═CR4′—CR5═CR5′—; [1207] (b) —CR4(R4′)—CR5(R5′)—C(O)—; [1208] (c) —CR4(R4′)—C(O)—CR5(R5′)—; [1209] (d) —C(O)—CR4(R4′)—CR5(R5′); [1210] (e) —CR4(R5)—O—C(O)—; [1211] (f) —C(O)—O—CR4(R5)—; [1212] (g) —O—C(O)—CR4(R5)—; [1213] (h) —S—N═CR4—; [1214] (i) —O—N═CR4—; [1215] (j) —CR4(R5)—NR3—C(O)—; [1216] (k) —C(O)—NR3—CR4(R5)—; [1217] (l) —NR3—C(O)—CR4(R5)—; [1218] (m) —CR4(R5)—S—C(O)—; [1219] (n) —C(O)—S—CR4(R5)—; [1220] (o)—S—C(O)—CR4(R5)—; [1221] (q) —C(O)—CR4═CR4—; [1222] (r) —O—CR4═CR4′—; [1223] (s) —S—CR4═CR4′—; [1224] (t) —NR3—CR4═CR5—; [1225] (u) —S—NR3—C(O)—; [1226] (v) —O—NR3—C(O)—; or [1227] (w) —NR3—N═CR4—; [1228] R1, R1′, R2, R3, R4, R4′, R5 and R5′ are as defined herein. [1229] Another embodiment of the present invention provides nitrosated and/or nitrosylated compounds of Formula (X): 15 [1230] wherein: [1231] X15 is: [1232] (a) —C(O)—; [1233] (b) —CH2—; [1234] (c) —CH(OD1)—; [1235] (d) —C═N—O-lower alkyl-; [1236] (e) —O—; [1237] (f) —S(O)o—; [1238] (g) —NR92; or [1239] (g) covalent bond; [1240] Y15 is: [1241] (a) aryl; or [1242] (b) cycloalkyl; [1243] Z15 is: [1244] (a) hydrogen; [1245] (b) alkyl; [1246] (c) haloalkyl; [1247] (d) cycloalkyl; [1248] (e) alkoxy; [1249] (f) alkylthio; [1250] (g) cycloalkylalkylthio; [1251] (h) cycloalkylalkoxy; [1252] (i) —OD1; [1253] (j) halo; [1254] (k) cyano; [1255] (l) —C(O)OD1; [1256] (m) —C(O)-lower alkyl; [1257] R92 is: [1258] (a) hydrogen; [1259] (b) lower alkyl; [1260] (c) —C(O)-lower alkyl; or [1261] (d) K; [1262] R1, D1, K and o are as defined herein. [1263] Compounds of the present invention that have one or more asymmetric carbon atoms may exist as the optically pure enantiomers, pure diastereomers, mixtures of enantiomers, mixtures of diastereomers, racemic mixtures of enantiomers, diastereomeric racemates or mixtures of diastereomeric racemates. The present invention includes within its scope all such isomers and mixtures thereof. [1264] Another aspect of the present invention provides processes for making the novel compounds of the invention and to the intermediates useful in such processes. The reactions are performed in solvents appropriate to the reagents and materials used are suitable for the transformations being effected. It is understood by one skilled in the art of organic synthesis that the functionality present in the molecule must be consistent with the chemical transformation proposed. This will, on occasion, necessitate judgment by the routineer as to the order of synthetic steps, protecting groups required, and deprotection conditions. Substituents on the starting materials may be incompatible with some of the reaction conditions required in some of the methods described, but alternative methods and substituents compatible with the reaction conditions will be readily apparent to one skilled in the art. The use of sulfur and oxygen—protecting groups is well known for protecting thiol and alcohol groups against undesirable reactions during a synthetic procedure and many such protecting groups are known and described by, for example, Greene and Wuts, Protective Groups in Organic Synthesis, Third Edition, John Wiley & Sons, New York (1999). [1265] The chemical reactions described herein are generally disclosed in terms of their broadest application to the preparation of the compounds of this invention. Occasionally, the reactions may not be applicable as described to each compound included within the disclosed scope. The compounds for which this occurs will be readily recognized by one skilled in the art. In all such cases, either the reactions can be successfully performed by conventional modifications known to one skilled in the art, e.g., by appropriate protection of interfering groups, by changing to alternative conventional reagents, by routine modification of reaction conditions, and the like, or other reactions disclosed herein or otherwise conventional, will be applicable to the preparation of the corresponding compounds of this invention. In all preparative methods, all starting materials are known or readily prepared from known starting materials. [1266] The compounds of Formulas (I), (II), (III), (IV), (V), (VI), (VII), (VIII), (IX) and (X) can be synthesized by one skilled in the art following the methods and examples described herein. The synthesis of the parent COX-2 inhibitors (i.e. non-nitrosated and/or non-nitrosylated COX-2 inhibitors) are disclosed in, for example, U.S. Pat. Nos. 5,344,991, 5,393,790, 5,466,823, 5,474,995, 5,486,534, 5,504,215, 5,508,426, 5,510,496, 5,516,907, 5,521,207, 5,536,752, 5,550,142, 5,563,165, 5,616,601, 5,620,999, 5,677,318, 5,668,161, 5,691,374, 5,698,584, 5,710,140, 5,753,688, 5,859,257, 5,908,858, 5,945,539, 5,994,381, 6,080,876, 6,083,969 and 6,071,954 and in WO 91/19708, WO 94/15932, WO 94/26731, WO 94/27980, WO 95/00501, WO 95/11883, WO 95/15315, WO 95/15316, WO 95/15317, WO 95/15318, WO 95/18799, WO 95/21817, WO 95/30652, WO 96/30656, WO 96/03387, WO 96/03392, WO 96/03385, WO 96/03387, WO 96/03388, WO 96/09293, WO 96/09304, WO 96/16934, WO 96/19462, WO 96/19463, WO 96/19469, WO 96/25405, WO 96/36617, WO 96/36623, WO 97/11704, WO 97/13755, WO 97/27181, WO 97/14691, WO 97/16435, WO 97/34882, WO 97/36863, WO 97/40012, WO 97/45420, WO 98/00416, WO 98/11080, WO 98/22422, WO 98/41516, WO 98/46594, WO 98/52937, WO 99/15531, WO 99/23087, WO 99/33796, WO 99/25695, WO 99/61016, WO 99/62884 and WO 99/64415 and in EP 0 745 596 A1, EP 0 087 629 B1, EP 0 418 845 B1, EP 0 554 829 A2, EP 0 863 134 A1, EP 1 006 114 A1 for the parent compounds of Formulas (I) and (II); and in U.S. Pat. Nos. 5,733,909, 5,789,413 and 5,849,943 and in WO 96/13483, WO 97/28120 and WO 97/28121 for the parent compounds of Formula (III); and in U.S. Pat. Nos. 5,861,419 and 6,001,843 and in WO 96/10012, WO 96/16934, WO 96/24585, WO 98/03484, WO 98/24584, WO 98/47871, WO 99/14194 and WO 99/14195 for the parent compounds of Formula (IV); and in WO 98/41511, WO 99/10331, WO 99/10332 and WO 00/24719 for the parent compounds of Formula (V); and in U.S. Pat. No. 5,807,873 and WO 98/43966 for the parent compounds of Formula (VI); and in U.S. Pat. Nos. 5,521,213 and 5,552,422 and in WO 96/06840, WO 96/21667, WO 96/31509, WO 99/12930, WO 00/08024 and WO 00/26216 for the parent compounds of Formula (VII); and in WO 99/61436 for the parent compounds of Formula (VIII); and in WO 00/10993 for the parent compounds of Formula (IX); and in WO 98/32732 for the parent compounds of Formula (X); the disclosures of each of which are incorporated by reference herein in their entirety. The parent COX-2 inhibitor compounds can then be nitrosated and/or nitrosylated through one or more sites such as oxygen, sulfur and/or nitrogen using the methods described in the examples herein and using conventional methods known to one skilled in the art. For example, known methods for nitrosating and nitrosylating compounds are described in U.S. Pat. Nos. 5,380,758 and 5,703,073; WO 97/27749; WO 98/19672; and Oae et al, Org. Prep. Proc. Int., 15(3):165-198 (1983), the disclosures of each of which are incorporated by reference herein in their entirety. The methods of nitrosating and/or nitrosylating the compounds described in the examples herein and in these references can be applied by one skilled in the art to produce any of the nitrosated and/or nitrosylated COX-2 inhibitors described herein. [1267] The compounds of the present invention include the parent COX-2 inhibitors, including those described herein, which have been nitrosated and/or nitrosylated through one or more sites such as oxygen (hydroxyl condensation), sulfur (sulfhydryl condensation) and/or nitrogen. The nitrosated and/or nitrosylated COX-2 inhibitors of the present invention donate, transfer or release a biologically active form of nitrogen monoxide (i.e., nitric oxide). Nitrogen monoxide can exist in three forms: NO— (nitroxyl), NO. (uncharged nitric oxide) and NO+ (nitrosonium). NO. is a highly reactive short-lived species that is potentially toxic to cells. This is critical because the pharmacological efficacy of NO depends upon the form in which it is delivered. In contrast to the nitric oxide radical (NO.), nitrosonium (NO+) does not react with O2 or O2− species, and functionalities capable of transferring and/or releasing NO+ and NO— are also resistant to decomposition in