Aspirin full name. Aspirin - benefits and harms to the human body

Aspirin is arguably the most widely used drug in human history. The German pharmaceutical giant Bayer, who launched the new product on the market in 1899, did not disclose the name of its creator for a long time. And when he opened it, he gave out a heartbreaking story about an unfortunate genius chemist who created aspirin in an attempt to save his father.

In 1763, the English priest Edward Stone discovered that a decoction of crushed willow bark was excellent remedy with fever. Stone's research was continued by European chemists, who synthesized salicin crystals from the bark. Later, salicylic acid was obtained. But acetylsalicylic acid, which is similar in structure, turned out to be too tough for chemists. The Frenchman Charles Gerard in 1853 was able to synthesize it, but failed to make it safe for the human stomach and abandoned experiments.

Breakthrough in biochemistry

Medical needs for a chemical analogue of crushed bark only increased. In 1899, a new drug appeared under the brand name Aspirin.

It was the same acetylsalicylic acid. It is said that the trade name of the drug comes from the name of Saint Aspirinus, who was prayed to reduce headaches. According to another version, this is an abbreviation for the German name acetylsalicylic acid- Acetylspirsaure.

Aspirin was released by the Bayer company, which was engaged in paints, household chemicals and pharmaceuticals. With the release of aspirin, the company published a catalog of its drugs and sent it free of charge to 30,000 doctors in Europe.

The drug was sold in millions of packages, and already in 1915 it could be bought without a prescription. By 1977, aspirin was on the World Health Organization's list of essential drugs. Today, more than 80 billion aspirin tablets are taken annually by mankind.

The discovery of aspirin was a major breakthrough in biochemistry. The scientific world wanted to know who was the first to get acetylsalicylic acid. In 1934, the official history of Bayer was published, from which the name of the creator of aspirin became known. According to the official version, unable to look at the torment of his rheumatic father, in August 1897, aspirin was secretly synthesized by an employee of Bauer Felix Hoffman. After testing on animals, Hoffman offered his invention to the company's management. But in Bayer his idea was treated without enthusiasm. Then Hoffman tested his father. The old man got better, but his stomach remained unharmed.

forgotten genius

Legislation did not allow registration of a patent for a chemical compound. But no one forbade registering the trademark that owned the formula. And such a brand - "Aspirin" - was soon created.

In addition to aspirin, Hoffman created another revolutionary drug in 1898. This is a cough medicine based on diacetylmorphine. It was believed that, unlike morphine and opium, it was not addictive, and its results were impressive. Baueg called the drug Negot. Only years later it became clear that heroin is converted in the liver into the same morphine. And in 1931, the company was forced to stop producing heroin.

However, decades later, a professor from Glasgow Walter Snyder, having studied the documents, came to the conclusion that it was not Hoffman who was the first to synthesize aspirin, but another collaborator of Bayer, Arthur Eichengrün.

He initiated the idea of ​​creating aspirin in the mid-90s of the XIX century. His boss, Heinrich Dreser, believed that such developments were futile, because the drug gives a heart complication. But Eichengrün not only synthesized aspirin, but also tested it on himself. The head of the company, Karl Duisberg, instructed, on the basis of Eichengrün's documentation, to synthesize aspirin with the help of other employees. This is exactly what Felix Hoffman did in August 1897.

But then why didn't the Bayer company glorify Eichengrün? It turned out that the elderly scientist was thinking about leaving the company. Therefore, it was considered unreasonable to give him the laurels of the father of the invention in Bayer. And after the Nazis came to power in Germany in 1933, the Jew Eichengrün could not be considered a genius at all. It was then, in 1934, that the myth of the Aryan genius Hoffman was fed to the world.

Eichengrün left Wauger in 1908 to found his own company and became a millionaire. But everything collapsed after 1933. Although the Waueg concern tried to save its worker from the concentration camp, in 1944 Eichengrün ended up there anyway. The 77-year-old chemist was released in May 1945 by soldiers of the Red Army. In 1949, he wrote the true history of aspirin in the journal Pharmazie. However, the article went unnoticed, and two weeks after its publication, Eichengrün died.

Systematic (IUPAC) name: 2-acetoxybenzoic acid
Legal status: Dispensed by pharmacist only (S2) (Australia); allowed for free sale (UK); available without a prescription (USA).
In Australia, the drug is on Schedule 2 except intravenous use(in this case, the drug is included in list 4), and is used in veterinary medicine (list 5/6).
Application: most often orally, also rectally; lysine acetylsalicylate can be used intravenously or intramuscularly
Bioavailability: 80-100%
Protein binding: 80-90%
Metabolism: hepatic, (CYP2C19 and possibly CYP3A), some is hydrolyzed to salicylate in the walls of the esophagus.
Half-life: dose dependent; 2-3 hours for small doses, and up to 15-30 hours for large doses.
Excretion: urine (80-100%), sweat, saliva, feces
Synonyms: 2-acetoxybenzoic acid; acetylsalicylate;
acetylsalicylic acid; O-acetylsalicylic acid
Formula: C9H8O4
Mol. mass: 180.157 g/mol
Density: 1.40 g/cm³
Melting point: 136°C (277°F)
Boiling point: 140 °C (284 °F) (decomposes)
Solubility in water: 3 mg/ml (20 °C)
Aspirin (acetylsalicylic acid) is a salicylate drug used as an analgesic to relieve mild pain, as well as an antipyretic and anti-inflammatory agent. Aspirin is also an antiplatelet agent and inhibits the production of thromboxane, which normally binds platelet molecules and creates a patch over damaged blood vessel walls. Since this patch can also grow and block blood flow, aspirin is also used to prevent heart attacks, stroke, and blood clots. Aspirin in low doses is used immediately after heart attack to reduce the risk of re-attack or death of cardiac tissue. Aspirin may be effective tool for the prevention of certain types of cancer, especially cancer of the colon and rectum. The main side effects of aspirin are: stomach ulcers, stomach bleeding, and tinnitus (especially when taken in high doses). Aspirin is not recommended for children and adolescents with flu-like symptoms or viral infections due to the risk of Reye's syndrome. Aspirin belongs to a group of drugs called non-steroidal anti-inflammatory drugs (NSAIDs), but has a different mechanism of action than most other NSAIDs. Although aspirin and drugs with a similar structure act like other NSAIDs (showing antipyretic, anti-inflammatory, analgesic effects) and inhibit the same cyclooxygenase (COX) enzyme, aspirin differs from them in that it acts irreversibly and, unlike other drugs, affects more COX-1 than COX-2.

