What are the signs of aspirin overdose. How does aspirin poisoning occur. When should you seek medical care for aspirin toxicity. What tests are done to diagnose aspirin poisoning. How is aspirin overdose treated.

Understanding Aspirin and Its History

Aspirin, also known as acetylsalicylic acid, is a widely used pain reliever and fever reducer. Its origins can be traced back to ancient times, with the Greek physician Hippocrates utilizing willow bark extract for medicinal purposes in the 5th century BC. Today, aspirin remains a common over-the-counter medication, but its widespread availability also poses risks of accidental or intentional poisoning.

What is aspirin and how does it work?

Aspirin belongs to a class of drugs called salicylates. It works by inhibiting the production of prostaglandins, which are responsible for pain, inflammation, and fever. While effective for many conditions, aspirin can be dangerous if taken in excessive amounts or by certain individuals.

Causes of Aspirin Poisoning

Aspirin poisoning can occur through various means, both intentional and accidental. Understanding these causes is crucial for prevention and early intervention.

Intentional aspirin overdose

In some cases, individuals may deliberately ingest large amounts of aspirin for reasons such as:

• Suicide attempts
• Seeking attention
• Child abuse (when administered to children)

Accidental aspirin poisoning

Unintentional overdoses can happen due to:

• Improper dosing, especially in children and elderly individuals
• Combination of multiple medications containing aspirin or similar substances
• Long-term use of high doses
• Ingestion of aspirin-containing products by young children

While child-resistant packaging has reduced the incidence of accidental poisoning in children, it remains a concern, particularly for older adults with chronic health conditions who may be taking multiple medications.

Recognizing the Symptoms of Aspirin Poisoning

Aspirin toxicity can manifest in various ways, with symptoms ranging from mild to severe. Recognizing these signs early is crucial for prompt treatment.

Early symptoms of aspirin overdose

The initial indicators of aspirin poisoning may include:

• Tinnitus (ringing in the ears)
• Impaired hearing
• Rapid breathing (hyperventilation)
• Nausea and vomiting
• Dehydration
• Fever
• Double vision
• Lightheadedness

Advanced symptoms of aspirin toxicity

As poisoning progresses, more severe symptoms may develop:

• Drowsiness or confusion
• Bizarre behavior
• Unsteady gait
• Coma
• Rapid and deep breathing
• Severe dehydration

When to Seek Medical Care for Aspirin Poisoning

Knowing when to contact medical professionals is critical in cases of suspected aspirin overdose.

Mild symptoms requiring medical advice

If you experience tinnitus while taking aspirin, consult your doctor to determine if the dosage should be adjusted or discontinued.

Severe symptoms requiring immediate medical attention

Call emergency services (911 in the US) immediately if you observe any of the following:

• Agitation, fever, convulsions, or collapse
• Confusion or coma
• Low blood pressure
• Rapid heart rate or breathing
• Wheezing
• Severe nausea and vomiting
• Bleeding
• Hallucinations
• Extreme drowsiness

Diagnosis and Examination of Aspirin Poisoning

When a patient presents with suspected aspirin poisoning, healthcare professionals will conduct a thorough evaluation to determine the severity and appropriate treatment.

Medical history and physical examination

The doctor will gather information about the patient’s medical history and perform a physical exam to look for signs of aspirin toxicity. This includes checking vital signs, assessing breathing, and evaluating the patient’s level of consciousness.

Laboratory tests for aspirin poisoning

Several tests may be conducted to confirm the diagnosis and assess the extent of poisoning:

• Blood tests to measure salicylate levels
• Acid-base status assessment
• Organ function tests to check for damage to various body systems

The doctor will use these results, along with the patient’s symptoms and the estimated amount of aspirin ingested, to guide treatment decisions.

Treatment Approaches for Aspirin Poisoning

The management of aspirin overdose requires prompt and appropriate intervention, which may include both at-home care and medical treatment.

