Aspirin
Definition
Aspirin is a medicine that relieves pain and reduces fever.
Purpose
Aspirin is used to relieve many kinds of minor aches and pains--headaches,
toothaches, muscle pain, menstrual cramps, the joint pain from arthritis,
and aches associated with colds and flu. Some people take aspirin daily to
reduce the risk of stroke, heart attack, or other heart problems.
Description
Aspirin--also known as acetylsalicylic acid--is sold over the counter and
comes in many forms, from the familiar white tablets to chewing gum and
rectal suppositories. Coated, chewable, buffered, and extended release
forms
are available. Many other over-the-counter medicine
contain aspirin.
Alka-Seltzer Original Effervescent Antacid Pain Reliever, for example,
contains aspirin for pain relief and sodium bicarbonate to relieve acid
indigestion, heartburn, and sour stomach.
Aspirin belongs to a group of drugs called salicylates.
Other members of
this group include sodium salicylate, choline salicylate, and magnesium
salicylate. These drugs are more
expensive and no more effective than
aspirin. However, they are a little easier on the stomach. Aspirin is
quickly absorbed into the bloodstream and provides quick and relatively
long-lasting pain relief. Aspirin also reduces inflammation. Researchers
believe these effects come about because aspirin blocks the production of
pain-producing chemicals called prostaglandins.
In addition to relieving pain and reducing inflammation, aspirin also lowers
fever by acting on the part of the brain that regulates temperature. The
brain then signals the blood vessels to widen, which allows heat to leave
the body more quickly.
Recommended dosage
Adults
TO RELIEVE PAIN OR REDUCE FEVER
one to two tablets every three to four hours, up to six times per day.
TO REDUCE THE RISK OF STROKE
one tablet four times a day or two tablets twice a day.
TO REDUCE THE RISK OF HEART ATTACK
Check with a physician for the proper dose and number of times per week
aspirin should, if at all, be taken.
Children
Check with a physician.
Precautions
Aspirin--even children's aspirin--should never be given to children or
teenagers with flu-like symptoms or chickenpox. Aspirin can cause Reye's
syndrome, a life-threatening condition that affects the nervous system and
liver. As many as 30% of children and teenagers who
develop Reye's syndrome
die. Those who survive may have permanent brain damage.
Check with a physician before giving aspirin to a child under 12 years for
arthritis, rheumatism, or any condition that requires long-term use of the
drug.
No one should take aspirin for more than 10 days in a row unless told to do
so by a physician. Anyone with fever should not take aspirin for more than
3
days without a physician's consent. Do not to take more than the
recommended
daily dosage.
People in the following categories should not use aspirin without first
checking with their physician:
* Pregnant women. Aspirin can cause bleeding
problems in both the mother and
the developing fetus. Aspirin
can also cause the infant's weight to be too
low at birth.
* Women who are breastfeeding. Aspirin can
pass into breast milk and may
affect the baby.
* People with a history of bleeding problems.
* People who are taking blood-thinning drugs,
such as warfarin (Coumadin).
* People with a history of ulcers.
* People with a history of asthma, nasal
polyps, or both. These people are
more likely to be allergic to
aspirin.
* People who are allergic to fenoprofen, ibuprofen, indomethacin,
ketoprofen,
meclofenamate sodium, naproxen, sulindac,
tolmetin, or the
orange food-coloring tartrazine. They may also be allergic to aspirin.
* People with AIDS or AIDS-related complex
who are taking AZT (zidovudine).
Aspirin can increase the risk
of bleeding in these patients.
* People taking certain other drugs
(discussed in Interactions).
* People with liver damage or severe kidney
failure.
Aspirin should not be taken before surgery, as it can increase the risk of
excessive bleeding. Anyone who is scheduled for surgery should check with
his or her surgeon to find out how long before surgery to avoid taking
aspirin.
Aspirin can cause stomach irritation. To reduce the likelihood of that
problem, take aspirin with food or milk or drink a full 8-oz glass of water
with it. Taking coated or buffered aspirin can also help. Be aware that
drinking alcohol can make the stomach irritation worse.
Stop taking aspirin immediately and call a physician if any of these
symptoms develop:
* ringing or buzzing in the ears
* hearing loss
* dizziness
* stomach pain that does not go away
Do not take aspirin that has a vinegary smell. That is a sign that the
aspirin is too old and ineffective. Flush such aspirin down the toilet.
Because aspirin can increase the risk of excessive bleeding, do not take
aspirin daily over long periods -- to reduce the risk of stroke or heart
attack, for example -- unless advised to do so by a physician.
Side effects
The most common side effects include stomachache, heartburn, loss of
appetite, and small amounts of blood in stools. Less common side effects
are
rashes, hives, fever, vision problems, liver damage, thirst, stomach ulcers,
and bleeding. People who are allergic to aspirin or those who have asthma,
rhinitis, or polyps in the nose may have trouble breathing after taking
aspirin.
Interactions
Aspirin may increase, decrease, or change the effects of many drugs.
Aspirin
can make drugs such as methotrexate (Rheumatrex) and valproic acid
(Depakote, Depakene)
more toxic. If taken with blood-thinning drugs, such as
warfarin (Coumadin)
and dicumarol, aspirin can increase the risk of
excessive bleeding. Aspirin counteracts the effects of other drugs, such as
angiotensin-converting enzyme (ACE)
inhibitors and beta blockers, which
lower blood pressure, and medicines used to treat gout (probenecid
and
sulfinpyrazone). Blood pressure may drop
unexpectedly and cause fainting or
dizziness if aspirin is taken along with nitroglycerin tablets. Aspirin may
also interact with diuretics, diabetes medicines, other nonsteroidal
anti-inflammatory drugs (NSAIDs), seizure
medications, and steroids. Anyone
who is taking these drugs should ask his or her physician whether they can
safely take aspirin.
Key Terms
Diuretic
Medicine that increases the amount of urine produced and relieves excess
fluid buildup in body tissues. Diuretics may be used in treating high blood
pressure, lung disease, premenstrual syndrome, and other conditions.
Inflammation
Pain, redness, swelling, and heat that usually develop in response to
injury
or illness.
NSAIDs
Nonsteroidal anti-inflammatory drugs.
Drugs such as ketoprofen and
ibuprofen
which relieve pain and reduce inflammation.
Polyp
A lump of tissue protruding from the lining of an organ, such as the nose,
bladder, or intestine. Polyps can sometimes block the passages in which
they
are found.
Prostaglandin
A hormonelike
chemical produced in the body. Prostaglandins have a wide
variety of effects, and may be responsible for the production of some types
of pain and inflammation.
Reye's syndrome
A life-threatening disease that affects
the liver and the brain and
sometimes occurs after a viral infection, such as flu or chickenpox.
Children or teenagers who are given aspirin for flu or chickenpox are at
increased risk of developing Reye's syndrome.
Rhinitis
Inflammation of the membranes inside the nose.
Salicylates
A group of drugs that includes aspirin and related compounds.
Salicylates
are used to relieve pain, reduce inflammation, and lower fever.
For Your Information
Periodicals
* "How to Give
Medicine to Children" (Includes related article on
health risks of aspirin
for children). FDA Consumer (Jan./Feb.
1996): 6.
*
"The Miracle Drug in Your Medicine Cabinet."
American Health (Jan./Feb.
1996): 67.
*
"No Aspirin, Please." Current
Health (Dec. 1992): 12.
* "What's the Best Pain Reliever? Depends on Your Pain." Consumer
Reports,
May 1996, 62.
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