The active ingredient in aspirin was first discovered in willow bark in 1763 by Edward Stone of Wadham College, Oxford. The doctor discovered salicylic acid, the active metabolite of aspirin. Aspirin was first synthesized by Felix Hoffmann, a chemist from the German company Bayer, in 1897. Aspirin is one of the most widely used medicines in the world. Approximately 40,000 tons of aspirin are consumed worldwide every year. In countries where aspirin is a registered trademark of Bayer, generic acetylsalicylic acid is sold. The drug is included in the list of essential medicines of the World Health Organization.

The use of aspirin in medicine

Aspirin is used to treat a range of symptoms, including fever, pain, rheumatic fever, and inflammatory diseases such as rheumatoid arthritis, pericarditis, and Kawasaki disease. In low doses, aspirin is used to reduce the risk of death from a heart attack or stroke. There is evidence that aspirin can be used to treat bowel cancer, but the mechanism of its action in this case has not been proven.

Aspirin analgesic

Aspirin is an effective analgesic for the treatment acute pain, inferior, however, to ibuprofen, since the latter is associated with a lower risk of gastric bleeding. Aspirin is not effective for pain caused by muscle cramps, flatulence, bloating, or severe skin lesions. As with other NSAIDs, the effectiveness of aspirin is increased when taken in combination with. Effervescent aspirin tablets, such as Alkoseltzer or Blowfish, relieve pain faster than conventional tablets and are effective in treating migraines. Aspirin ointment is used to treat some types of neuropathic pain.

Aspirin and headache

Aspirin, alone or in combination formulas, is effective in treating some types of headaches. Aspirin may not be effective for treating secondary headaches (caused by other illnesses or injuries). The international classification of diseases associated with headaches distinguishes tension headaches among primary headaches. headache(the most common type of headache), migraine and cluster headaches. Tension headaches are treated with aspirin or other over-the-counter analgesics. Aspirin, especially as a component of the acetaminophen/aspirin/ (Excedrin Migraine) formula, is considered an effective first-line treatment for migraine, and is comparable in efficacy to low-dose sumatriptan. The drug is most effective for stopping migraine at its onset.

aspirin and fever

Aspirin acts not only on pain but also on fever through the prostaglandin system by irreversibly inhibiting COX. Although aspirin is widely approved for use in adults, many medical societies and regulatory agencies (including the American Academy of Family Therapists, the American Academy of Pediatrics, and the FDA) do not recommend the use of aspirin as an antipyretic in children. Aspirin may be associated with a risk of developing Reye's syndrome, a rare but often fatal disease associated with the use of aspirin or other salicylates in children with a viral or bacterial infection. In 1986, the FDA required manufacturers to place a warning on all aspirin labels about the risks of aspirin use in children and adolescents.

Aspirin and heart attacks

The first studies on the effects of aspirin on the heart and heart attacks were carried out in the early 1970s by Professor Peter Slate, emeritus professor of cardiac medicine at the University of Oxford, who formed the Aspirin Research Society. In some cases, aspirin may be used to prevent heart attacks. At lower doses, aspirin is effective in preventing the development of existing cardiovascular disease, as well as in reducing the risk of developing these diseases in individuals with a history of such diseases. Aspirin is less effective for people at low risk of having a heart attack, such as people who have never had a heart attack in the past. Some studies recommend taking aspirin on an ongoing basis, while others discourage such use due to side effects such as stomach bleeding, which usually outweigh any potential benefit of the drug. When using aspirin in preventive purposes the phenomenon of aspirin resistance can be observed, manifested in a decrease in the effectiveness of the drug, which may lead to an increase in the risk of a heart attack. Some authors suggest testing resistance to aspirin or other antithrombotic drugs before starting a course of treatment. Aspirin has also been proposed as a component of a drug for the treatment of cardiovascular disease.

Post-surgical treatment

The US Agency for Health Research and Quality Guidelines recommends long-term use of aspirin after a percutaneous coronary intervention procedure such as stent placement coronary artery. Aspirin is often combined with adenosine diphosphate receptor inhibitors such as clopidogrel, prasugrel, or ticagrel to prevent blood clots (dual antiplatelet therapy). Recommendations for the use of aspirin in the United States and in Europe differ slightly regarding how long and for what indications combination therapy after surgery. In the US, dual antiplatelet therapy is recommended for a minimum of 12 months, and in Europe for 6–12 months after a drug-containing stent is used. However, recommendations in both countries are consistent on the indefinite use of aspirin after completion of antiplatelet therapy.

Aspirin and cancer prevention

The effect of aspirin on cancer, especially colon cancer, has been extensively studied. Numerous meta-analyses and reviews indicate that chronic aspirin use reduces the long-term risk of bowel cancer and mortality. However, no relationship has been found between aspirin dose, duration of use, and various risk measures, including mortality, disease progression, and disease risk. Although much of the evidence regarding aspirin and bowel cancer risk comes from observational studies rather than randomized controlled trials, the available data from randomized trials suggest that long-term use of low doses of aspirin may be effective in preventing some types of bowel cancer. In 2007, the U.S. Preventive Service issued a policy on this issue, giving the use of aspirin to prevent colon cancer a "D" rating. The service also discourages physicians from using aspirin for this purpose.

Other uses of aspirin

Aspirin is used as first-line therapy for symptoms of fever and joint pain in acute rheumatic fever. Treatment often lasts for one to two weeks, and the drug is rarely prescribed for long periods of time. After getting rid of fever and pain, the need to take aspirin disappears, but the drug does not reduce the risk of heart complications and residual rheumatic heart disease. Naproxen has the same efficacy as aspirin and is less toxic, however, due to limited clinical data, naproxen is only recommended as a second line treatment. In children, aspirin is recommended only for Kawasaki disease and rheumatic fever, due to the lack of high-quality data on its effectiveness. At low doses, aspirin is moderately effective in preventing preeclampsia.

aspirin resistance

In some people, aspirin is not as effective on platelets as it is in others. This effect is called "aspirin resistance", or insensitivity. In one study, women were shown to be more resistant than men. An aggregation study involving 2930 patients showed that 28% of patients develop resistance to aspirin. A study of 100 Italian patients showed that, on the other hand, of the 31% of aspirin-resistant patients, only 5% had actual resistance, and the rest had non-compliance (non-compliance with the drug intake). Another study in 400 healthy volunteers showed that none of the patients had actual resistance, but some had "pseudo-resistance, reflecting delayed or reduced absorption of the drug".