Self-care measures for mild cases

For minor symptoms or while awaiting medical assistance:

• Stop taking aspirin immediately
• Contact a poison control center for guidance
• Provide information about the amount and type of aspirin ingested
• Do not induce vomiting unless instructed by a medical professional

Medical interventions for aspirin toxicity

In more severe cases, treatment may involve:

• Gastric lavage (stomach pumping) to remove unabsorbed aspirin
• Administration of activated charcoal to bind remaining aspirin
• Intravenous fluids to correct dehydration and electrolyte imbalances
• Sodium bicarbonate to alkalinize the blood and enhance aspirin excretion
• Hemodialysis in extreme cases to remove aspirin from the bloodstream
• Supportive care for symptoms such as fever, seizures, or respiratory distress

Prevention Strategies for Aspirin Poisoning

Preventing aspirin poisoning is crucial, especially given its potentially severe consequences. By implementing proper safety measures and educating the public, many cases of aspirin toxicity can be avoided.

Safe storage and handling of medications

To reduce the risk of accidental poisoning:

• Store all medications, including over-the-counter drugs, in child-resistant containers
• Keep medicines out of reach and sight of children
• Avoid referring to medications as “candy” to children
• Properly dispose of expired or unused medications

Education and awareness

Increasing public knowledge about aspirin poisoning can help prevent accidental overdoses:

• Educate patients about proper dosing and potential drug interactions
• Raise awareness about the dangers of mixing medications containing aspirin or similar substances
• Encourage regular medication reviews, especially for older adults taking multiple drugs
• Promote the use of medication tracking tools or apps to prevent dosing errors

Long-term Outlook and Follow-up Care

The prognosis for aspirin poisoning varies depending on the severity of the overdose and the timeliness of treatment. Understanding the long-term implications and necessary follow-up care is essential for patients and caregivers.

Recovery and potential complications

With prompt and appropriate treatment, many patients recover fully from aspirin poisoning. However, some may experience complications such as:

• Kidney damage
• Liver problems
• Persistent hearing loss or tinnitus
• Gastrointestinal issues

The severity and duration of these complications depend on factors such as the amount of aspirin ingested, the duration of exposure, and the individual’s overall health.

Follow-up care and monitoring

After initial treatment for aspirin poisoning, patients may require ongoing care and monitoring:

• Regular check-ups to assess organ function and recovery
• Blood tests to monitor salicylate levels and electrolyte balance
• Psychological evaluation and support, especially in cases of intentional overdose
• Adjustment of medication regimens to prevent future incidents
• Education on safe medication use and alternatives to aspirin when appropriate

By adhering to follow-up care recommendations, patients can optimize their recovery and reduce the risk of long-term complications from aspirin poisoning.

Resources and Support for Aspirin Poisoning

Accessing appropriate resources and support systems is crucial for both prevention and management of aspirin poisoning. Various organizations and services are available to provide information, guidance, and assistance.

Emergency contacts and poison control centers

In the event of suspected aspirin poisoning:

• Call emergency services (911 in the US) for immediate medical attention
• Contact the local poison control center for guidance (1-800-222-1222 in the US)
• Keep these numbers easily accessible, such as posted near telephones or saved in mobile devices

Educational resources and support groups

For ongoing education and support:

• Consult reputable health websites for information on medication safety
• Participate in community health education programs
• Join support groups for individuals recovering from drug overdoses or dealing with chronic pain management
• Utilize medication management apps to track doses and potential interactions

By leveraging these resources, individuals can better protect themselves and their loved ones from the risks associated with aspirin poisoning while ensuring proper use of this valuable medication.

Aspirin Poisoning

Written by WebMD Editorial Contributors

• Aspirin Poisoning Overview
• Aspirin Poisoning Causes
• Aspirin Poisoning Symptoms
• When to Seek Medical Care
• Exams and Tests
• Aspirin Poisoning Treatment – Self-Care at Home
• Medical Treatment
• Medications
• Other Therapy
• Next Steps
• Follow-up
• Prevention
• Outlook
• For More Information – Web Links
• Synonyms and Keywords
• More

Aspirin is another name for acetylsalicylic acid, a common pain reliever (also called an analgesic). The earliest known uses of the drug can be traced back to the Greek physician Hippocrates in the fifth century BC. He used powder extracted from the bark of willows to treat pain and reduce fever.

