Aspirin

Acetyl salicylic acid.

Comes from willow bark(Cricket bat).

Most consumed drug in the whole world.

Mostly consumed for CVS indications.

Mode of action of Aspirin:Aspirin irreversibly inhibits the cyclo-oxygenase enz(Prostaglandin synthatase).So no formation of PG,prostacyclin & Thromboxane.Recovery of enzyme action requires re-synthesis.

Pharmacological effect of Aspirin:

  • Anti-inflammatory effects.
  • Analgesic effect.
  • Antipyretic effect.
  • Antiplatelet effect(Aspirin mainly do this).
  • Uricosuric effect.
  • Effect on respiration,GIT.
  • Respiratory stimulation.

Anti-inflammatory effect of Aspirin:

  • Inhibits leucocyte adhesion to vascular endothelium.
  • Inhibits chemotaxis.
  • Inhibits phagocytosis.
  • Stabilizes the lysosomal membrane.
  • Acts as scavenger for derived free radicals.

Adverse effects of Aspirin:

[A]GIT effects:

  • Nausea,vomoting.
  • Irritation
  • Hyperacidity
  • Ulceration(gastric and duodenal).
  • Perforation
  • Hematemesis,maleana.

[B]Salicylism:Due to chronic mild intoxication of Aspirins:

  • Tinnitus
  • Hearing difficulty.
  • Vertigo
  • Dizziness
  • Headache

[C]Hepatotoxicity:

  • Abnormal liver function tests and
  • Rare liver failure.

[D]Allergy:

[E]Renal toxicity:

  • Renal insufficiency.
  • Renal failure.
  • Hyperkalemia and

(Ref:Katzung-11th,P-624)

Indications of Aspirin:

[A]Somatic/inflammatory pain.

[B]Fever.

[C]Rheumatoid arthritis,auto-immune disease.       

[E]Cardiovascular indications:

  • Transient ischemic attack.
  • Cerebro-vascular accident.
  • Primary effects of MI.
  • Atrial fibrillation.
  • Prosthetic heart valve.
  • Mitral valve prolapse.
  • Deep vein thrombosis.
  • Pulmonary embolism.
  • Patent ductus anteriosus.(PDA)

[F]Gynaecological indications:

  • Dysmenorrhoea/Spasmotic dysmenorrhoea(Painful menstrual bleeding).
  • Premenstrual mastalgia(tenderness of breast)

[G]Obstetrical indications:

  • Threvtened abortion.
  • Premature labour.
  • Pre-eclamptic toxaemia.

[H]Ophthalmic indications:

  • Macular oedema.
  • Diabetic retinopathy.

Most use of Aspirin:           

  • Cardiovascular diseases.
  • Rheumatoid arthritis.
  • Low dose 75 mg/day.

Contraindications of Aspirin:

  • Peptic ulcer.
  • Bleeding disorder.e.g Haemophilia.
  • Liver & kidney disease.
  • undergoing electric surgery.
  • Immediate before or after or during labour.
  • Baby below 1 year having pyrexia.
  • History of Aspirin allergy.
  • Bronchial asthma.

Aspirin is contraindicated in pregnancy because

[A]1st trimester:Aspirin is contra-indicated due to risk fo

  1. Teratogenesis(Cleft lip/palate,talepes).

[B]Near the term:Aspirin is contra-indicated.Because it may cause

  1. Delayed labour:Post maturity→Dangerous for mother as well as the foetus→ change of infection.
  2. Profuse bleeding due to
  • Anti-platelet effect.
  • DIcoumarol like effect.
  1. Patency of ductus arteriosus in the foetus is impaired→Foetal hypertension.

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