Dosage of aspirin

Aspirin tablets for adults are produced in standard dosages, which vary slightly in different countries eg 300 mg in the UK and 325 mg in the US. Reduced dosages are also associated with existing standards, such as 75 mg and 81 mg. Tablets of 81 mg are conventionally referred to as the "children's dose", although they are not recommended for use in children. The difference between the 75 and 81 mg tablets is not of significant medical significance. Interestingly, in the US, 325mg tablets are equivalent to 5 grains of aspirin, used before the metric system used today. In general, for the treatment of fever or arthritis, adults are advised to take aspirin 4 times a day. For the treatment of rheumatic fever, doses close to the maximum have historically been used. For the prevention of rheumatoid arthritis in individuals with known or suspected coronary artery disease, lower doses once daily are recommended. The U.S. Preventive Service recommends using aspirin for primary prevention of coronary heart disease in men aged 45–79 years and women aged 55–79 years only if the potential benefits (reducing the risk of myocardial infarction in men or stroke in women) outweigh the potential risk stomach damage. The Women's Health Initiative study showed that regular low-dose aspirin use (75 or 81 mg) in women reduces the risk of death from cardiovascular disease by 25% and the risk of death from other causes by 14%. Low-dose aspirin use is also associated with a reduced risk of cardiovascular disease, and doses of 75 or 81 mg/day may optimize efficacy and safety in patients taking aspirin for long-term prevention. In children with Kawasaki disease, the dose of aspirin is based on body weight. The drug is started with four times a day for a maximum of four weeks, and then, over the next 6-8 weeks, the drug is taken at lower doses once a day.

Side effects of aspirin

Contraindications

Aspirin is not recommended for people who are allergic to ibuprofen or naproxen, or who have an intolerance to salicylate, or a more generalized intolerance to NSAIDs. Caution should be observed in persons suffering from asthma or bronchospasm caused by NSAIDs. Since aspirin acts on the walls of the stomach, manufacturers recommend that patients suffering from stomach ulcers, diabetes, or gastritis consult their doctor before using aspirin. Even in the absence of the above conditions, the combined use of aspirin with or alcohol increases the risk of stomach bleeding. Patients with hemophilia or other bleeding disorders should not take aspirin or other salicylates. Aspirin can cause hemolytic anemia in individuals with a genetic disease of glucose-6-phosphate dehydrogenase deficiency, especially at high doses and depending on the severity of the disease. The use of aspirin in dengue fever is not recommended due to an increased risk of bleeding. Aspirin is also not recommended for people suffering from kidney disease, hyperuricemia, or gout because aspirin inhibits the ability of the kidney to excrete uric acid and thus may exacerbate these diseases. Aspirin is not recommended for children and adolescents to treat flu and cold symptoms because such use may be associated with the development of Reye's syndrome.

Gastrointestinal tract

Aspirin has been shown to increase the risk of stomach bleeding. Even though there are enteric-coated aspirin tablets marketed as "soft on the stomach", one study showed that even this did not help reduce harmful effect aspirin in the stomach. Combining aspirin with other NSAIDs also increases the risk. When using aspirin in combination with clopidogrel or the risk of stomach bleeding also increases. Aspirin's blockade of COX-1 elicits a protective response in the form of an increase in COX-2. The use of COX-2 inhibitors and aspirin leads to increased erosion of the gastric mucosa. Thus, care should be taken when combining aspirin with any natural COX-2 inhibitory supplements such as garlic extracts, curcumin, blueberries, pine bark, ginkgo, fish oil, genistein, quercetin, resorcinol, and others. To reduce the harmful effects of aspirin on the stomach, in addition to the use of enteric coatings, manufacturing companies use the "buffer" method. "Buffer" substances serve to prevent the accumulation of aspirin on the walls of the stomach, but the effectiveness of such drugs is disputed. As "buffers" almost any means used in antacids are used. Bufferin, for example, uses MgO. Other formulations use CaCO3. More recently, vitamin C has been added to protect the stomach when taking aspirin. When taken together, there is a decrease in the number of damage, compared with the use of aspirin alone.

Central effect of aspirin

In experiments on rats, large doses of salicylate, a metabolite of aspirin, have been shown to cause temporary ringing in the ears. This occurs as a result of exposure to arachidonic acid and the NMDA receptor cascade.

Aspirin and Reye's Syndrome

Reye's syndrome, a rare but very dangerous disease characterized by acute encephalopathy and fatty liver, develops when children and adolescents take aspirin to reduce fever or to treat other symptoms. From 1981 to 1997, 1,207 cases of Reye's syndrome were reported in the United States among patients under 18 years of age. In 93% of cases, patients felt unwell three weeks before the development of Reye's syndrome, and most often complained of respiratory infections, chicken pox or diarrhea. Salicylates were found in the body of 81.9% of children. Since the link between Reye's syndrome and aspirin use has been proven and safety measures have been taken (including a call from the chief medical officer and changes to packaging), aspirin use by children in the US has dropped dramatically, resulting in a decrease in the incidence of Reye's syndrome; a similar situation was observed in the UK. The US FDA does not recommend taking aspirin or aspirin-containing products for children under 12 years of age with symptoms of a fever. UK regulatory agency for medical supplies And medicines Do not recommend taking aspirin to children under 16 without a doctor's prescription.

Allergic reactions to aspirin

In some people, aspirin can cause allergy-like symptoms, including redness and swelling of the skin and headache. This reaction is caused by salicylate intolerance and is not an allergy in the truest sense of the word, but rather an inability to metabolize even small amounts of aspirin, which can quickly lead to an overdose.

Other side effects of aspirin

Aspirin can cause angioedema (swelling of skin tissue) in some people. One study showed that some patients develop angioedema 1-6 hours after taking aspirin. However, angioedema developed only when taking aspirin in combination with other NSAIDs. Aspirin causes an increased risk of cerebral microbleeding, which is shown on MRI as dark spots with a diameter of 5-10 mm or less. These bleedings may be the first signs ischemic stroke or hemorrhagic stroke, Binswanger's disease and Alzheimer's disease. A study of a group of patients taking an average dose of aspirin of 270 mg per day showed an average absolute increase in the risk of hemorrhagic stroke, equal to 12 cases per 10,000 people. In comparison, the absolute reduction in the risk of myocardial infarction was 137 cases per 10,000 people, and the reduction in the risk of ischemic stroke was 39 cases per 10,000 people. In the case of a pre-existing hemorrhagic stroke, the use of aspirin increases the risk of mortality, with doses of approximately 250 mg per day causing a decrease in the risk of mortality within three months after a hemorrhagic stroke. Aspirin and other NSAIDs can cause hyperkalemia by inhibiting prostaglandin synthesis; however, these drugs do not tend to cause hyperkalemia in the presence of normal hepatic function. Aspirin can increase postoperative bleeding for up to 10 days. One study showed that 30 of 6499 elective surgery patients required reoperations due to bleeding. Diffuse bleeding was observed in 20 patients, and local bleeding in 10. In 19 of 20 patients, diffuse bleeding was associated with preoperative use of aspirin alone or in combination with other NSAIDs.