For a variety of reasons, some people intentionally ingest poisons or poison others. Some reasons include:

• Suicide
• Gaining personal attention
• Child abuse

Aspirin poisoning can also be accidental and was once the most common cause of accidental poisoning of children. Safety precautions such as child-resistant packaging has helped make it less common.

Inappropriate dosing in both children and elderly people is one of the reasons accidental aspirin poisonings continue to happen. Hundreds of medications — both over-the-counter and prescription medicines — contain aspirin or aspirin-like substances. Unintentional poisoning can result if these medications are taken in combination, in inappropriate doses, or over a long time period. This is especially likely to occur in older people with chronic health problems.

The earliest symptoms of acute aspirin poisoning may include ringing in the ears (tinnitus) and impaired hearing. More clinically significant signs and symptoms may include rapid breathing (hyperventilation), vomiting, dehydration, fever, double vision, and feeling faint.

Later signs of aspirin poisoning, or signs of more significant poisoning, can include drowsiness or confusion, bizarre behavior, unsteady walking, and coma.

The abnormal breathing caused by aspirin poisoning is usually rapid and deep. Vomiting may occur 3-8 hours after taking too much aspirin. Serious dehydration may occur from hyperventilation, vomiting, and fever.

If you have been taking aspirin and begin to have ringing in your ears, call your doctor to see if the medication should be stopped or the dosage reduced..

For all other symptoms, call 911 (or the local emergency phone number) immediately. Serious symptoms include the following:

• Agitation, fever, convulsions, collapse, confusion, coma
• Low blood pressure
• Rapid heart rate
• Rapid breathing
• Wheezing
• Nausea and vomiting
• Bleeding
• Hallucinations
• Drowsiness

The doctor will take a history and perform a physical examination to look for evidence of poisoning. The doctor will order laboratory tests to look for damage to organ systems that can be harmed by aspirin overdose and, depending on the timing, also to check for the level of aspirin in the bloodstream.

The doctor will make sure you are able to breathe and will check vital signs including body temperature. The doctor will check alertness by asking you to respond to questions. If you are unconscious, the doctor will give oxygen and perhaps use machines to help you breathe.

Blood will be taken for lab testing. One blood test will measure the amount of salicylate, the active ingredient in aspirin, in your blood. Sometimes the blood level of salicylate can increase over time even though an individual has not taken any more aspirin. This may indicate the person has taken coated tablets or sustained-release tablets, which release salicylate into the bloodstream slowly.

The doctor will make treatment decisions based on the dose of active ingredient ingested, the time over which it was ingested, your age, the symptoms you are experiencing, and your acid-base status. Acid-base status is the balance of acid and base in the blood. Aspirin may change this balance quickly, so the doctor will monitor this to guide treatment.

Call 911 immediately if a drug overdose is discovered or suspected, and the victim is unconscious, having convulsions, not breathing, or is otherwise seriously ill.

If the person who took the aspirin is not having symptoms, do not wait to see if symptoms develop. Call the local poison control center immediately. It is a good idea to post the telephone number of the local poison control center near the phone. This information can be found at: American Association of Poison Control Centers. Or call (800) 222-1222 if you have a poisoning emergency.

Providing as much information as possible to the poison control center can help determine what the next course of action should be. The poison control center, paramedics, and emergency department staff will want the following information:

• Is the person conscious?
• Is the person breathing?
• What medications were taken? Try to locate the medicine container.
• What is the medicine’s name and how many milligrams (mg) is each pill?
• How much of the medicine did the person take and when was it taken?
• Was the medicine taken with alcohol or any other drugs or chemicals?
• How old is the person who took the medicine?
• What are the current symptoms?
• What medical conditions does the person have?

