Aspirin, oracetylsalicylic acid  is a drug, often used as an analgesic (pain relieving medication) to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory agent.

Aspirin also has an antiplatelet or "anti-blood clotting" effect and is used in long-term, low doses to prevent heart attacks, strokes and blood clot formation in people at high risk for developing blood clots.8301 It has also been established that low doses of aspirin may be given immediately after a heart attack to reduce the risk of another heart attack or of the death of cardiac muscle tissue.9601

Gastrointestinalâ€"ulcers and bleeding from the stomach are the main side effects associated with aspirin.  Tinnitus, especially in higher doses may also occur. In children under 19 years of age, aspirin is no longer used to control flu-like symptoms or the symptoms of chickenpox, due to the risk of Reye's syndrome, apotentially fatal disease that causes numerous detrimental effects to many organs, especially the brain and liver. In addition to aspirin, It is associated with viral illnesses such as chickenpox.

Aspirin was the first-discovered member of the group of drugs called non-steroidal anti-inflammatory drugs (NSAIDs), not all of which are salicylates, although they all have similar effects and most have some mechanism of action which involvesinhibition of the enzyme cyclooxygenase. Aspirin is one of the most widely used medications in the world, with an estimated 40,000 metric tons of it being consumed annually.

History of Aspirin

Medicines containing derivatives of salicylic acid, that are chemically similar to aspirin, have been in medical use since ancient times. Salicylate-rich willow bark extract became recognized for its beneficial effects on fever, pain and inflammation in the mid-eighteenth century.

The French chemist, Gerhardt, was the first to prepare acetylsalicylic acid (named aspirin in 1899) in 1853.

By 1899, Bayer, a drug and dye company, had named this drugAspirin and was smarketing it around the world.The name Aspirin is derived from A = Acetyl and "Spirsäure" = an old (German) name for salicylic acid. Aspirin's popularity grew over the first half of the twentieth century, spurred by its effectiveness in the wake of Spanish flu pandemic of 1918.

Aspirin's popularity declined after the releases of paracetamol (acetaminophen) in 1956 and ibuprofen in 1969. In the 1960s and 1970s, John Vane and others discovered the basic mechanism of aspirin's effects, while clinical trials and other studies from the 1960s to the 1980s established aspirin's efficacy as an anti-clotting agent that reduces the risk of clotting diseases. Aspirin sales have revived significantly in the last forty years of the twentieth century, with widespread use as a preventive treatment for heart attacks and strokes.

Therapeutic uses of Aspirin

Aspirin is one of the most frequently used drugs in the treatment of mild to moderate pain, including that of migraine and pyrexia (fever). It is often combined with other non-steroidal anti-inflammatory drugs and opioids in the treatment of moderate to severe pain.In lower dosage, aspirin has properties as an inhibitor of platelet aggregation, and has been shown to decrease the incidence of transient ischemic attacks and unstable angina in men, and can be used prophylactically. Low doses of aspirin are also recommended for the prevention of stroke, and myocardial infarction in patients with either diagnosed coronary artery disease or who have an elevated risk.

Contraindications and resistance

Aspirin should be avoided by those known to be allergic to other NSAIDs such as ibuprofen or naproxen. and caution should be exercised in those with asthma. There is an increased risk of stomach bleeding when aspirin is taken with alcohol or warfarin. Patients with haemophilia or other bleeding tendencies should not receive aspirin. Aspirin should not be given to children or adolescents to control cold or influenza symptoms as it has been associated with with Reye's syndrome.

Interactions

Acetazolamide has been known to enhance the intoxicating effect of salicyclates, and alcohol also enhances the gastrointestinal bleeding associated with these types of drugs as well. Aspirin is known to displace a number of drugs from protein binding sites in the blood, including:

  • the anti-diabetic drugs tolbutamide and chlorpropamide,
  • the immunosuppressant methotrexate,
  • phenytoin,
  • probenecid,
  • valproic acid
  • Corticosteroids may also reduce the concentration of aspirin.
  • The activity of spironolactone may be reduced by taking aspirin
  • aspirin is known to compete with Penicillin  for renal tubular secretion.
  • Aspirin may also inhibit the absorption of vitamin C.

 

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