the presence of many redox metals. Consequently, administration of charged NO equivalents (positive and/or negative) is a more effective means of delivering a biologically active NO to the desired site of action. [1268] Compounds contemplated for use in the invention (e.g., COX-2 selective inhibitors that can be optionally nitrosated and/or nitrosylated) are, optionally, used in combination with nitric oxide and compounds that release nitric oxide or otherwise directly or indirectly deliver or transfer a biologically active form of nitrogen monoxide to a site of its intended activity, such as on a cell membrane in vivo. [1269] The term “nitric oxide” encompasses uncharged nitric oxide (NO.) and charged nitrogen monoxide species, preferably charged nitrogen monoxide species, such as nitrosonium ion (NO+) and nitroxyl ion (NO—). The reactive form of nitric oxide can be provided by gaseous nitric oxide. The nitrogen monoxide releasing, delivering or transferring compounds have the structure F—NO, wherein F is a nitrogen monoxide releasing, delivering or transferring moiety, and include any and all such compounds which provide nitrogen monoxide to its intended site of action in a form active for its intended purpose. The term “NO adducts” encompasses any nitrogen monoxide releasing, delivering or transferring compounds, including, for example, S-nitrosothiols, nitrites, nitrates, S-nitrothiols, sydnonimines, 2-hydroxy-2-nitrosohydrazines, (NONOates), (E)-alkyl-2-((E)-hydroxyimino)-5-nitro-3-hexeneamide (FK-409), (E)-alkyl-2-((E)-hydroxyimino)-5-nitro-3-hexeneamines, N-((2Z, 3E)-4-ethyl-2-(hydroxyimino)-6-methyl-5-nitro-3-heptenyl)-3-pyridinecarboxamide (FR 146801), nitrosoamines, furoxans as well as substrates for the endogenous enzymes which synthesize nitric oxide. NONOates include, but are not limited to, (Z)-1-(N-methyl-N-(6-(N-methyl-ammoniohexyl)amino))diazen-1-ium-1,2-diolate (“MAHMA/NO”), (Z)-1-(N-(3-ammoniopropyl)—N-(n-propyl)amino)diazen-1-ium-1,2-diolate (“PAPA/NO”), (Z)-1-(N-(3-aminopropyl)—N-(4-(3-aminopropylammonio) butyl)-amino)diazen-1-ium-1,2-diolate (spermine NONOate or “SPER/NO”) and sodium (Z)-1-(N,N-diethylamino) diazenium-1,2-diolate (diethylamine NONOate or “DEA/NO”) and derivatives thereof. NONOates are also described in U.S. Pat. Nos. 6,232,336, 5,910,316 and 5,650,447, the disclosures of which are incorporated herein by reference in their entirety. The “NO adducts” can be mono-nitrosylated, poly-nitrosylated, mono-nitrosated and/or poly-nitrosated at a variety of naturally susceptible or artificially provided binding sites for biologically active forms of nitrogen monoxide. [1270] One group of NO adducts is the S-nitrosothiols, which are compounds that include at least one —S—NO group. These compounds include S-nitroso-polypeptides (the term “polypeptide” includes proteins and polyamino acids that do not possess an ascertained biological function, and derivatives thereof); S-nitrosylated amino acids (including natural and synthetic amino acids and their stereoisomers and racemic mixtures and derivatives thereof); S-nitrosylated sugars; S-nitrosylated, modified and unmodified, oligonucleotides (preferably of at least 5, and more preferably 5-200 nucleotides); straight or branched, saturated or unsaturated, aliphatic or aromatic, substituted or unsubstituted S-nitrosylated hydrocarbons; and S-nitroso heterocyclic compounds. S-nitrosothiols and methods for preparing them are described in U.S. Pat. Nos. 5,380,758 and 5,703,073; WO 97/27749; WO 98/19672; and Oae et al, Org. Prep. Proc. Int., 15(3):165-198 (1983), the disclosures of each of which are incorporated by reference herein in their entirety. [1271] Another embodiment of the invention is S-nitroso amino acids where the nitroso group is linked to a sulfur group of a sulfur-containing amino acid or derivative thereof. Such compounds include, for example, S-nitroso-N-acetylcysteine, S-nitroso-captopril, S-nitroso-N-acetylpenicillamine, S-nitroso-homocysteine, S-nitroso-cysteine, S-nitroso-glutathione, S-nitroso- cysteinyl-glycine, and the like. [1272] Suitable S-nitrosylated proteins include thiol-containing proteins (where the NO group is attached to one or more sulfur groups on an amino acid or amino acid derivative thereof) from various functional classes including enzymes, such as tissue-type plasminogen activator (TPA) and cathepsin B; transport proteins, such as lipoproteins; heme proteins, such as hemoglobin and serum albumin; and biologically protective proteins, such as immunoglobulins, antibodies and cytokines. Such nitrosylated proteins are described in WO 93/09806, the disclosure of which is incorporated by reference herein in its entirety. Examples include polynitrosylated albumin where one or more thiol or other nucleophilic centers in the protein are modified. [1273] Other examples of suitable S-nitrosothiols include: [1274] (i) HS(C(Re)(Rf))mmSNO; [1275] (ii) ONS(C(Re)(Rf))mmRe; and [1276] (iii) H2N—CH(CO2H)—(CH2)mm—C(O)NH—CH(CH2SNO)—C(O)NH—CH2—CO2H; [1277] wherein mm is an integer from 2 to 20; Re and Rf are each independently a hydrogen, an alkyl, a cycloalkoxy, a halogen, a hydroxy, an hydroxyalkyl, an alkoxyalkyl, an arylheterocyclic ring. a cycloalkylalkyl, a heterocyclicalkyl, an alkoxy, a haloalkoxy, an amino, an alkylamino, a dialkylamino, an arylamino, a diarylamino, an alkylarylamino, an alkoxyhaloalkyl, a haloalkoxy, a sulfonic acid, a sulfonic ester, an alkylsulfonic acid, an arylsulfonic acid, an arylalkoxy, an alkylthio, an arylthio, a cyano, an aminoalkyl, an aminoaryl, an alkoxy, an aryl, an arylalkyl, a carboxamido, a alkylcarboxamido, an arylcarboxamido, an amidyl, a carboxyl, a carbamoyl, an alkylcarboxylic acid, an arylcarboxylic acid, an alkylcarbonyl, an arylcarbonyl, an ester, a carboxylic ester, an alkylcarboxylic ester, an arylcarboxylic ester, a haloalkoxy, a sulfonamido, an alkylsulfonamido, an arylsulfonamido, an alkylsulfonyl, an alkylsulfonyloxy, an arylsulfonyl, an arylsulfonyloxy, a carbamoyl, a urea, a nitro, —T—Q—, or (C(Re)(Rf))k—T—Q, or Re and Rf taken together are an oxo, a methanthial, a heterocyclic ring, a cycloalkyl group or a bridged cycloalkyl group; Q is —NO or —NO2; and T is independently a covalent bond, a carbonyl, an oxygen, —S(O)o— or —N(Ra)Ri—, wherein o is an integer from 0 to 2, Ra is a lone pair of electrons, a hydrogen or an alkyl group; Ri is a hydrogen, an alkyl, an aryl, an alkylcarboxylic acid, an arylcarboxylic acid, an alkylcarboxylic ester, an arylcarboxylic ester, an alkylcarboxamido, an arylcarboxamido, an alkylsulfinyl, an alkylsulfonyl, an alkylsulfonyloxy, an arylsulfinyl, an arylsulfonyloxy, an arylsulfonyl, a sulfonamido, a carboxamido, a carboxylic ester, an aminoalkyl, an aminoaryl, —CH2—C(T—Q)(Re)(Rf), or —(N2O2—)−.M+, wherein M+ is an organic or inorganic cation; with the proviso that when R1 is —CH2—C(T—Q)(Re)(Rf) or —(N2O2—).M+; then “—T—Q” can be a hydrogen, an alkyl group, an alkoxyalkyl group, an aminoalkyl group, a hydroxy group or an aryl group. [1278] In cases where Re and Rf are a heterocyclic ring or taken together Re and Rf are a heterocyclic ring, then Ri can be a substituent on any disubstituted nitrogen contained within the radical wherein Ri is as defined herein. [1279] Nitrosothiols can be prepared by various methods of synthesis. In general, the thiol precursor is prepared first, then converted to the S-nitrosothiol derivative by nitrosation of the thiol group with NaNO2 under acidic conditions (pH is about 2.5) which yields the S-nitroso derivative. Acids which can be used for this purpose include aqueous sulfuric, acetic and hydrochloric acids. The thiol precursor can also be nitrosylated by reaction with an organic nitrite such as tert-butyl nitrite, or a nitrosonium salt such as nitrosonium tetraflurorborate in an inert solvent. [1280] Another group of NO adducts for use in the invention, where the NO adduct is a compound that donates, transfers or releases nitric oxide, include compounds comprising at least one ON—O—, ON—N— or ON—C— group. The compounds that include at least one ON—O—, ON—N— or ON—C— group are preferably ON—O—, ON—N— or ON—C-polypeptides (the term “polypeptide” includes proteins and polyamino acids that do not possess an ascertained biological function, and derivatives thereof); ON—O—, ON—N— or