Although ipecac syrup was used in the past to make the victim vomit, it is rarely recommended today and is not usually appropriate in aspirin poisoning. Causing vomiting can be very dangerous in the case of an altered mental status or convulsions.

Doctors may use gastric lavage, or pumping out the stomach contents, to try to prevent further absorption of the aspirin into the body. Dialysis is also sometimes used to reduce the amount of salicylate in the body.

Activated charcoal: To prevent more absorption, the doctor may give activated charcoal to absorb the salicylate from the stomach. A laxative may be given with the activated charcoal to move the mixture through the gastrointestinal system more rapidly. People who have been severely poisoned may be given repeated doses of activated charcoal.

IV fluids: Dehydration occurs early in aspirin poisoning. To correct dehydration, the doctor will start an IV to provide fluids. The doctor will also work to correct imbalances in the body’s blood chemistries.

Alkaline diuresis: This is a way to reduce the amount of salicylate in the body. Alkaline diuresis is the process of giving a person who has been poisoned compounds that alter the chemistry of the blood and urine in a way that allows the kidneys to remove more salicylate. Specifically, sodium bicarbonate is given via IV to make the blood and urine less acidic (more alkaline). This encourages the kidneys to capture more salicylate that can leave the body through the urine. Sometimes, other compounds, such as potassium, also have to be given to help with this process.

The emergency physician may have to perform other procedures or give other medications as supportive care in the case of a dangerous aspirin overdose. These actions may include the following:

• Placing a breathing tube (intubation) and assisting breathing with a ventilator for a person who is in a coma, cannot protect their own airway, or needs mechanical breathing
• Placing of a catheter into the bladder to monitor urine output and frequently check the acidity (pH) of the urine
• Giving other medicines as needed to treat agitation, convulsions (seizures), or other complications of aspirin poisoning

• A person with serious symptoms may be admitted to an intensive care unit.
• If the overdose was intentional, psychiatric services should be provided.
• A person with minor symptoms such as ringing in the ears or nausea may be admitted to the hospital for further observation.

The following people, will likely be admitted to the hospital regardless of salicylate levels:

• Infants and elderly persons
• People with long-term salicylism
• People who ingested sustained-release products

• Psychiatric and medical follow-up may be recommended.
• Careful monitoring of medication will also be recommended.
• Tests to monitor kidney function may be done periodically after hospital discharge, especially in elderly people.

• Prescription medications should be used according to your doctor’s and pharmacist’s directions.
• Never take a medicine prescribed for someone else.
• To protect children from accidental drug overdose, all medications should be stored in containers with child-resistant caps. All medications should be out of sight and out of reach of children, preferably in a locked cabinet.
• Take suicidal threats seriously.
• Never give or take medication in the dark.
• Always tell the doctor of any previous side effects or adverse reactions to medication as well as any new or unusual symptoms that occur.
• Never take more than the recommended or prescribed dose of a medication.
• Inform your doctor about all the medications you are taking. Be sure to mention over-the-counter medications.

Recovery is likely if the proper treatment is given and the dose of aspirin taken is not too high.

With chronic aspirin poisoning outcomes are less predictable.

With acute aspirin poisoning, severity and outcome depend on many factors including the dose taken and the person’s body weight.

American Association of Poison Control Centers

aspirin poisoning, aspirin overdose, aspirin toxicity, salicylate poisoning, ASA, analgesic, acetylsalicylic acid, poisoning, drug overdose, medication overdose, signs of aspirin poisoning, signs of aspirin overdose

Top Picks

Aspirin Poisoning

Written by WebMD Editorial Contributors

• Aspirin Poisoning Overview
• Aspirin Poisoning Causes
• Aspirin Poisoning Symptoms
• When to Seek Medical Care
• Exams and Tests
• Aspirin Poisoning Treatment – Self-Care at Home
• Medical Treatment
• Medications
• Other Therapy
• Next Steps
• Follow-up
• Prevention
• Outlook
• For More Information – Web Links
• Synonyms and Keywords
• More

Aspirin is another name for acetylsalicylic acid, a common pain reliever (also called an analgesic). The earliest known uses of the drug can be traced back to the Greek physician Hippocrates in the fifth century BC. He used powder extracted from the bark of willows to treat pain and reduce fever.