Aspirin overdose

Aspirin overdose can be acute or chronic. Acute overdose is associated with a single dose of a large dose of aspirin. Chronic overdose is associated with prolonged intake of doses above the recommended norm. Acute overdose is associated with a 2% risk of mortality. Chronic overdose is more dangerous and more often has fatal outcome(in 25% of cases); chronic overdose is especially dangerous in children. In case of poisoning, apply various means, including Activated carbon, sodium bicarbonate, intravenous dextrose and salt, and dialysis. Diagnosis of poisoning is made by measuring salicylate, the active metabolite of aspirin, in plasma using automated spectrophotometric methods. Plasma salicylate levels are 30–100 mg/l at the usual dose, 50–300 mg/l at high doses, and 700–1400 mg/l at acute overdose. Salicylate is also produced from bismuth subsalicylate, methyl salicylate, and sodium salicylate.

Interactions of aspirin with other drugs

Aspirin may interact with other drugs. For example, azetazolamide and ammonium chloride increase the harmful effects of salicylates, while alcohol increases stomach bleeding when taking aspirin. Aspirin can displace some drugs from protein binding sites, including the antidiabetic drugs tolbutamil and chlorpropamide, methotrexate, phenytoin, probenecid, valproic acid (by interfering with beta-oxidation, an important part of valproate metabolism), and other NSAIDs. Corticosteroids may also decrease aspirin concentrations. Ibuprofen may reduce the antiplatelet effect of aspirin, which is used to protect the heart and prevent stroke. Aspirin may reduce the pharmacological activity of spironolactone. Aspirin competes with pinicillin G for renal tubular secretion. Aspirin may also inhibit the absorption of vitamin C.

Chemical characteristics of aspirin

Aspirin is rapidly cleaved in solutions of ammonium acetate or acetates, carbonates, citrates, or alkali metal hydroxides. It is stable in dry form, but undergoes significant hydrolysis upon contact with acetylic or salicylic acid. In reaction with alkali, hydrolysis occurs rapidly, and the pure solutions formed may consist entirely of acetate or salicylate.

Physical characteristics of aspirin

Aspirin, an acetyl derivative of salicylic acid, is a white, crystalline, weakly acid compound with a melting point of 136 °C (277 °F), and a boiling point of 140 °C (284 °F). The substance's acid dissociation constant (pKa) is 25 °C (77 °F).

Synthesis of aspirin

The synthesis of aspirin is classified as an esterification reaction. Salicylic acid is treated with acetyl anhydride, an acidic derivative, causing a chemical reaction that converts the hydroxy group of salicylic acid into an ester group (R-OH → R-OCOCH3). As a result, aspirin and acetylic acid are formed, which is considered a by-product of this reaction. Small amounts of sulfuric acid (and sometimes phosphoric acid) are commonly used as catalysts.

The mechanism of action of aspirin

Discovery of the mechanism of action of aspirin

In 1971, British pharmacologist John Robert Vane, who was later admitted to the Royal College of Surgery London, demonstrated that aspirin inhibited the production of prostaglandins and thromboxanes. For this discovery, the scientist was awarded the Nobel Prize in Medicine in 1982, together with Sune Bergström and Bengt Samuelson. In 1984 he was awarded the title of Knight Bachelor.

Suppression of prostaglandins and thromboxanes

The ability of aspirin to suppress the production of prostaglandins and thromboxanes is due to its irreversible inactivation of the cyclooxygenase (COX; official name - prostaglandin endoperoxide synthase) enzyme associated with the synthesis of prostaglandin and thromboxane. Aspirin acts as an acetylating agent by covalently attaching an acetyl group to a residue on the active site of the COX enzyme. This is the main difference between aspirin and other NSAIDs (such as diclofenac and ibuprofen), which are reversible inhibitors. Aspirin at low doses irreversibly blocks the formation of thromboxane A2 in platelets, having an inhibitory effect on platelet aggregation during their life cycle(8–9 days). Due to this antithrombotic action, aspirin is used to reduce the risk of a heart attack. Aspirin at 40 mg daily can inhibit a large percentage of maximal thromboxane A2 release, with little effect on prostaglandin I2 synthesis; however, high doses of aspirin may enhance the inhibition. Prostaglandins, local hormones produced in the body, have various effects, including the transmission of pain signals to the brain, modulation of the hypothalamic thermostat, and inflammation. Thromboxanes are responsible for the aggregation of platelets, which form blood clots. The main cause of a heart attack is blood clotting, and low-dose aspirin is recognized as an effective preventive measure. acute infarction myocardium. An undesirable side effect of the antithrombotic effect of aspirin is that it can cause excessive bleeding.

Inhibition of COX-1 and COX-2

There are at least two types of cyclooxygenase: COX-1 and COX-2. Aspirin irreversibly inhibits COX-1 and modifies COX-2 enzymatic activity. COX-2 normally produces prostanoids, most of which are pro-inflammatory. Aspirin-modified PTGS2 produces lipoxins, most of which are anti-inflammatory. To inhibit only PTGS2 and reduce the risk of gastrointestinal side effects, a new generation of NSAIDs, COX-2 inhibitors, have been developed. However, new generation COX-2 inhibitors such as rofecoxib (Vioxx) have recently been withdrawn from the market following evidence that PTGS2 inhibitors increase the risk of heart attack. Endothelial cells express PTGS2 and, by selective inhibition of PTGS2, reduce the production of prostaglandin (namely PGI2; prostacyclin), depending on thromboxane levels. Thus, the protective anticoagulant effect of PGI2 is reduced and the risk of blood clots and heart attacks is increased. Since platelets do not have DNA, they cannot synthesize new PTGS. Aspirin irreversibly inhibits the enzyme, which is its most important difference from reversible inhibitors.