ON—C-amino acids (including natural and synthetic amino acids and their stereoisomers and racemic mixtures); ON—O—, ON—N— or ON—C-sugars; ON—O—, ON—N— or ON—C— modified or unmodified oligonucleotides (comprising at least 5 nucleotides, preferably 5-200 nucleotides); ON—O—, ON—N— or ON—C— straight or branched, saturated or unsaturated, aliphatic or aromatic, substituted or unsubstituted hydrocarbons; and ON—O—, ON—N— or ON—C-heterocyclic compounds. [1281] Another group of NO adducts for use in the invention include nitrates that donate, transfer or release nitric oxide, such as compounds comprising at least one O2N—O—, O2N—N—, O2N—S— or O2N—C— group. Preferred among these compounds are O2N—O—, O2N—N—, O2N—S— or O2N—C— polypeptides (the term “polypeptide” includes proteins and also polyamino acids that do not possess an ascertained biological function, and derivatives thereof); O2N—O—, O2N—N—, O2N—S— or O2N—C— amino acids (including natural and synthetic amino acids and their stereoisomers and racemic mixtures); O2N—O—, O2N—N—, O2N—S— or O2N—C-sugars; O2N—O—, O2N—N—, O2N—S— or O2N—C— modified and unmodified oligonucleotides (comprising at least 5 nucleotides, preferably 5-200 nucleotides); O2N—O—, O2N—N—, O2N—S— or O2N—C— straight or branched, saturated or unsaturated, aliphatic or aromatic, substituted or unsubstituted hydrocarbons; and O2N—O—, O2N—N—, O2N—S— or O2N—C— heterocyclic compounds. Preferred examples of compounds comprising at least one O2N—O—, O2N—N—, O2N—S— or O2N—C— group include isosorbide dinitrate, isosorbide mononitrate, clonitrate, erythrityl tetranitrate, mannitol hexanitrate, nitroglycerin, pentaerythritoltetranitrate, pentrinitrol, propatylnitrate and organic nitrates with a sulfhydryl-containing amino acid such as, for example SPM 3672, SPM 5185, SPM 5186 and those disclosed in U.S. Pat. Nos. 5,284,872, 5,428,061, 5,661,129, 5,807,847 and 5,883,122 and in U.S. Provisional Application No. 60/311,175 and in WO 97/46521 and WO 00/54756, the disclosures of each of which are incorporated by reference herein in their entirety. [1282] Another group of NO adducts are N-oxo-N-nitrosoamines that donate, transfer or release nitric oxide and are represented by the formula: R1R2—N(O—M+)—NO, where R1 and R2 are each independently a polypeptide, an amino acid, a sugar, a modified or unmodified oligonucleotide, a straight or branched, saturated or unsaturated, aliphatic or aromatic, substituted or unsubstituted hydrocarbon, or a heterocyclic group, and where M+ is an organic or inorganic cation, such as, for example, an alkyl substituted ammonium cation or a Group I metal cation. [1283] The invention is also directed to compounds that stimulate endogenous NO or elevate levels of endogenous endothelium-derived relaxing factor (EDRF) in vivo or are substrates for nitric oxide synthase. Such compounds include, for example, L-arginine, L-homoarginine, and N-hydroxy-L-arginine, including their nitrosated and nitrosylated analogs (e.g., nitrosated L-arginine, nitrosylated L-arginine, nitrosated N-hydroxy-L-arginine, nitrosylated N-hydroxy-L-arginine, nitrosated L-homoarginine and nitrosylated L-homoarginine), precursors of L-arginine and/or physiologically acceptable salts thereof, including, for example, citrulline, omithine, glutamine, lysine, polypeptides comprising at least one of these amino acids, inhibitors of the enzyme arginase (e.g., N-hydroxy-L-arginine and 2(S)-amino-6-boronohexanoic acid) and the substrates for nitric oxide synthase, cytokines, adenosin, bradykinin, calreticulin, bisacodyl, and phenolphthalein. EDRF is a vascular relaxing factor secreted by the endothelium, and has been identified as nitric oxide (NO) or a closely related derivative thereof (Palmer et al, Nature, 327:524-526 (1987); Ignarro et al, Proc. Natl. Acad. Sci. USA, 84:9265-9269 (1987)). [1284] Another embodiment of the present invention provides compositions comprising at least one parent COX-2 inhibitor and at least one compound that donates, transfers or releases nitric oxide, or elevates levels of endogenous EDRF or nitric oxide, or is a substrate for nitric oxide synthase. The parent COX-2 inhibitors includes any of those described in the prior art, including those described in the patents and publications cited herein, as well as the novel compounds described herein. [1285] The invention is also based on the discovery that compounds and compositions of the invention may be used in conjunction with other therapeutic agents for co-therapies, partially or completely, in place of other conventional antiinflammatory compounds, such as, for example, together with steroids, NSAIDs, 5-lipoxygenase (5-LO) inhibitors, leukotriene B4 (LTB4) receptor antagonists, leukotriene A4 (LTA4) hydrolase inhibitors, 5-HT agonists, HMG-CoA inhibitors, H2 receptor antagonists, antineoplastic agents, antiplatelet agents, thrombin inhibitors, thromboxane inhibitors, decongestants, diuretics, sedating or non-sedating anti-histamines, inducible nitric oxide synthase inhibitors, opiods, analgesics, Helicobacter pylori inhibitors, proton pump inhibitors, isoprostane inhibitors, and mixtures thereof. [1286] Leukotriene A4 (LTA4) hydrolase inhibitors refer to compounds that selectively inhibit leukotriene A4 hydrolase with an IC50 of less than about 10 μM, and preferably with an IC50 of less than about 1 μM. Suitable LTA4 hydrolase inhibitors include, but are not limited to, RP-64966, (S,S)-3-amino-4-(4-benzyloxyphenyl)-2-hydroxybutyric acid benzyl ester, N-(2(R)-(cyclohexylmethyl)-3-(hydroxycarbamoyl)propionyl)—L-alanine, 7-(4-(4-ureidobenzyl)phenyl) heptanoic acid and 3 (3-(1E,3E-tetradecadienyl)-2-oxiranyl)benzoic acid lithium salt, and mixtures thereof. [1287] Suitable LTB4 receptor antagonists include, but are not limited to, ebselen, linazolast, ontazolast; WAY 121006; Bay-x-1005; BI—RM-270; CGS-25019C; ETH-615; MAFP; TMK-688; T-0757; LY 213024, LY 210073, LY 223982, LY 233469, LY 255283, LY 264086, LY 292728 and LY 293111; ONO—LB457, ONO-4057, and ONO—LB-448, S-2474, calcitrol; PF 10042; Pfizer 105696; RP 66153; SC-53228, SC-41930, SC-50605, SC-51146 and SC-53228; SB-201146 and SB-209247; SKF-104493; SM 15178; TMK-688; BPC 15, and mixtures thereof. The preferred LTB4 receptor antagonists are calcitrol, ebselen, Bay-x-1005, CGS-25019C, ETH-615, LY-2931 11, ONO-4057 and TMK-688, and mixtures thereof. [1288] Suitable 5-LO inhibitors include, but are not limited to, A-76745, 78773 and ABT761; [1289] Bay-x-1005; CMI-392; E-3040; EF-40; F-1322; ML-3000; PF-5901; R-840; rilopirox, flobufen, linasolast, lonapolene, masoprocol, ontasolast, tenidap, zileuton, pranlukast, tepoxalin, rilopirox, flezelastine hydrochloride, enazadrem phosphate, and bunaprolast, and mixtures thereof. [1290] Suitable 5-LO inhibitors are also described more fully in WO 97/29776, the disclosure of which is incorporated herein by reference in its entirety. [1291] Suitable 5-HT agonists, include, but are not limited to, rizatriptan, sumatriptan, naratriptan, zolmitroptan, eleptriptan, almotriptan, ergot alkaloids. ALX 1323, Merck L 741604 SB 220453 and LAS 31416. Suitable 5-HT agonists are described more fully in WO 0025779, and in WO 00/48583. 