For a variety of reasons, some people intentionally ingest poisons or poison others. Some reasons include:

• Suicide
• Gaining personal attention
• Child abuse

Aspirin poisoning can also be accidental and was once the most common cause of accidental poisoning of children. Safety precautions such as child-resistant packaging has helped make it less common.

Inappropriate dosing in both children and elderly people is one of the reasons accidental aspirin poisonings continue to happen. Hundreds of medications — both over-the-counter and prescription medicines — contain aspirin or aspirin-like substances. Unintentional poisoning can result if these medications are taken in combination, in inappropriate doses, or over a long time period. This is especially likely to occur in older people with chronic health problems.

The earliest symptoms of acute aspirin poisoning may include ringing in the ears (tinnitus) and impaired hearing. More clinically significant signs and symptoms may include rapid breathing (hyperventilation), vomiting, dehydration, fever, double vision, and feeling faint.

Later signs of aspirin poisoning, or signs of more significant poisoning, can include drowsiness or confusion, bizarre behavior, unsteady walking, and coma.

The abnormal breathing caused by aspirin poisoning is usually rapid and deep. Vomiting may occur 3-8 hours after taking too much aspirin. Serious dehydration may occur from hyperventilation, vomiting, and fever.

If you have been taking aspirin and begin to have ringing in your ears, call your doctor to see if the medication should be stopped or the dosage reduced..

For all other symptoms, call 911 (or the local emergency phone number) immediately. Serious symptoms include the following:

• Agitation, fever, convulsions, collapse, confusion, coma
• Low blood pressure
• Rapid heart rate
• Rapid breathing
• Wheezing
• Nausea and vomiting
• Bleeding
• Hallucinations
• Drowsiness

The doctor will take a history and perform a physical examination to look for evidence of poisoning. The doctor will order laboratory tests to look for damage to organ systems that can be harmed by aspirin overdose and, depending on the timing, also to check for the level of aspirin in the bloodstream.

The doctor will make sure you are able to breathe and will check vital signs including body temperature. The doctor will check alertness by asking you to respond to questions. If you are unconscious, the doctor will give oxygen and perhaps use machines to help you breathe.

Blood will be taken for lab testing. One blood test will measure the amount of salicylate, the active ingredient in aspirin, in your blood. Sometimes the blood level of salicylate can increase over time even though an individual has not taken any more aspirin. This may indicate the person has taken coated tablets or sustained-release tablets, which release salicylate into the bloodstream slowly.

The doctor will make treatment decisions based on the dose of active ingredient ingested, the time over which it was ingested, your age, the symptoms you are experiencing, and your acid-base status. Acid-base status is the balance of acid and base in the blood. Aspirin may change this balance quickly, so the doctor will monitor this to guide treatment.

Call 911 immediately if a drug overdose is discovered or suspected, and the victim is unconscious, having convulsions, not breathing, or is otherwise seriously ill.

If the person who took the aspirin is not having symptoms, do not wait to see if symptoms develop. Call the local poison control center immediately. It is a good idea to post the telephone number of the local poison control center near the phone. This information can be found at: American Association of Poison Control Centers. Or call (800) 222-1222 if you have a poisoning emergency.

Providing as much information as possible to the poison control center can help determine what the next course of action should be. The poison control center, paramedics, and emergency department staff will want the following information:

• Is the person conscious?
• Is the person breathing?
• What medications were taken? Try to locate the medicine container.
• What is the medicine’s name and how many milligrams (mg) is each pill?
• How much of the medicine did the person take and when was it taken?
• Was the medicine taken with alcohol or any other drugs or chemicals?
• How old is the person who took the medicine?
• What are the current symptoms?
• What medical conditions does the person have?