Additional mechanisms of action of aspirin

Aspirin has at least three additional mechanisms of action. It blocks oxidative phosphorylation in cartilaginous (and renal) mitochondria by diffusing from the inner membrane region as a proton carrier back into the mitochondrial space, where it re-ionizes to release protons. In short, aspirin buffers and transports protons. When taken in high doses, aspirin can cause fever due to a thermal spike from the electron transport chain. In addition, aspirin promotes the formation of NO-radicals in the body, which, as shown in experiments on mice, is an independent mechanism for reducing inflammation. Aspirin reduces leukocyte adhesion, which is an important mechanism immune protection from infections; however, these data do not provide conclusive evidence for the effectiveness of aspirin against infections. Newer data also show that salicylic acid and its derivatives modulate signaling through NF-κB. NF-κB, a transcription factor complex, plays an important role in many biological processes, including inflammation. In the body, aspirin quickly breaks down to salicylic acid, which itself has anti-inflammatory, anti-temperature and analgesic effects. In 2012, salicylic acid was shown to activate AMP-activated protein kinase, which may be a possible explanation for some of the effects of salicylic acid and aspirin. The acetyl in the aspirin molecule also has a special effect on the body. Acetylation of cellular proteins is an important phenomenon that affects the regulation of protein function at the post-translational level. Recent studies show that aspirin can acetylate more than just COX isoenzymes. These acetylation reactions may explain many of the hitherto unexplained effects of aspirin.

Hypothalamic-pituitary-adrenal activity

Aspirin, like other drugs that affect prostaglandin synthesis, has a powerful effect on the pituitary gland, and indirectly affects some hormones and physiological functions. Aspirin has been directly shown to affect growth hormone, prolactin and thyroid-stimulating hormone(with a relative effect on T3 and T4). Aspirin reduces the effect of vasopressin and increases the effect of naloxone by secreting adrenocorticotropic hormone and cortisol in the hypothalamic-pituitary-adrenal axis, which occurs through interaction with endogenous prostaglandins.

Pharmacokinetics of aspirin

Salicylic acid is weak acid and a very small part of it is ionized in the stomach after oral administration. Acetylsalicylic acid is slightly soluble in the acidic environment of the stomach, due to which its absorption can be delayed by 8-24 hours when taken in high doses. The increased pH and greater coverage of the small intestine promotes rapid uptake of aspirin at that site, which in turn promotes greater dissolution of salicylate. However, in overdose, aspirin dissolves much more slowly, and its plasma concentrations may increase within 24 hours after ingestion. About 50–80% of salicylate in the blood is protein-bound, with the remainder remaining in the active ionized form; protein binding is concentration dependent. Saturation of the binding sites leads to an increase in the amount of free salicylate and an increase in toxicity. The volume of distribution is 0.1–0.2 l/kg. Acidosis increases the volume of distribution due to increased cellular penetration of salicylates. 80% of the therapeutic dose of salicylic acid is metabolized in the liver. When binding with, salicyluric acid is formed, and with glucuronic acid, salicylic acid and phenolic glucuronide are formed. These metabolic pathways have only limited opportunities. A small amount of salicylic acid is also hydrolyzed to gentisic acid. When taking large doses of salicylate, the kinetics shift from the first to the zero order, as the metabolic pathways are saturated and the importance of renal excretion increases. Salicylates are excreted from the body with the help of the kidneys in the form of salicyluric acid (75%), free salicylic acid (10%), salicylic phenol (10%) and acyl glucuronides (5%), gentisic acid (< 1%) и 2,3-дигидроксибензойной кислоты. При приеме небольших доз (меньше 250 мг у взрослых), все пути проходят кинетику первого порядка, при этом период полувыведения составляет от 2.0 до 4.5 часов. При приеме больших доз салицилата (больше 4 г), период полураспада увеличивается (15–30 часов), поскольку биотрансформация включает в себя образование салицилуровой кислоты и насыщение салицил фенольного глюкоронида. При увеличении pH мочи с 5 до 8 наблюдается увеличение почечного клиренса в 10-20 раз.

The history of the discovery of aspirin

Herbal extracts, including willow bark and meadowsweet (spirea), whose active ingredient is salicylic acid, have been used since ancient times to relieve headaches, pain and fever. Father modern medicine Hippocrates (460-377 BC) described the use of powdered willow bark and leaves to relieve such symptoms. French chemist Charles Frederic Gerhard first made acetylsalicylic acid in 1853. While working on the synthesis and properties of various acid anhydrides, he mixed acetyl chloride with the sodium salt of salicylic acid (sodium salicylate). A powerful reaction followed, and the resulting alloy was modified. Gerhard named this compound "salicylic acetyl anhydride" (wasserfreie Salicylsäure-Essigsäure). 6 years later, in 1859, von Hilm obtained analytically pure acetylsalicylic acid (which he called acetylierte Salicylsäure, acetylated salicylic acid) by reacting salicylic acid and acetyl chloride. In 1869, Schroeder, Prinzorn and Kraut repeated the experiments of Gerhard and von Gilm and reported that both reactions lead to the synthesis of the same substance - acetylsalicylic acid. They were the first to describe the correct structure of matter (in which the acetyl group is attached to the phenolic oxygen). In 1897, chemists at Bayer AG produced a synthetically modified version of salicin, extracted from the plant Filipendula ulmaria (meadowsweet), which causes less stomach irritation than pure salicylic acid. It is still not clear who was the chief chemist who conceived this project. Bayer reported that the work was carried out by Felix Hoffmann, but the Jewish chemist Artur Eichengrun later stated that he was the main developer and records of his contributions were destroyed during the Nazi regime. New drug, formally acetylsalicylic acid, was named "Aspirin" by Bayer AG, after the old botanical name of the plant it contains (meadowsweet), Spiraea ulmaria. The word "Aspirin" is derived from the words "acetyl" and "Spirsäure", the old German word for salicylic acid, which in turn comes from the Latin "Spiraea ulmaria". By 1899, Bayer was already selling aspirin around the world. Aspirin's popularity increased in the first half of the 20th century due to its supposed effectiveness in treating the 1918 Spanish flu epidemic. Recent studies, however, show that the 1918 flu death toll was partly caused by aspirin, however this claim is controversial and not widely accepted in academic circles. The popularity of aspirin led to fierce competition and the separation of aspirin brands, especially after the expiration of Bayer's US patent in 1917. After the introduction of (acetaminophen) in 1956 and ibuprofen in 1969, aspirin's popularity waned somewhat. In the 1960s and 1970s, John Wayne and his team discovered the basic mechanisms of action of aspirin, and clinical trials and other studies conducted between the 1960s and 1980s. demonstrated that aspirin is effective drug against blood clots. In the last decades of the 20th century, sales of aspirin rose again, and remain at a fairly high level to this day.

A brand name for aspirin

As part of the 1919 Treaty of Versailles reparations following Germany's defeat in World War I, aspirin (as well as heroin) lost its registered trademark status in France, Russia, the UK, and the US, where it became generic. To date, aspirin is considered generic in Australia, France, India, Ireland, New Zealand, Pakistan, Jamaica, Colombia, the Philippines, South Africa, the United Kingdom and the United States. Aspirin, with a capital "A", remains a registered trademark of Bayer in Germany, Canada, Mexico and over 80 other countries where the trademark is owned by Bayer.