5-HT agonists refers to a compound that is an agonist to any 5-HT receptor, including but not limited to, 5-HT1 agonists, 5-HT1B agonists and 5-HT1D agonists, and the like. [1292] Suitable steroids, include, but are not limited to, budesonide, dexamethasone, corticosterone, prednisolone, and the like. Suitable steroids are described more fully in the literature, such as in the Merck Index on CD-ROM, Twelfth Edition, Version 12:1, 1996. [1293] Suitable HMG CoA inhibitors, include, but are not limited to, reductase and synthase inhibitors, such as, for example, squalene synthetase inhibitors, benzodiazepine squalene synthase inhibitors, squalene epoxidase inhibitors, acyl-coenzyme A, bile acid sequestrants, cholesterol absorption inhibitors, and the like. Suitable HMG CoA inhibitors include simvastatin, pravastatin, lovastatin, and the like, and are described more fully in U.S. Pat. No. 6,245,797 and WO 99/20110, the disclosures of which are incorporated herein by reference in their entirety. [1294] Suitable NSAIDs, include, but are not limited to, acetaminophen, aspirin, diclofenac, ibuprofen, ketoprofen, naproxen and the like. Suitable NSAIDs are described more fully in the literature, such as in Goodman and Gilman, The Pharmacological Basis of Therapeutics (9th Edition), McGraw-Hill, 1995, Pgs. 617-657; the Merck Index on CD-ROM, Twelfth Edition, Version 12:1, 1996; and in U.S. Pat. Nos. 6,057,347 and 6,297,260 assigned to NitroMed Inc., the disclosures of which are incorporated herein by reference in their entirety. [1295] Suitable H2 receptor anatgonists, include, but are not limited to, cimetidine, roxatidine, rantidine and the like. Suitable H2 receptor antagonists are described more fully in the literature, such as in Goodman and Gilman, The Pharmacological Basis of Therapeutics (9th Edition), McGraw-Hill, 1995, Pgs. 901-915; the Merck Index on CD-ROM, Twelfth Edition, Version 12:1, 1996; and in WO 00/28988 assigned to NitroMed Inc., the disclosures of which are incorporated herein by reference in their entirety. [1296] Suitable antineoplastic agents, include but are not limited to, 5-FU-fibrinogen, acanthifolic acid, aminothiadiazole, altretamine, anaxirone, aclarubicin and the like. Suitable antineoplastic agents are also described in U.S. Pat. No. 6,025,353 and WO 00/38730, the disclosures of which are incorporated herein by reference in their entirety. [1297] Suitable antiplatelet agents, include but are not limited to, aspirin, ticlopidine, dipyridamole, clopidogrel, glycoprotein IIb/IIa receptor antagonists, and the like. Suitable antineoplastic agents are also described in WO 99/45913, the disclosure of which is incorporated herein by reference in its entirety. [1298] Suitable thrombin inhibitors, include but are not limited to, N′-((1-(aminoiminomethyl)-4-piperidinyl)methyl)-N-(3,3-diphenylpropinyl)-L-proline amide), 3-(2-phenylethylamino)-6-methyl-1-(2-amino-6-methyl-5-methylene-carboxamidomethylpyridinyl)-2-pyrazinone, 3-(2-phenethylamino)-6-methyl-1-(2-amino-6-methyl-5-methylene carboxamidomethylpyridinyl)-2-pyridinone, and the like. Suitable thrombin inhibitors are also described in WO 00/18352, the disclosure of which is incorporated herein by reference in its entirety. [1299] Suitable thromboxane inhibitors, include but are not limited to thromboxane synthase inhibitors, thromboxane receptor antagonists, and the like. Suitable thromboxane inhibitors, are also described in WO 01/87343, the disclosure of which is incorporated herein by reference in its entirety. [1300] Suitable decongestants include, but are not limited to, phenylephrine, phenylpropanolamine, pseudophedrine, oxymetazoline, ephinephrine, naphazoline, xylometazoline, propylhexedrine, levo-desoxyephedrine, and the like. [1301] Suitable antitussives include, but are not limited to, codeine, hydrocodone, caramiphen, carbetapentane, dextramethorphan, and the like. [1302] Suitable proton pump inhibitors, include, but are not limited to, omeprazole, esomeprazole, lansoprazole, rabeprazole, pantoprazole, and the like. Suitable proton pump inhibitors are described more fully in the literature, such as in Goodman and Gilman, The Pharmacological Basis of Therapeutics (9th Edition), McGraw-Hill, 1995, Pgs. 901-915; the Merck Index on CD-ROM, Twelfth Edition, Version 12:1, 1996; and in WO 00/50037 assigned to NitroMed Inc., the disclosures of which are incorporated herein by reference in their entirety. [1303] The compounds and compositions of the invention, may also be used in combination therapies with opioids and other analgesics, including, but not limited to, narcotic analgesics, Mu receptor antagonists, Kappa receptor antagonists, non-narcotic (i.e. non-addictive) analgesics, monoamine uptake inhibitors, adenosine regulating agents, cannabinoid derivatives, neurokinin 1 receptor antagonists, Substance P antagonists, neurokinin-1 receptor antagonists, sodium channel blockers, N-methyl-D-aspartate receptor antagonists, and mixtures thereof. Preferred combination therapies would be with morphine, meperidine, codeine, pentazocine, buprenorphine, butorphanol, dezocine, meptazinol, hydrocodone, oxycodone, methadone, Tramadol ((+) enantiomer), DuP 747, Dynorphine A, Enadoline, RP-60180, HN-11608, E-2078, ICI-204448, acetominophen (paracetamol), propoxyphene, nalbuphine, E-4018, filenadol, mirtentanil, amitriptyline, DuP631, Tramadol ((-) enantiomer), GP-531, acadesine, AKI-1, AKI-2, GP-1683, GP-3269, 4030W92, tramadol racemate, Dynorphine A, E-2078, AXC3742, SNX-111, ADL2-1294, ICI-204448, CT-3, CP-99,994, CP-99,994, and mixtures thereof. [1304] The compounds and compositions of the invention can also be used in combination with inducible nitric oxide synthase (iNOS) inhibitors. Suitable iNOS inhibitors are disclosed in U.S. Pat. Nos. 5,132,453 and 5,273,875, and in WO 97/38977 and WO 99/18960, the disclosures of each of which are incorporated by reference herein in their entirety. [1305] The invention is also based on the discovery that the administration of a therapeutically effective amount of the compounds and compositions described herein is effective for treating inflammation, pain (both chronic and acute), and fever, such as, for example, analgesic in the treatment of pain, including, but not limited to headaches, migraines, postoperative pain, dental pain, muscular pain, and pain resulting from cancer; as an antipyretic for the treatment of fever, including but not limited to, rheumatic fever, symptoms associated with influenza or other viral infections, common cold, low back and neck pain, dysmenorrhea, headache, toothache, sprains, strains, myositis, neuralgia, synovitis; arthritis, including but not limited to rheumatoid arthritis, degenerative joint disease (osteoarthritis), spondyloarthropathies, gouty arthritis, systemic lupus erythematosus and juvenile arthritis. For example, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor of the invention. In another embodiment, the patient can be administered a therapeutically effective amount of at least one nitrosated and/or nitrosylated COX-2 selective inhibitor. In another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, and at least one compound that donates, transfers or releases nitric oxide, or elevates levels of endogenous EDRF or nitric oxide, or is a substrate for nitric oxide synthase. In yet another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, and, at least one therapeutic agent, including but not limited to, steroids, nonsterodal antiinflammatory compounds (NSAID), 5-lipoxygenase (5-LO) inhibitors, leukotriene B4 (LTB4) receptor antagonists, leukotriene A4 (LTA4) hydrolase inhibitors, 5-HT agonists, 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) inhibitors, H2 antagonists, antineoplastic agents, antiplatelet agents, thrombin inhibitors, thromboxane inhibitors, decongestants, diuretics, sedating or non-sedating anti-histamines, inducible nitric oxide synthase inhibitors, opioids, analgesics, Helicobacter pylori inhibitors, proton pump inhibitors, isoprostane inhibitors, and, optionally, at least one compound that donates, transfers or releases nitric oxide, or elevates levels of endogenous EDRF or nitric oxide, or is a substrate for nitric oxide synthase. The compounds can be administered separately or in the form of a composition. [1306] Another embodiment of the invention provides methods for decreasing and/or preventing gastrointestinal disorders and improving the gastrointestinal properties of the COX-2 selective inhibitor by administering to the patient in need thereof a therapeutically effective amount of the compounds and/or compositions described herein. Such gastrointestinal disorders refer to any disease or disorder of the upper gastrointestinal tract (e.g., esophagus, the stomach, the duodenum, jejunum) including, for example, inflammatory bowel disease, Crohn's disease, gastritis, irritable bowel syndrome, ulcerative colitis, peptic ulcers, stress ulcers, gastric hyperacidity, dyspepsia, gastroparesis, Zollinger-Ellison syndrome, gastroesophageal reflux disease, bacterial infections (including, for example, a Helicobacter Pylori associated disease), short-bowel (anastomosis) syndrome, hypersecretory states associated with systemic mastocytosis or basophilic leukemia and hyperhistaminemia, and bleeding peptic ulcers that result, for example, from neurosurgery, head injury, severe body trauma or bums. For example, the