Although ipecac syrup was used in the past to make the victim vomit, it is rarely recommended today and is not usually appropriate in aspirin poisoning. Causing vomiting can be very dangerous in the case of an altered mental status or convulsions.

Doctors may use gastric lavage, or pumping out the stomach contents, to try to prevent further absorption of the aspirin into the body. Dialysis is also sometimes used to reduce the amount of salicylate in the body.

Activated charcoal: To prevent more absorption, the doctor may give activated charcoal to absorb the salicylate from the stomach. A laxative may be given with the activated charcoal to move the mixture through the gastrointestinal system more rapidly. People who have been severely poisoned may be given repeated doses of activated charcoal.

IV fluids: Dehydration occurs early in aspirin poisoning. To correct dehydration, the doctor will start an IV to provide fluids. The doctor will also work to correct imbalances in the body’s blood chemistries.

Alkaline diuresis: This is a way to reduce the amount of salicylate in the body. Alkaline diuresis is the process of giving a person who has been poisoned compounds that alter the chemistry of the blood and urine in a way that allows the kidneys to remove more salicylate. Specifically, sodium bicarbonate is given via IV to make the blood and urine less acidic (more alkaline). This encourages the kidneys to capture more salicylate that can leave the body through the urine. Sometimes, other compounds, such as potassium, also have to be given to help with this process.

The emergency physician may have to perform other procedures or give other medications as supportive care in the case of a dangerous aspirin overdose. These actions may include the following:

• Placing a breathing tube (intubation) and assisting breathing with a ventilator for a person who is in a coma, cannot protect their own airway, or needs mechanical breathing
• Placing of a catheter into the bladder to monitor urine output and frequently check the acidity (pH) of the urine
• Giving other medicines as needed to treat agitation, convulsions (seizures), or other complications of aspirin poisoning

• A person with serious symptoms may be admitted to an intensive care unit.
• If the overdose was intentional, psychiatric services should be provided.
• A person with minor symptoms such as ringing in the ears or nausea may be admitted to the hospital for further observation.

The following people, will likely be admitted to the hospital regardless of salicylate levels:

• Infants and elderly persons
• People with long-term salicylism
• People who ingested sustained-release products

• Psychiatric and medical follow-up may be recommended.
• Careful monitoring of medication will also be recommended.
• Tests to monitor kidney function may be done periodically after hospital discharge, especially in elderly people.

• Prescription medications should be used according to your doctor’s and pharmacist’s directions.
• Never take a medicine prescribed for someone else.
• To protect children from accidental drug overdose, all medications should be stored in containers with child-resistant caps. All medications should be out of sight and out of reach of children, preferably in a locked cabinet.
• Take suicidal threats seriously.
• Never give or take medication in the dark.
• Always tell the doctor of any previous side effects or adverse reactions to medication as well as any new or unusual symptoms that occur.
• Never take more than the recommended or prescribed dose of a medication.
• Inform your doctor about all the medications you are taking. Be sure to mention over-the-counter medications.

Recovery is likely if the proper treatment is given and the dose of aspirin taken is not too high.

With chronic aspirin poisoning outcomes are less predictable.

With acute aspirin poisoning, severity and outcome depend on many factors including the dose taken and the person’s body weight.

American Association of Poison Control Centers

aspirin poisoning, aspirin overdose, aspirin toxicity, salicylate poisoning, ASA, analgesic, acetylsalicylic acid, poisoning, drug overdose, medication overdose, signs of aspirin poisoning, signs of aspirin overdose

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Aspirin: good or bad? – RIA Novosti, May 17, 2011 15

Alexey Yakovlev’s blog

acetylsalicylic acid in the article “Inhibition of prostaglandin synthesis as a mechanism of action of aspirin-like drugs”, Aspirin has been used throughout the world to prevent cardiovascular disease. Wayne found that acetylsalicylic acid slows down the production of prostaglandins and thromboxane A2 in platelets, which determines its antithrombotic and cardioprotective effects, convincingly proven later in many large studies and meta-analyses.