Use of aspirin in veterinary medicine

Occasionally, aspirin is used for pain relief or as an anticoagulant in veterinary medicine, primarily in dogs and occasionally in horses, although newer drugs with fewer side effects are currently being used. Dogs and horses show the gastrointestinal side effects of aspirin associated with salicylates, but aspirin is often used to treat arthritis in older dogs. Aspirin has been shown to be effective for laminitis (hoof inflammation) in horses, but is no longer used for this purpose. Aspirin should only be used in animals under close medical supervision; in particular, cats lack glucuronide conjugates that promote aspirin excretion, as a result of which even small doses of the drug can be potentially toxic to them.

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Aspirin know everything, which is understandable - this year (1997) marks one hundred years since its discovery. Initially, the drug was used only as a remedy for pain in the joints. Then they discovered its antipyretic and anti-inflammatory properties. And today it is known that aspirin also prevents the formation of blood clots, promotes, that is, it is good for the prevention and treatment of heart attacks and strokes. Scientists today, every now and then, find some new properties in this medicine, because research on aspirin does not stop.

Who discovered aspirin and when?

The basis of aspirin is acetylsalicylic acid. For the first time, it was received in a chemically pure and stable form in 1897 by a young chemist Felix Hoffman, who worked at Bayer. He was looking for a drug that could help his father, who suffered from joint pain. The path of the search for Hoffmann was suggested by the doctor: his father could not take the sodium salicylate prescribed to him, because it caused severe irritation of the gastric mucosa. Two years later, the name "aspirin" was registered as a trademark of a new drug in the patent office in Berlin. It is an abbreviated name for acetylsalicylic acid: the prefix "a" is an acetyl group attached to salicylic acid, the root "spir" indicates Spirsaure - "spiric acid" (this is salicylic acid, which is present in the form of esters in some plants, for example, in spirea flowers), and the ending "in" at that time was often used in the names of medicines.

Chemical composition

The molecule of acetylsalicylic acid (aspirin) contains, as it were, two substances: salicylic and acetic acids. If you store aspirin even at room temperature, it decomposes under the influence of moisture into its components:

acetylsalicylic acid (ASA)

salicylic acid + acetic acid

Therefore, in a powder or tablet of aspirin, along with acetylsalicylic acid, there are always some free salicylic and acetic acids. Over time, they gradually become more, and acetylsalicylic acid - respectively less. It is on this that the expiration date of the drug, which is always indicated on the package, depends.

We take a pill

Acetylsalicylic acid enters the stomach and then into the duodenum. Gastric juice does not affect it: aspirin dissolves well in alkalis, and poorly in acids. From duodenum it is absorbed into the blood, and it is there that its main transformations begin. Salicylic acid is released first. As you move to the liver, and then to the kidneys, the amount of both salicylic and acetylsalicylic acids decreases, and their water-soluble derivatives (metabolites) increase. Through the blood vessels, they enter the liver, heart, brain and, completing their journey through the body, end up in the kidneys, from where they are excreted along with urine. By this time, only 0.5% of acetylsalicylic acid remains, the rest is its metabolites. They provide therapeutic effect on the body. Recall that there are four such therapeutic effects: aspirin prevents the formation of blood clots, has anti-inflammatory, and analgesic effects.

How does aspirin prevent blood clots?

A blood clot forms where the walls of a blood vessel are damaged. Here, the fibers that hold the cells together are exposed (they consist of collagen protein). Blood platelets linger on them, which secrete a substance that enhances the process of their adhesion and narrows the vessel - thromboxane. Usually, the action of thromboxane in a healthy body is opposed by another substance - prostacyclin: on the contrary, it prevents platelets from sticking together and dilates blood vessels. When the vessel is damaged, the balance between prostacyclin and thromboxane shifts - prostacyclin ceases to be produced, and thromboxane is produced in excess. A lump of agglutinated platelets grows, erythrocytes are woven into it, and now a blood clot has formed. If the vessels are narrowed or there are sclerotic cholesterol plaques on their walls, the vessel is quickly clogged. The part of the body that it serves does not receive enough nutrients and oxygen. This can later lead to a heart attack or stroke.
But now the body has an invisible helper - aspirin. Salicylic and acetic acids bind blood enzymes (histamine, serotonin, kinin) and substances responsible for the formation of thromboxane. Metabolites are obtained, which are easily and quickly excreted from the body. The synthesis of prostacyclin in vascular cells resumes. The thrombus stops growing, the vessel expands. Platelets “neutralized” by aspirin will restore their ability to stick together only after 7-8 days. True, during this time, new active batches of them can enter the blood from the bone marrow, so aspirin is prescribed not once, but in courses.

Antipyretic properties of aspirin

Since aspirin dilates blood vessels, including skin ones, the heat released by the body is removed more intensively - the temperature drops. At the same time, aspirin acts on the thermoregulatory centers of the brain, which give a signal to lower the temperature.

Anti-inflammatory and action of aspirin

Aspirin also actively intervenes in inflammatory processes in the body. It prevents the release of various inflammatory mediators into the blood, as well as substances that cause pain. At the same time, aspirin enhances the synthesis of histamine, a hormone that dilates blood vessels and causes an influx of leukocytes to the site of inflammation. In addition, it strengthens the walls of small blood vessels and reduces their permeability. All this together and gives an anti-inflammatory and analgesic effect.

What's so bad about aspirin?

Despite all the positive properties of aspirin, it cannot be considered a completely safe medicine: it is a rather aggressive remedy.
Firstly, of course, you should not take an expired drug - free salicylic acid can cause severe irritation of the mucous membranes of the stomach and duodenum. Moreover, people suffering from diseases of these organs should take aspirin only as prescribed by a doctor, after meals and drink it not with water, but with milk. Also, people suffering from bronchial asthma, allergic diseases, diseases of the kidneys and liver should be very careful.
There is evidence that taking large doses of salicylates in the first three months of pregnancy is associated with an increased risk of developing deformities in the child: cleft palate, heart defects. However, at usual doses this risk, apparently, is small. Taking aspirin in the last three months before childbirth is definitely undesirable - it can weaken labor pains, lengthen the pregnancy period, and cause prolonged bleeding
Children should be given aspirin with extreme caution, and if they suddenly develop severe vomiting, they should immediately consult a doctor. This may be a manifestation of Reye's syndrome, a rare but dangerous disease.
Like any active substance, aspirin can interact with other drugs: it enhances the effect of some, weakens others. Therefore, do not let lulling advertising relax you - before taking any, even, as it seems to you, the most harmless medicine, consult your doctor.
Despite these side effects, aspirin is tipped for a very bright future. Now scientists are looking for supplements that could reduce these effects. Experts believe that other drugs for the treatment of the same ailments will not replace aspirin, but on the contrary, it will find new areas of application.