patient can be administered a therapeutically effective amount of at least one nitrosated and/or nitrosylated COX-2 selective inhibitor of the invention. In another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, and at least one compound that donates, transfers or releases nitric oxide, or elevates levels of endogenous EDRF or nitric oxide, or is a substrate for nitric oxide synthase. In yet another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, and at least one therapeutic agent, including but not limited to, steroids, nonsterodal antiinflammatory compounds (NSAID), 5-lipoxygenase (5-LO) inhibitors, leukotriene B4 (LTB4) receptor antagonists, leukotriene A4 (LTA4) hydrolase inhibitors, 5-HT agonists, 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) inhibitors, H2 antagonists, antineoplastic agents, antiplatelet agents, thrombin inhibitors, thromboxane inhibitors, decongestants, diuretics, sedating or non-sedating anti-histamines, inducible nitric oxide synthase inhibitors, opioids, analgesics, Helicobacter pylori inhibitors, proton pump inhibitors, isoprostane inhibitors, and, optionally, at least one compound that donates, transfers or releases nitric oxide, or elevates levels of endogenous EDRF or nitric oxide, or is a substrate for nitric oxide synthase. The compounds can be administered separately or in the form of a composition. [1307] Yet another embodiment of the invention provides methods for facilitating wound healing (such as, for example, ulcer healing) by administering to the patient in need thereof a therapeutically effective amount of the compounds and/or compositions described herein. Wound refers to, and includes, any lesion that is characterized by loss of tissue, and, includes, but are not limited to, ulcers, cuts, burns, and the like. Ulcers refers to lesions of the upper gastrointestinal tract lining that are characterized by loss of tissue, and, include, but are not limited to, gastric ulcers, duodenal ulcers, gastritis, and the like. For example, the patient can be administered a therapeutically effective amount of at least one nitrosated and/or nitrosylated COX-2 selective inhibitor of the invention. In another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, and at least one nitric oxide donor. In yet another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, and at least one therapeutic agent, and, optionally, at least one nitric oxide donor. The compounds can be administered separately or in the form of a composition. [1308] Another embodiment of the invention provides methods to decrease or reverse renal and other toxicities (such as, for example, kidney toxicity) by administering to a patient in need thereof a therapeutically effective amount of the compounds and/or compositions described herein. For example, the patient can be administered a therapeutically effective amount of at least one nitrosated and/or nitrosylated COX-2 selective inhibitor of the invention. In another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, and at least one nitric oxide donor. In yet another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, and at least one therapeutic agent, and, optionally, at least one nitric oxide donor. The compounds can be administered separately or in the form of a composition. [1309] Another embodiment of the invention provides methods to treat or prevent disorders resulting from elevated levels of COX-2 by administering to a patient in need thereof a therapeutically effective amount of the compounds and/or compositions described herein. For example, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, of the invention. In another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, and at least one compound that donates, transfers or releases nitric oxide, or elevates levels of endogenous EDRF or nitric oxide, or is a substrate for nitric oxide synthase. In yet another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, and at least one therapeutic agent, including but not limited to, steroids, a nonsterodal antiinflammatory compounds (NSAID), 5-lipoxygenase (5-LO) inhibitors, leukotriene B4 (LTB4) receptor antagonists, leukotriene A4 (LTA4) hydrolase inhibitors, 5-HT agonists, 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) inhibitors, H2 antagonists, antineoplastic agents, antiplatelet agents, thrombin inhibitors, thromboxane inhibitors, decongestants, diuretics, sedating or non-sedating anti-histamines, inducible nitric oxide synthase inhibitors, opioids, analgesics, Helicobacter pylori inhibitors, proton pump inhibitors, isoprostane inhibitors, and, optionally, at least one compound that donates, transfers or releases nitric oxide, or elevates levels of endogenous EDRF or nitric oxide, or is a substrate for nitric oxide synthase. The compounds can be administered separately or in the form of a composition. [1310] Disorders resulting from elevated levels of COX-2 (e.g., COX-2 mediated disorders) include, but are not limited to, for example, angiogenisis, arthritis, asthma, bronchitis, menstrual cramps, premature labor, tendinitis, bursitis; skin-related conditions, such as, for example, psoriasis, eczema, surface wounds, burns and dermatitis; post-operative inflammation including from ophthalmic surgery, such as, for example, cataract surgery and refractive surgery, and the like; treatment of neoplasia, such as, for example, brain cancer, bone cancer, epithelial cell-derived neoplasia (epithelial carcinoma), such as, for example, basal cell carcinoma, adenocarcinoma, gastrointestinal cancer, such as, for example, lip cancer, mouth cancer, esophageal cancer, small bowel cancer and stomach cancer, colon cancer, liver cancer, bladder cancer, pancreas cancer, ovary cancer, cervical cancer, lung cancer, breast cancer and skin cancer, such as squamus cell and basal cell cancers, prostate cancer, renal cell carcinoma, and other known cancers that effect epithelial cells throughout the body, benign and cancerous tumors, growths, polyps, adenomatous polyps, including, but not limited to, familial adenomatous polyposis, fibrusis resulting from radiation therapy, and the like; treatment of inflammatory processes in diseases, such as, for example, vascular diseases, migraine headaches, periarteritis nodosa, thyroiditis, aplastic anemia, Hodgkin's disease, sclerodoma, rheumatic fever, type I diabetes, neuromuscular junction disease including myasthenia gravis, white matter disease including multiple sclerosis, sarcoidosis, nephrotic syndrome, Behcet's syndrome, polymyositis, gingivitis, nephritis, hypersensitivity, swelling occurring after injury, myocardial ischemia, and the like; treatment of ophthalmic diseases and disorders, such as, for example, retinitis, retinopathies, uveitis, ocular photophobia, acute injury to the eye tissue, glaucoma, inflammation of the eye and elevation of intraocular pressure and the like; treatment of pulmonary inflammation, such as, for example, those associated with viral infections and cystic fibrosis, and the like; treatment of central nervous system disorders, such as, for example, cortical dementias including Alzheimer's disease, vascular dementia, multi-infarct dementia, pre-senile dementia, alcoholic dementia, senile dementia, and central nervous system damage resulting from stroke, ischemia and trauma, and the like; treatment of allergic rhinitis, respiratory distress syndrome, endotoxin shock syndrome, atherosclerosis; treatment of inflammations and/or microbial infections including, for example, inflammations and/or infections of the eyes, ears, nose, throat, and/or skin; treatment and/or prevention of cardiovascular disorders, such as, for example, coronary artery disease, aneurysm, arteriosclerosis, atherosclerosis, including, but not limited to, cardiac transplant atherosclerosis, myocardial infaraction, hypertension, ischemia, embolism, stroke, thrombosis, venous thrombosis, thromboembolism, thrombotic occlusion and reclusion, restenosis, angina, unstable angina, shock, heart failure, coronary plaque inflammation, bacterial-induced inflammation, such as, for example, Chlamydia-induced inflammation, viral induced inflammation, inflammation associated with surgical procedures, such as, for example, vascular grafting, coronary artery bypass surgery, revascularization