It has become apparent that long-term use of this drug in low doses can be used to reduce the risk of thrombosis, including coronary and cerebral arteries, which significantly reduces the risk of heart attacks, ischemic strokes and other cardiovascular problems. In 1982, for this revolutionary discovery, Wayne was awarded the Nobel Prize, and Queen Elizabeth II of Great Britain knighted him. Very quickly, the antiaggregant (“blood-thinning”) effect of the drug overshadowed its anti-inflammatory properties, and at present the prevention of thrombosis is the only practically justified use of this remedy.

“Thinning” the blood, aspirin not only prevents thrombus formation, but also increases bleeding, which makes its use as an antipyretic dangerous in case of many infectious diseases (flu, Dengue fever, etc. ). Children with viral fevers should not be given aspirin because of the risk of developing a rare but deadly Reye’s syndrome. For these reasons, other non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol are now preferred to reduce body temperature, fight pain and swelling.

After a certain age or if you have individual risk factors, your doctor may recommend low (50-100 mg) aspirin daily but still effective doses to prevent myocardial infarction and other clotting disorders. Even first aid for myocardial infarction includes chewing one aspirin tablet, which greatly increases the patient’s chances of a favorable outcome.

However, where there is good, there is evil. A well-known unpleasant side effect of NSAIDs is the induction of ulceration and bleeding in the upper gastrointestinal tract (ulcerogenic effect). Alas, even the lowest cardioprotective doses of aspirin increase the risk of bleeding from the upper gastrointestinal tract by 2-3 times – one of the most formidable complications of peptic ulcer.

Now that doctors in developed countries have learned to effectively deal with the main cause of ulcers, the bacterium Helicobacter pylori, and systematically achieve successful eradication of this microorganism, the main cause of complications of peptic ulcer and its recurrence is the widespread use of non-steroidal anti-inflammatory drugs, including low doses of aspirin for the prevention of cardiovascular diseases.

However, at this point a great confusion begins in the minds of the masses. And popular delusions have always created fertile ground for unscrupulous extortion of money from patients. So in the case of aspirin, pharmaceutical companies decided in every possible way to support the myth that a stomach ulcer is formed as a result of “burning” the mucous membrane with acetylsalicylic acid, that is, aspirin.

In 1993, a new product from Bayer, Aspirin Cardio®, appeared on the German pharmaceutical market. Thanks to a special shell, a tablet of such aspirin passes through the stomach entirely and dissolves only in the intestines, where the active ingredients are absorbed. Thus, the people began to be told that an aspirin tablet coated with a special shell allows you to completely protect the stomach from the negative effects of acetylsalicylic acid with prolonged use. Manufacturers of forms of aspirin, containing special buffer substances such as MgO, which have an antacid effect, also heated up on the same delusion, which was also designed to protect the stomach and prevent the development of new ulcers and bleeding from existing ones.

However, in the 1990s, a number of large studies showed that the use of coated and buffered forms of aspirin did not reduce ulcerogenic risks in the upper gastrointestinal tract.

The fact is that the mechanism of action of all NSAIDs is associated with the inhibition of the enzyme cyclooxygenase (COX), which is involved in the synthesis of those same Wein prostaglandins – inflammation regulators. In this case, COX is of 2 types – COX-1 and COX-2. Simply put, COX-2 is responsible for the synthesis of “bad” inflammatory prostaglandins, while COX-1 is involved in the synthesis of “good”, protective ones. Protective endogenous prostaglandins regulate blood circulation in the gastric mucosa, its restoration through the proliferation of epithelial cells, control the functions of mucosal immune cells, mucus secretion, as well as the secretion of bicarbonates and hydrochloric acid in the stomach. Most NSAIDs, including aspirin, are non-selective, that is, they hit both COXs. As a result, both inflammation and protection of the gastric mucosa are removed. The last undesirable property of NSAIDs leads to an exacerbation of erosions and ulcers in people prone to this. Thus, it is the inhibition of prostaglandins, and by no means the direct damaging effect of acetylsalicylic acid on the gastric mucosa, that is the determining mechanism in drug ulcer formation. Several other substances induced by aspirin and other NSAIDs also play a role, such as tumor necrosis factor-alpha and leukotrienes, which also contribute to mucosal damage.

