Aspirin

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Information about Aspirin

Aspirin or acetylsalicylic acid is perhaps the most commonly used analgesic and antipyretic medication worldwide, having been in clinical use for over 100 years.  Aspirin has been shown to be helpful when used daily to lower the risk of heart attack, clot-related strokes and other blood flow problems in patients who have cardiovascular disease or who have already had a heart attack or stroke. Many medical professionals prescribe aspirin for these uses. There may be a benefit to daily aspirin use for you if you have some kind of heart or blood vessel disease, or if you have evidence of poor blood flow to the brain. However, the risks of long-term aspirin use may be greater than the benefits if there are no signs of, or risk factors for heart or blood vessel disease.

Benefits and risks

Every prescription and over-the-counter medicine has benefits and risks — even such a common and familiar medicine as aspirin. Aspirin use can result in serious side effects, such as stomach bleeding, bleeding in the brain, kidney failure, and some kinds of strokes. No medicine is completely safe. By carefully reviewing many different factors, your health professional can help you make the best choice for you.

Liver safety of Aspirin

Aspirin can cause several forms of liver injury:  in high doses, aspirin can cause moderate to marked serum aminotransferase elevations occasionally with jaundice or signs of liver dysfunction, and in lower doses in susceptible children with a febrile illness aspirin can lead to Reye syndrome.

Mechanism of action of Aspirin

Aspirin is a salicylate, but technically is also a nonsteroidal antiinflammatory drug (NSAID).  Like the NSAIDs, salicylates are inhibitors of tissue cyclooxygenases (Cox-1 and -2) which cause a decrease in synthesis of proinflammatory prostaglandins, potent mediators of pain and inflammation.  In distinction to other NSAIDs, however, aspirin is a noncompetitive and irreversible inhibitor of Cox-1, so that its effects are longer lasting and less easily reversed than those of typical NSAIDs.  Aspirin has potent effects in inhibiting platelet function that lasts for the lifetime of the platelet.  Aspirin’s potent and lasting effects on Cox-1 in gastric epithelial cells account for its frequent gastric side effects and association with peptic ulcer disease and gastrointestinal bleeding. 

Clinical use of Aspirin

Aspirin is indicated for the treatment of mild to moderate pain from headaches, colds, arthritis, menstrual periods, toothaches and joint and muscle aches caused by trauma, osteoarthritis, or rheumatoid arthritis.  Higher, more continuous doses of aspirin are effective in therapy of juvenile rheumatoid arthritis, systemic lupus erythematosus, rheumatoid arthritis, acute rheumatic fever and Kawasaki disease.  Aspirin has antipyretic effects and can be used for management of fever, but should not be used in children or adolescents because of its potential to cause Reye syndrome.  In low daily doses (81 mg), aspirin is used to decrease the risk of coronary and cerebrovascular disease and reocclusion after coronary revascularization or stent placement. 

FDA approval information for Aspirin

Aspirin became clinically available in the United States in the early part of the 20th century and is currently widely used as an over-the-counter medication.  It is available in multiple generic formulations, either alone or in combination with other pain relievers, antacids, or cough and cold medications. 

Dosage and administration for Aspirin

Aspirin is typically taken in doses of 330 to 660 mg every 4 to 6 hours.  The dose used for antiplatelet effects in prevention of complications of atherosclerosis is 81 mg once daily. 

Brand name for Aspirin

Common brand names for aspirin alone or in combination with other agents include Bayer’s Aspirin, Alka Seltzer, Anacin, Ascriptin, Aspergum, BC Powder, Bufferin, Ecotrin, Excedrin and Stanback.

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