procedures, such as, for example, angioplasty, stent placement, endarterectomy, vascular procedures involving arteries, veins, capillaries, and the like; treatment and/or prevention of urinary and/or urological disorders, such as, for example, incontinence and the like; treatment and/or prevention of endothelial dysfunctions, such as, for example, diseases accompanying these dysfunctions, endothelial damage from hypercholesterolemia, endothelial damage from hypoxia, endothelial damage from mechanical and chemical noxae, especially during and after drug, and mechanical reopening of stenosed vessels, for example, following percutaneous transluminal angiography (PTA) and percuntaneous transluminal coronary angiography (PTCA), endothelial damage in postinfarction phase, endothelium-mediated reocculusion following bypass surgery, blood supply distrubances in peripheral arteries, as well as, cardiovascular diseases, and the like; disorders treated by the preservation of organs and tissues, such as, for example, for organ transplants, and the like; disorders treated by the inhibition and/or prevention of activation, adhesion and infiltration of neutrophils at the site of inflammation; and disorders treated by the inhibition and/or prevention of platelet aggregation. The compounds and compositions of the invention can also be used as a pre-anesthetic medication in emergency operations to reduce the danger of aspiration of acidic gastric contents. [1311] Another embodiment of the invention provides methods for improving the cardiovascular profile of COX-2 selective inhibitors by administering to a patient in need thereof a therapeutically effective amount of the compounds and/or compositions described herein. For example, the patient can be administered a therapeutically effective amount of at least one nitrosated and/or nitrosylated COX-2 selective inhibitor of the invention. In another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, and at least one nitric oxide donor. In yet another embodiment, the patient can be administered a therapeutically effective amount of at least one COX-2 selective inhibitor, that is optionally nitrosated and/or nitrosylated, at least one of 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) inhibitors, antiplatelet agents, thrombin inhibitors, thromboxane inhibitors, and, optionally, at least one nitric oxide donor. The compounds can be administered separately or in the form of a composition. [1312] When administered in vivo, the compounds and compositions of the invention can be administered in combination with pharmaceutically acceptable carriers and in dosages described herein. When the compounds and compositions of the invention are administered as a mixture of at least one COX-2 selective inhibitor and/or at least one nitrosated and/or nitrosylated COX-2 selective inhibitor and/or at least one nitric oxide donor and/or therapeutic agent, they can also be used in combination with one or more additional compounds which are known to be effective against the specific disease state targeted for treatment. The nitric oxide donors, therapeutic agents and/or other additional compounds can be administered simultaneously with, subsequently to, or prior to administration of the COX-2 selective inhibitor and/or nitrosated and/or nitrosylated COX-2 selective inhibitor. [1313] The compounds and compositions of the invention can be administered by any available and effective delivery system including, but not limited to, orally, bucally, parenterally, by inhalation spray, by topical application, by injection, transdermally, or rectally (e.g., by the use of suppositories) in dosage unit formulations containing conventional nontoxic pharmaceutically acceptable carriers, adjuvants, and vehicles, as desired. Parenteral includes subcutaneous injections, intravenous, intramuscular, intrasternal injection, or infusion techniques. [1314] Transdermal compound administration, which is known to one skilled in the art, involves the delivery of pharmaceutical compounds via percutaneous passage of the compound into the systemic circulation of the patient. Topical administration can also involve the use of transdermal administration such as transdermal patches or iontophoresis devices. Other components can be incorporated into the transdermal patches as well. For example, compositions and/or transdermal patches can be formulated with one or more preservatives or bacteriostatic agents including, but not limited to, methyl hydroxybenzoate, propyl hydroxybenzoate, chlorocresol, benzalkonium chloride, and the like. Dosage forms for topical administration of the compounds and compositions can include creams, sprays, lotions, gels, ointments, eye drops, nose drops, ear drops, and the like. In such dosage forms, the compositions of the invention can be mixed to form white, smooth, homogeneous, opaque cream or lotion with, for example, benzyl alcohol 1% or 2% (wt/wt) as a preservative, emulsifying wax, glycerin, isopropyl palmitate, lactic acid, purified water and sorbitol solution. In addition, the compositions can contain polyethylene glycol 400. They can be mixed to form ointments with, for example, benzyl alcohol 2% (wt/wt) as preservative, white petrolatum, emulsifying wax, and tenox II (butylated hydroxyanisole, propyl gallate, citric acid, propylene glycol). Woven pads or rolls of bandaging material, e.g., gauze, can be impregnated with the compositions in solution, lotion, cream, ointment or other such form can also be used for topical application. The compositions can also be applied topically using a transdermal system, such as one of an acrylic-based polymer adhesive with a resinous crosslinking agent impregnated with the composition and laminated to an impermeable backing. [1315] Solid dosage forms for oral administration can include capsules, tablets, effervescent tablets, chewable tablets, pills, powders, sachets, granules and gels. In such solid dosage forms, the active compounds can be admixed with at least one inert diluent such as sucrose, lactose or starch. Such dosage forms can also comprise, as in normal practice, additional substances other than inert diluents, e.g., lubricating agents such as magnesium stearate. In the case of capsules, tablets, effervescent tablets, and pills, the dosage forms can also comprise buffering agents. Soft gelatin capsules can be prepared to contain a mixture of the active compounds or compositions of the invention and vegetable oil. Hard gelatin capsules can contain granules of the active compound in combination with a solid, pulverulent carrier such as lactose, saccharose, sorbitol, mannitol, potato starch, corn starch, amylopectin, cellulose derivatives of gelatin. Tablets and pills can be prepared with enteric coatings. [1316] Liquid dosage forms for oral administration can include pharmaceutically acceptable emulsions, solutions, suspensions, syrups, and elixirs containing inert diluents commonly used in the art, such as water. Such compositions can also comprise adjuvants, such as wetting agents, emulsifying and suspending agents, and sweetening, flavoring, and perfuming agents. [1317] Suppositories for vaginal or rectal administration of the compounds and compositions of the invention, such as for treating pediatric fever and the like, can be prepared by mixing the compounds or compositions with a suitable nonirritating excipient such as cocoa butter and polyethylene glycols which are solid at room temperature but liquid at rectal temperature, such that they will melt in the rectum and release the drug. [1318] Injectable preparations, for example, sterile injectable aqueous or oleaginous suspensions can be formulated according to the known art using suitable dispersing agents, wetting agents and/or suspending agents. The sterile injectable preparation can also be a sterile injectable solution or suspension in a nontoxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol. Among the acceptable vehicles and solvents that can be used are water, Ringer's solution, and isotonic sodium chloride solution. Sterile fixed oils are also conventionally used as a solvent or suspending medium. [1319] The compositions of this invention can further include conventional excipients, i.e., pharmaceutically acceptable organic or inorganic carrier substances