New properties of aspirin

For the past ten years, oncologists have been interested in aspirin. In 1988, epidemiologists noticed that people who regularly take aspirin as an anti-inflammatory drug were less likely to develop bowel cancer and some other types of tumors. The risk is reduced by 50% - even special anticancer drugs do not give such a result. At the Cancer Research Center in Heidelberg, a group of scientists led by Professor F. Marx came to grips with the study of the anti-cancer properties of aspirin. They have learned a few things over the years. It turned out that aspirin blocks the synthesis of enzymes that produce prostaglandins. Prostaglandins, if they are in excess, damage DNA, which makes it possible for a malignant degeneration of the cell. And the enzyme prostaglandin synthetase-2 is involved in the synthesis of prostaglandins in tumor cells - this is what aspirin turns off, interrupting the sinister chain of events.
Scientists, however, believe that the success of aspirin in oncology should not be overestimated. Firstly, as already mentioned, aspirin causes side effects, and secondly, after stopping its use, the tumor may begin to grow again. Therefore, researchers are now looking for drugs that can, like aspirin, block the enzyme, but have a longer effect and do not have the drawbacks of aspirin.
And aspirin continues to expand its field of action.
Recent studies conducted at the Department of Nervous Diseases of the Moscow Medical Academy. Sechenov, under the guidance of Professor Wayne, showed that aspirin affects the central nervous system in particular on the brain.
Scientists have found that aspirin improves human sleep - speeds up falling asleep and makes non-REM sleep deeper. Moreover, it can be used to treat one of the long-standing enemies of humanity -. Researchers periodically recorded the slow potentials of the brain of patients and noticed that after the end of the attack, the amplitude of these potentials slowly increases until the very beginning of the next attack. In patients who received aspirin, slow potentials practically remained normal or increased slightly - and their seizures were less frequent and weaker. It became clear to scientists that aspirin changes the excitability of the brain. These results gave a powerful impetus to further research in nature and the search for other drugs that have a similar effect.

Tablets, powders, pops...

148 registered on the Russian market today dosage forms containing acetylsalicylic acid, with 57 of them having the same composition. Even domestic acetylsalicylic acid can be hidden under different names: aspivatrin, aspirin, aspirin. The names of imported drugs are often not at all associated with their true origin: “kolfarit”, “malayt”, “mikristin”, etc. All this variety is imported to us from 20 countries, but the largest supplier is Germany.
In addition to pure aspirin, 12 more formulations are produced containing aspirin with additives that give the drug additional properties. This, for example, aspirin with citric acid and sodium bicarbonate - preparations "Alka-seltzer", "Alka-prim". When citric acid reacts with sodium bicarbonate, that is, with soda, carbon dioxide is released - a "pop" is obtained.
Vitamin C is often added to acetylsalicylic acid. This does not give any unexpected new properties to the drug - the vitamin acts quite independently, exerting its usual restorative effect.
"Citramon P" (acetylsalicylic acid + caffeine + paracetamol + cocoa) can also be found under other names ("citrapar", "algon", "algomin"). Exactly these combined preparations best taken for headaches. However, even the same chemical composition medicines can differ in their effect depending on the form in which they are taken. Various pharmaceutical companies offer aspirin in the form of tablets, powder, capsules, effervescent granules, soluble, dispersible and effervescent tablets, enteric-coated tablets, and even chewable.
Ordinary (insoluble) tablets of acetylsalicylic acid are not its best form, since they lie like a stone in the stomach and corrode its mucosa. If you have to drink aspirin daily (as an anti-inflammatory agent or to thin the blood), then it is better to use soluble, dispersible or enteric-coated tablets.
The degree of dispersion can also very noticeably change the nature of the action of the drug. Students - future pharmacists - are often given an example of how grinding one of the drugs used in medical practice ten times makes it toxic to the body. Fortunately, this does not apply to aspirin, in this case the slogan should be "The smaller, the better." Therefore, when a quick effect is needed (for colds to reduce temperature, for headaches), experts recommend using effervescent tablets. Unfortunately, if an ordinary, insoluble and not dispersed, aspirin tablet is crushed at home in a mortar, the desired dispersion, which means the necessary safety for the stomach, will still not be achieved ...

F. Bayburtsky, T. Zimina

The authors thank T.A. Babayan (Department of Pharmaceutical Chemistry) and N.A. Fomenko (Department of Inorganic Chemistry) staff members of the I.M. Sechenov Moscow Medical Academy for the information provided.
According to the materials of the journal "Chemistry and Life" No. 12 for 1997

There is probably no other medicine in the world that could compete with aspirin in terms of popularity. As there is no person who, with his help, at least once in his life, did not bring down the fever during a cold. Over the course of its more than 100-year history, aspirin has sold more than 1 trillion. tablets, and in 1950 aspirin entered the Guinness Book of Records as the world's most common pain reliever.

But the history of this popular drug began much earlier, and the well-known tree, the willow, became its progenitor. In 1763, an English priest discovered that a decoction of willow bark had anti-inflammatory and antipyretic properties. After 100 years, scientists managed to isolate the main active substance of the bark - the alkaloid salicin, and then salicylic acid. Medicines based on it turned out to be not only more effective than natural predecessors, but also, importantly, 10 times cheaper. In 1874, a factory for the production of chemically synthesized salicylic acid started operating in Germany. The miracle pill was supposed to save humanity. But soon the euphoria gave way to doubts. It turned out that the new medicine is not so safe, because with prolonged use it literally corroded the mucous membrane of the stomach and intestines. What was to be done? Is it possible to refuse the affordable drug that has become so familiar? In 1899, the pharmaceutical market experienced a shock. One company, which has now become world famous, managed to establish an industrial production of a drug based on the safer acetylsalicylic acid. She patented not only the name of the new tablets - "aspirin", but also the technological process of their production. The main slogan of the aspirin advertising campaign was that aspirin is devoid of the side effects of salicylic acid. The aspirin expansion was fueled by a touching story: Aspirin author Felix Hoffman created it to help his father. The old man suffered from rheumatism, but due to stomach problems, he could not take salicylic acid. And the drug synthesized by my son helped relieve pain attacks without harm to health! It is not surprising that aspirin soon had dozens of analogues and competitors, and gradually he lost his position as the leader of the pharmacy hit parade. The second youth of the drug began in the mid-1950s, when new healing properties aspirin. It turned out that aspirin is also one of the most effective, safe and inexpensive funds to combat cardiovascular disease. Currently, in almost 40% of cases, people regularly take aspirin in small doses to prevent heart attacks and strokes. While the number of people taking aspirin for colds and flu is no more than 23% of all drug users.

