Alternative Names: Acetylsalicylic Acid.
Aspirin (acetylsalicylic acid) is one of the most widely-used medications in the world, with an estimated 40,000 tonnes being consumed each year. A great body of evidence also suggests that regular aspirin use may offer strong protection against the consequences of heart attack, liver disease, and various cancers.
Other drugs with similar medicinal properties to aspirin have subsequently been developed, being collectively known as the non-steroidal anti-inflammatory
). NSAIDs such as aspirin, indomethacin, piroxicam and sulindac are valuable drugs for the alleviation of pain, inflammation
and fever. NSAIDs are widely used in the treatment of inflammatory
musculoskeletal diseases such as arthritis
. Of all of the NSAIDs, aspirin is the most widely used since it is inexpensive, easily available and is indicated in many common conditions such as headache and the common cold.
Aspirin is a well-established and relatively safe drug, having first been isolated in 1897, and previously being used for 3,000 years in the form of tea made from boiling the bark of the white willow, which contains salicylic acid. Its medicinal properties have been recognised since the days of the Assyrians and the Egyptians.Enteric-coated
aspirin, such as 81mg Bayer, (120 count) or a generic variety, is recommended over the child's aspirin, which are generally found in a tamper-proof bottle with a count of only 20 or so.
Function; Why it is Recommended
Aspirin is used to prevent blood clots within the blood vessel wall, be it in the heart vessels which can cause a heart attack, or in the neck and head vessels which can cause a stroke
. The basis for the use of low dose aspirin lies in its unique inhibitory effect on a single key enzyme, COX-1 (cyclooxygenase-1). Actually, there are two forms (isoforms) of COX. The other is known as COX-2. The latter is inducible and undetectable in most normal tissues but under certain conditions such as inflammatory
processes, becomes elevated. Therefore, a high dose of aspirin (10 grains or 2 adult tablets), which is an anti-inflammatory
, and other medications such as ibuprofen quell the COX-2 and the inflammatory process. As a consequence of this, the good effects of COX-2, which gives protection of the stomach and kidneys
are lost and problems with this such as ulcers
bleeding, kidney failure
, fluid retention and high blood pressure can occur with the higher dosage.
The therapeutic and toxic properties of aspirin and other NSAIDs
can be explained pharmacologically. NSAIDs inhibit the cyclo-oxygenase enzyme and thus prevent the formation of prostaglandins
and thromboxanes from precursor arachidonic acid. Arachidonic acid is an essential polyunsaturated fatty acid
that is derived from the diet. It is believed that the analgesic
and antipyretic effects of aspirin are related to prostaglandin
It is believed that the therapeutic effects of NSAIDs
against pain, inflammation
and fever are largely related to cyclo-oxygenase-2 inhibition while the toxic effects of NSAIDs to the stomach and kidney
are largely related to cyclo-oxygenase-1 inhibition.
Aspirin is absorbed and goes directly to the liver
. The liver inactivates the aspirin by deacetylation. A transdermal patch may be available soon that will not do this, in that it would go right into the blood stream to do its good thing of preventing excess blood clotting.
Aspirin also has a unique usefulness among the family of NSAIDs
in that it can reduce the risk of cardiovascular
disease. Low doses (100-300mg per day) can reduce by 30% the risk of myocardial infarction and stroke
among patients who already have a history of these disorders; lower doses of between 75-150mg per day are also showing promise in reducing the risk of cardiovascular disease in patients with a pre-existing condition. The prevention of cardiovascular disease is thought to be related to thromboxane inhibition in platelets
leading to a reduced risk of potentially dangerous blood clots forming in the heart and brain blood vessels.
Aspirin has also been shown to decrease the incidence of gastrointestinal
cancer and gall bladder
disease, and improve diabetes
symptoms, and pregnancy outcomes. The American Cancer Society epidemiologists found that while low dose aspirin use had no effect on cancers of most organ systems, the risks were greatly reduced for fatal cancers of the esophagus
, stomach, rectum and colon
. These four digestive tract cancers were approximately 40% lower among men and women who used aspirin 16 times per month or more for at least one year compared to those who used no aspirin.
As with heart disease, studies have shown that taking low doses of aspirin, and maintaining a diet low in fat and high in fiber-grains, fruits and vegetables-reduces the risk of many of the digestive cancers.
When cholesterol-saturated bile
accumulates and becomes lodged in the cystic duct, gallstones
are formed. During acute cholecystitis
, usually a bacterial inflammation
associated with gallstones, the production of prostaglandins
are increased as part of the normal inflammation and repair processes. This process involves much pain, increased fluid secretions, muscle contraction and decreased bile, all of which perpetuate the inflammation more. Several studies have been conducted to show that prostaglandin
inhibitors such as aspirin and non-steroidal anti-inflammatory
drugs can prevent the formation of gallstones
, as well as reduce the biliary pain associated with this process.
Years ago, researchers noticed a link between arthritis
, leprosy and the incidence of Alzheimer's
. As part of the standard treatment for arthritis and leprosy was the use of aspirin. These patients were proven to have a lower incidence of Alzheimer's. Researchers from Johns Hopkins Alzheimer's Disease
Research Center found that as the use of aspirin and other non-steroidal anti-inflammatory
drugs increases, the rate of mental deterioration decreases. In the November 8, 1999 issue of Business Week, a pharmaceutical report indicated anti-inflammatory drugs reduce the inflammation
that accompanies plaque formation in the brain. Also, population studies have long noted that aspirin and other nonsteroidal anti-inflammatory drugs appear to reduce the risk of Alzheimer's
and borderline diabetes, aspirin magnifies and enhances the effects of insulin
and oral hypoglycemic agents. This means that aspirin may protect somewhat against diabetic
Many small studies have concluded that low dose aspirin reduces the risks of pregnancy induced hypertension
toxcemia and severe low birth weight.
When an analgesic
is needed, read the label to make sure you do not take a product that contains additional aspirin. Acetaminophen (generic Tylenol) certainly is a good substitute.
Despite their beneficial effects, aspirin and other NSAIDs
do have toxic side-effects. Aspirin can reduce kidney
function, induce bronchoconstriction in asthmatics and in rare cases may precipitate haemorrhagic stroke
Although aspirin has in the past been associated with an increased risk of stomach bleeding and ulcers
, researchers have now found that the stomach bleeding is not caused by the aspirin, but by a "bug". A Nottingham University study showed that 60% of patients suffering from stomach bleeding while taking a low-dose aspirin also tested positive for the bacterium H. pylori
. Once the bacterium was removed, patients no longer had an increased risk of stomach bleeding when taking aspirin, and they did not suffer other recurring ulcer
symptoms.Note: Children should never be given aspirin or aspirin-containing cold medications because of the risks for developing Reye's syndrome, a severe acquired metabolic disease associated with liver and brain dysfunction and death.