suitable for parenteral application which do not deleteriously react with the active compounds. Suitable pharmaceutically acceptable carriers include, for example, water, salt solutions, alcohol, vegetable oils, polyethylene glycols, gelatin, lactose, amylose, magnesium stearate, talc, surfactants, silicic acid, viscous paraffin, perfume oil, fatty acid monoglycerides and diglycerides, petroethral fatty acid esters, hydroxymethyl-cellulose, polyvinylpyrrolidone, and the like. The pharmaceutical preparations can be sterilized and if desired, mixed with auxiliary agents, e.g., lubricants, preservatives, stabilizers, wetting agents, emulsifiers, salts for influencing osmotic pressure, buffers, colorings, flavoring and/or aromatic substances and the like which do not deleteriously react with the active compounds. For parenteral application, particularly suitable vehicles consist of solutions, preferably oily or aqueous solutions, as well as suspensions, emulsions, or implants. Aqueous suspensions may contain substances which increase the viscosity of the suspension and include, for example, sodium carboxymethyl cellulose, sorbitol and/or dextran. Optionally, the suspension may also contain stabilizers. [1320] The composition, if desired, can also contain minor amounts of wetting agents, emulsifying agents and/or pH buffering agents. The composition can be a liquid solution, suspension, emulsion, tablet, pill, capsule, sustained release formulation, or powder. The composition can be formulated as a suppository, with traditional binders and carriers such as triglycerides. Oral formulations can include standard carriers such as pharmaceutical grades of mannitol, lactose, starch, magnesium stearate, sodium saccharine, cellulose, magnesium carbonate, and the like. [1321] Various delivery systems are known and can be used to administer the compounds or compositions of the invention, including, for example, encapsulation in liposomes, microbubbles, emulsions, microparticles, microcapsules and the like. The required dosage can be administered as a single unit or in a sustained release form. [1322] The bioavailabilty of the compositions can be enhanced by micronization of the formulations using conventional techniques such as grinding, milling, spray drying and the like in the presence of suitable excipients or agents such as phospholipids or surfactants. [1323] The preferred methods of administration of the COX-2 selective inhibitors and compositions for the treatment of gastrointestinal disorders are orally, bucally or by inhalation. The preferred methods of administration for the treatment of inflammation and microbial infections are orally, bucally, topically, transdermally or by inhalation. [1324] The compounds and compositions of the invention can be formulated as pharmaceutically acceptable salt forms. Pharmaceutically acceptable salts include, for example, alkali metal salts and addition salts of free acids or free bases. The nature of the salt is not critical, provided that it is pharmaceutically-acceptable. Suitable pharmaceutically-acceptable acid addition salts may be prepared from an inorganic acid or from an organic acid. Examples of such inorganic acids include, but are not limited to, hydrochloric, hydrobromic, hydroiodic, nitric, carbonic, sulfuric and phosphoric acid and the like. Appropriate organic acids include, but are not limited to, aliphatic, cycloaliphatic, aromatic, heterocyclic, carboxylic and sulfonic classes of organic acids, such as, for example, formic, acetic, propionic, succinic, glycolic, gluconic, lactic, malic, tartaric, citric, ascorbic, glucuronic, maleic, fumaric, pyruvic, aspartic, glutamic, benzoic, anthranilic, mesylic, salicylic, p-hydroxybenzoic, phenylacetic, mandelic, embonic (pamoic), methanesulfonic, ethanesulfonic, benzenesulfonic, pantothenic, toluenesulfonic, 2-hydroxyethanesuifonic, sulfanilic, stearic, algenic, β-hydroxybutyric, cyclohexylaminosulfonic, galactaric and galacturonic acid and the like. Suitable pharmaceutically-acceptable base addition salts include, but are not limited to, metallic salts made from aluminum, calcium, lithium, magnesium, potassium, sodium and zinc or organic salts made from primary, secondary and tertiary amines, cyclic amines, N,N′-dibenzylethylenediamine, chloroprocaine, choline, diethanolamine, ethylenediamine, meglumine (N-methylglucamine) and procaine and the like. All of these salts may be prepared by conventional means from the corresponding compound by reacting, for example, the appropriate acid or base with the compound. [1325] While individual needs may vary, determination of optimal ranges for effective amounts of the compounds and/or compositions is within the skill of the art. Generally, the dosage required to provide an effective amount of the compounds and compositions, which can be adjusted by one of ordinary skill in the art, will vary depending on the age, health, physical condition, sex, diet, weight, extent of the dysfunction of the recipient, frequency of treatment and the nature and scope of the dysfunction or disease, medical condition of the patient, the route of administration, pharmacological considerations such as the activity, efficacy, pharmacokinetic and toxicology profiles of the particular compound used, whether a drug delivery system is used, and whether the compound is administered as part of a drug combination. [1326] The amount of a given COX-2 selective inhibitor of the invention that will be effective in the treatment of a particular disorder or condition will depend on the nature of the disorder or condition, and can be determined by standard clinical techniques, including reference to Goodman and Gilman, supra; The Physician's Desk Reference, Medical Economics Company, Inc., Oradell, N.J., 1995; and Drug Facts and Comparisons, Inc., St. Louis, Mo., 1993. The precise dose to be used in the formulation will also depend on the route of administration, and the seriousness of the disease or disorder, and should be decided by the physician and the patient's circumstances. [1327] The amount of nitric oxide donor in a pharmaceutical composition can be in amounts of about 0.1 to about 10 times the molar equivalent of the COX-2 selective inhibitor. The usual daily doses of the COX-2 selective inhibitors are about 0.001 mg to about 140 mg/kg of body weight per day, preferably 0.005 mg to 30 mg/kg per day, or alternatively about 0.5 mg to about 7 g per patient per day. For example, inflammations may be effectively treated by the administration of from about 0.01 mg to 50 mg of the compound per kilogram of body weight per day, or alternatively about 0.5 mg to about 3.5 g per patient per day. The compounds may be administered on a regimen of up to 6 times per day, preferably 1 to 4 times per day, and most preferably once per day. Effective doses may be extrapolated from dose-response curves derived from in vitro or animal model test systems and are in the same ranges or less than as described for the commercially available compounds in the Physician's Desk Reference, supra. [1328] The invention also provides pharmaceutical kits comprising one or more containers filled with one or more of the ingredients of the pharmaceutical compounds and/or compositions of the invention, including, at least, one or more of the novel COX-2 selective inhibitors, that is optionally nitrosated and/or nitrosylated, and one or more of the NO donors described herein. Associated with such kits can be additional therapeutic agents or compositions (e.g., steroids, NSAIDs, 5-lipoxygenase (5-LO) inhibitors, leukotriene B4 (LTB4) receptor antagonists and leukotriene A4 (LTA4) hydrolase inhibitors, 5-HT agonists, HMG-CoA inhibitors, H2 antagonists, antineoplastic agents, antiplatelet agents, thrombin inhibitors, thromboxane inhibitors, decongestants, diuretics, sedating or non-sedating anti-histamines, inducible nitric oxide synthase inhibitors, opioids, analgesics, Helicobacter pylori inhibitors, proton pump inhibitors, isoprostane inhibitors, and the like), devices for administering the compositions, and notices in the form prescribed by a governmental agency regulating the manufacture, use or sale of pharmaceuticals or biological products which reflects approval by the agency of manufacture, use or sale for humans.