I told all this not to confuse the reader with medical details, but in order to demonstrate how ignorance of the details and a simplified and distorted explanation of the reasons leads to mass delusion and abuse on the part of pharmaceutical manufacturers. Now that you know how the ulcerogenic effect of NSAIDs and aspirin is realized, it becomes clear why it is not so important in what form you take anti-inflammatory drugs – by mouth, in the form of an injection or ointment: the side effect on the stomach is realized in the same way. The ulcer is exacerbated not so much by the fact that the tablet irritates the gastric mucosa upon direct contact, but because the synthesis of COX-1 is suppressed.

And it is absolutely not necessary to buy expensive forms of aspirin to prevent cardiovascular diseases. Instead, you can buy quite high-quality and cheap aspirin in vials of 100 tablets, and divide them into quarters with a knife, and it’s okay if these quarters are not exactly the same. The aspirin in these tablets is the same, and the special shell, as you understand, protects little from anything.

The opinion of the author may not coincide with the position of the editors

Aspirin and paracetamol are not so harmless at all

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December 30, 2013 17:02

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The habit of mindlessly grabbing pills at the first sign of a headache can lead to extremely serious consequences, German scientists warn.

Headache – take a pill! Chill, catch a cold, ache a tooth, ache joints – take a pill! If one doesn’t work, take another! It would seem that it could be easier.

About four million Germans do just that: they regularly swallow painkillers and antipyretics, especially since the most common of them – aspirin and paracetamol – are available to everyone: they are inexpensive and sold without a prescription in any pharmacy. In addition, they seem to be time-tested: aspirin has been used in medicine for more than a hundred years, paracetamol – more than half a century.

What problems might arise here? Moreover, advertising contributes to the wide distribution of not only these painkillers themselves, but also a carefree attitude towards them. Meanwhile, all this causes serious concern among doctors.

Paracetamol has no place in pharmacies

The fact is that supposedly harmless pills can cause extremely severe and even life-threatening side reactions. “Today, paracetamol would not be approved as a drug at all, even by prescription, let alone free sale,” emphasizes Kay Brune, professor of pharmacology at the Faculty of Medicine at the University of Erlangen.

“Even the permitted daily dose – four grams – can cause severe poisoning and damage to the liver, and just a twofold excess of this dose is fraught with acute liver failure,” Kai Brune assures. a drug that, even with a slight overdose, can cause coma and death. Moreover, acute liver failure is a very painful death that lasts several days. In short, this drug has no place at all in pharmacies.”

Taking aspirin – an unjustified risk

According to the scientist, only slightly better than paracetamol and aspirin – the second classic non-narcotic analgesic OTC. Aspirin – that is, acetylsalicylic acid – also causes too many adverse reactions, so taking this drug is justified only for patients with serious cardiovascular diseases, but not as a pain reliever.

“The pain-relieving effect of acetylsalicylic acid lasts only a few hours, and the blood thinning effect lasts several days,” says Prof. Brune. , a sore in the mouth after a visit to the dentist. Such patients are contraindicated in surgery, even if several days have passed since the last aspirin they took. That is, taking aspirin means an increased – and usually unjustified – risk of bleeding. ”

Aspirin does more harm than good

Therefore, in response to the advice given from time to time to take aspirin preventively, without any indication, just for preventive purposes – to prevent atherothrombosis and coronary heart disease or to reduce the risk of developing cancer, – the pharmacologist is extremely skeptical.