Despite the active use of aspirin, the mechanism of its effect on the body was unknown for a long time. Work on this problem began in the mid-1970s. In 1982, the English professor J. Wein received the Nobel Prize for the discovery of the unique properties of acetylsalicylic acid. To activate Scientific research mechanism of action of aspirin and the search for its new medicinal properties, a special international award was also established. Recently, a scientist became its laureate, who proved that with the help of aspirin one can successfully fight migraine attacks. He managed to prove that acetylsalicylic acid is no less effective, but safer and more effective. cheap remedy for migraine than the currently popular triptan drugs. Currently underway clinical researches oncoprotective effect of aspirin on some intestinal tumors.

Aspirin is one of the most widely used medicines. This drug is used by people medicinal purposes with various diseases, sometimes opposite to each other. What are the properties of this medicine?

Therapeutic properties of aspirin

The properties of aspirin are very multifaceted. No wonder this drug is taken by people suffering from such ailments:

• heart disease;
• manifestations of migraine;
• rheumatism;
• cold infections.

Acetylsalicylic acid has a unique effect on the body. Its structure actively inhibits the activity of cyclooxygenase enzymes that are involved in the formation of inflammatory centers (prostaglandins).

Timely intake of this drug reduces the energy reserves of processes, against the background of which the latter begin to fade. Such a therapeutic effect is very important in situations associated with the development of rheumatic diseases in the body.

The main component of aspirin is acetylsalicylic acid. Its properties are aimed at eliminating the source of pain and lowering body temperature. The analgesic and antipyretic effects result from the inhibitory effect of acetylsalicylic acid on the central regions in the brain.

Against this background, pain sensitivity disappears and thermoregulatory processes normalize. Based on this, patients with high fever are given a tablet of the described remedy.

Aspirin tends to influence the activity of blood platelets. The specified medicine reduces the ability of blood to stick together, against which the likelihood of blood clots decreases. As a result, the blood becomes more liquefied, and the vascular lumens increase.

This has a positive effect on the general condition of the body, given elevated level intracranial pressure.

Among other things, the therapeutic effect of Aspirin is directed

• to eliminate pain in the head;
• to reduce the risk of thrombosis;
• prevention of heart attacks;
• a decrease in the likelihood of strokes.

For all its versatility, Aspirin (aspirin) is recommended to be taken in doses and if necessary.

Effect on the body

The benefits of using Aspirin for medicinal purposes are noticeable to the naked eye.

It has the following properties

• antiplatelet;
• antirheumatic;
• antipyretic;
• anti-inflammatory;
• painkillers.

This cardiomedicine belongs to the category of non-steroidal anti-inflammatory substances. Penetrating into the body, the active compound of Aspirin eliminates the processes of synthesis of prostaglandins with thromboxanes in an irreversible way.

The antipyretic effect of taking the described tablets is achieved by the normalization of thermoregulatory processes controlled by brain cells. The analgesic effect begins with the effect of acetylsalicylic acid on inflammatory mediators located in the central nervous system.

Once in the blood, the active compounds of the drug prevent platelet clotting, resulting in a decrease in the level of blood viscosity. And the blood vessel also expands.

Anti-inflammatory properties are developed due to a decrease in the permeability of small capillaries located in the painful focus. Against this background, the formation of inflammatory agents stops, which limits access to energy cellular reservoirs.

From all of the above, we can conclude that the pharmacological effect is very multifaceted and effective.

Who is prescribed the drug

Aspirin tablets have the following indications for use

1. Circulatory disorders in brain cells.

The described medicine helps to reduce the risk of circulatory disorders that feed the brain cells during ischemia.

1. Manifestations of myocarditis.

Regardless of the nature of the origin of myocarditis (allergic or infectious), acetylsalicylic acid copes with the disease.

1. The rise in body temperature.

The defeat of the body by infectious and inflammatory diseases is accompanied by an increase in temperature, which can be reduced by the described tablets.

1. Different degrees of rheumatism.

Acetylsalicylic acid is effective in rheumatoid arthritis with symptoms of rheumatism.

1. Pain in the head.

With the help of acetylsalicylic acid, it is possible to rid the body of various pains in the head associated with neuralgia or myalgia.

1. Thrombus formation.

Aspirin prevents blood from thickening and the occurrence of emboli with blood clots inside it.

1. Prevention of heart attacks.

Specified medicine is an excellent prophylactic against myocardial infarction.

Reception of Aspirin must be carried out with the appointment of a doctor or based on the instructions. For each disease, a certain dose of the drug and the frequency of administration have been developed.

For adults, the therapeutic dose is considered to be from 40 mlg to 1 g at a time. In some cases, up to 6 tablets of the drug are taken per 24 hours during the day. This should be done on a full stomach, since acetylsalicylic acid can have a detrimental effect on its mucosa.

In the case of taking these tablets without a doctor's prescription, the duration of the treatment course should not be more than a week when the analgesic effect is reached.

Contraindications to the use of aspirin

Contraindications to the use of these tablets for medicinal purposes are

• renal insufficiency;
• severe liver disease;
• lactation period;
• pregnancy;
• aortic aneurysm of a dissecting type;
• portal type hypertension;
• the state of hemophilia;
• lack of K-vitamin;
• low platelets;
• allergic reactions to the composition of the drug;
• internal bleeding in the digestive organs;
• ulcers in the intestines and stomach.

FROM big share caution, this medicine is used to treat people with manifestations of gout. Before using the described medication in treatment, you should consult a doctor or familiarize yourself with the contraindications to the drug.

Methods of taking aspirin

Take the specified drug should be in certain doses prescribed by the doctor or taken from the instructions. This will save a person’s health from the harm that an incorrectly taken medication can deliver.

When treating with Aspirin, you should not get involved in the intake of alcoholic beverages. This can lead to the development of seizures. bronchial asthma or bronchospasm.

Drink Aspirin with a small amount of water or milk after a meal. If necessary, the tablet is divided into shares or drunk completely. Heat body requires the simultaneous administration of not 1 tablet, but 2 or more. It is not recommended to take more than 3000 milligrams of acetylsalicylic acid per day (no more than 6 tablets).