EXAMPLES [1329] The following non-limiting examples further describe and enable one of ordinary skill in the art to make and use the present invention. In each of the examples, flash chromatography was performed on 40 micron silica gel (Baker).
Example 1
4-(4-((Fluoromethyl)sulfonyl)phenyl)-3-phenyl-5-hydrofuran-2-one [1330] 4-(4-methylthiophenyl)-3-phenyl-5-hydrofuran-2-one was synthesized as described by Rossi et al, Syn.Lett., 12: 1749-1752 (2000). Deoxy-Fluor™ (50 μL, 0.25 mmol) was added to a mixture of 4-(4-methylthiophenyl)-3-phenyl-5-hydrofuran-2-one (50 mg, 0.17 mmol) and antimony chloride (4 mg, 0.017 mmol) dissolved in CH2Cl2 (1 mL). The reaction was stirred at room temperature for 12 hr. Additional Deoxy-Fluor (100 μL, 0.5 mmol) was added and the reaction was stirred at room temperature for an additional 4 hr. A solution of m-CPBA (123 mg, 0.5 mmol) prepared in a minimum of CH2Cl2 was slowly added to the reaction mixture. The resultant mixture was stirred at room temperature for 4 hr. The reaction mixture was then diluted with CH2Cl2, washed with 1N HCl and 1N Na2CO3, dried over Na2SO4, and concentrated. The resultant residue was chromatographed on silica gel eluting with 1:1 Hexane:EtOAc then further purified by preparative TLC eluting with 1:1 Hexane:EtOAc to give the title compound as a clear oil (5 mg, 8%). 1H-NMR (300 MHz, CDCl3) δ: 7.95 (d, J=8.4 Hz, 2H), 7.55 (d, J=8.4 Hz, 2H), 7.38-7.43 (mult, 5H), 5.20 (s, 2H), 5.15 (d, JH—F =47.1, 2H); LC-MS(API—TIS) m/z 333 MH+ and 350 (M+NH4)+.
Example 2
Assay for COX-1 and COX-2 Activity [1331] The ovine COX-1 and human CO-2 activities and the measurement of the prostaglandin products synthesized were performed using the COX Inhibitor Screening Assay (Cayman Chemical, Ann Arbor, Mich., which also contained the Prostaglandin Screening EIA Kit, used for prostaglandin quantification). The test compounds were dissolved at 50 times the highest final reaction concentration in DMSO or any other suitable solvent as stock solutions. These stock solutions were then diluted in the same solvent. Eight glass test tubes (13×100 mm) were placed in a 37° C. water bath. To each test tube was added 950 μL of reaction buffer (0.1 M Tris-HCl, pH 8.0, containing 5 mM EDTA, and 2 mM phenol), 10 μL of 100 M heme solution, and 10 μL (5 units) of either ovine COX-1 or human COX-2 and the resulting mixture was incubated with the enzyme for 2 minutes. Twenty μL of the solvent was added to one tube (100% initial activity or solvent control) and 20 μL of each dilution of the test compound was added to one tube each. Each tube was vortexed immediately after the addition. The enzyme was incubated with the inhibitor for 3.5 minutes at 37° C. The enzymatic reaction was then initiated by the addition of 10 μL of freshly prepared 10 mM arachidonic acid (neutralized with KOH), vortexed and then incubated for 2 minutes at 37° C. The reaction was terminated by the addition of 50 μL of 1 M HCl, vortexed and placed at room temperature. One hundred microliters of a saturated stannous chloride solution (50 mg/mL of 0.1 M HCl) was added and the reaction mixture was allowed to stand at room temperature for at least 5 minutes. [1332] The prostaglandins (PG) produced in the reactions were assayed, after a 2,000-fold dilution, using the Prostaglandin Screening EIA Kit (Cayman Chemical, Ann Arbor, Mich.). The assay contains an antibody with broad specificity for all the prostaglandin families (PGF, PGE, PGD, and thromboxane B-type) synthesized in the COX-1/COX 2 reactions. The synthesized prostaglandin competes with a PG-tagged acetylcholine esterase tracer for binding to the PG antibody. Binding of synthesized PG lowers the colorimetric development of the Ellman's Reagent (computed as % B/Bo). The actual amount of synthesized PG was interpolated from a standard curve using known amounts of supplied prostaglandin E2 (PGE2) (PGE2 concentration vs. % B/Bo). The data generated were the mean ± standard deviation of triplicate wells in the EIA for a single reaction at a given inhibitor concentration. A plot of % of control (i.e., the solvent control without inhibitor) vs. test compound inhibitor concentration for both isoenzymes was used to determine the IC50 's for COX-1 and COX-2 for that test compound. The IC50 for the compound of Example 1 is given in Table 1. 1
TABLE 1% INHIBITION OF COX-1 AND COX-2COX-1 InhibitionCOX-2 InhibitionTest Compound(% at 100 μM)(% at 10 μM)Example 13040
[1333] The results show that the compound of Example 1 has COX-2 selectivity. [1334] The disclosure of each patent, patent application and publication cited or described in the present specification is hereby incorporated by reference herein in its entirety. [1335] Although the invention has been set forth in detail, one skilled in the art will appreciate that numerous changes and modifications can be made to the invention, and that such changes and modifications can be made without departing from the spirit and scope of the present invention.
Claims
1. A compound of formula (I), or a pharmaceutically acceptable salt thereof, wherein the compound of formula (I) is:
2. A composition comprising the compound of claim 1 and a pharmaceutically acceptable carrier.
RELATED APPLICATIONS
[0001] This application claims priority to U.S. Provisional Application No. 60/277,950 filed Mar. 23, 2001.
Patent Application
20020183366
