Most of us take medications containing acetylsalicylic acid for colds or headaches. But salicylic acid can save you from heart attack and stroke as well. How does acetylsalicylic acid work? What are the indications for taking it? What's the dosage? Who shouldn't be treated with drugs containing acetylsalicylic acid and what are the side effects of taking them?

Acetylsalicylic acidis a derivative of salicylic acid that has analgesic, anti-inflammatory, antipyretic and anti-aggregating properties. Already Hippocrates noticed that acetylsalicylic acid has an analgesic and anti-inflammatory effect. Today it is known thatacetylsalicylic acid(ASA) also has a beneficial effect on the circulatory system. How it's possible? To know the answer - first a little bit about our blood.

Acetylsalicylic acid - anti-degradation effect

Platelets have the ability to aggregate at the site of damage to a blood vessel, e.g. of a cut. This causes a local vasoconstriction and the bleeding is reduced. The plaques form a clot that clogs the wound like a cork. But they can also stick together inside arteries and veins, and such a situation is a serious threat to he alth and life.

If the inside of an artery is covered with mature plaque, it can rupture at any time. Then the place where it happened will be treated by the body as a wound on the skin. It will start producing a substance (thromboxane), which will make the platelets stick together and stick to the vessel wall faster.

When such a clot (wall clot) becomes large, it will reduce the lumen of the vessel and obstruct the blood flow. If a coronary artery is blocked, necrosis of the cells of the heart muscle, i.e. a heart attack, will occur within a few hours. This is the situation that acetylsalicylic acid can change.

  • The antithrombotic properties of acetylsalicylic acid have only been discovered in the last 20 years. They turned out to be due to the ability of acetylsalicylic acid to inhibit the activity of an enzyme called cyclooxygenase, which produces thromboxane, which is responsible for clumping of platelets.
  • Another advantage of acid is that it regulates the intensity of the production of prostacyclin - a substance that opposes thromboxane, i.e. preventsplatelets sticking to the vessel walls.
  • ASA has another important feature - it has antiatherosclerotic properties. The stuck together of the plaques impede blood flow, which leads to hypoxia in all organs, especially the heart. However, if you regularly take acetylsalicylic acid preparations, the process is slower. That is why ASA is used in the prevention of cardiovascular diseases.

Acetylsalicylic acid - indications

  • Symptomatic treatment of pain of mild and / or moderate intensity (e.g. headache, toothache, muscle pain)
  • Symptomatic treatment of pain and fever in the course of colds and flu
  • Regular use of the drug is recommended for people with advanced atherosclerosis and coronary artery disease
  • The drug is also administered to heart attacks because it reduces the risk of another attack, especially in the first 30 days after a heart attack
  • Taking acetylsalicylic acid also helps people with intermittent claudication, or obstructive atherosclerosis of peripheral arteries

Acetylsalicylic acid - contraindications. Who can't take it?

Preparations containing acetylsalicylic acid must not be taken:

  • people suffering from peptic ulcer disease of the stomach or duodenum, as acetylsalicylic acid reduces the secretion of protective mucus by the stomach walls;
  • breastfeeding women, as the acid passes into the milk and may harm the baby;
  • children up to 12 years of age - acid can cause them to develop dangerous Reye's syndrome;
  • asthmatics, because acetylsalicylic acid may cause an attack of breathlessness;
  • people with bleeding disorders and taking anticoagulants because acetylsalicylic acid thins the blood;
  • patients with diabetes - the acid increases the effect of antidiabetic drugs and may lead to a significant reduction in blood glucose levels and fainting;
  • patients waiting for surgery 7-10 days before the procedure, in order not to disturb the coagulation process.

Acetylsalicylic acid - dosage

The currently recommended very low doses of ASA minimize its side effects. Micro doses of the drug (no less than 75 mg and no more than 100-160 mg per day) are the treatment of choice.

In thrombosis prophylaxis, the desired effect is achieved only after a few days of taking the drug. Therefore, for the first days of treatment, even 320 mg of the drug is taken daily. After that, the dose is reduced.

The dose recommended by your doctor must not be changed on your own, because an excess of ASA may cause effects that are dangerous to your he alth.

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Acetylsalicylic acid and pregnancy

Acetylsalicylic acid is contraindicated in the last trimester of pregnancy as it may cause complications in the perinatal period, both in the mother and in the newborn.

Products containing acetylsalicylic acid should not be used in women during the first and second trimesters of pregnancy, unless absolutely necessary. If the use of acetylsalicylic acid is required by women trying to become pregnant, or in the first and second trimesters of pregnancy, the lowest possible dose should be taken for the shortest possible time.

Acetylsalicylic acid - symptoms of overdose

As with any drug, acetylsalicylic acid can also be overdosed. This initially manifests itself as:

  • dizzy
  • tinnitus
  • nausea
  • vomiting
  • hearing and vision impairment

Later on, metabolic acidosis develops. It may also lead to convulsions, coma, collapse or kidney failure. A large dose of acetylsalicylic acid can even be fatal.

Read also: Salicylic acid and its healing properties. How does it work and why is it worth using?

Acetylsalicylic acid reacts with medications

Acetylsalicylic acid intensifies the effect:

  • toxic to bone marrow methotrexate; acetylsalicylic acid should not be used concomitantly with methotrexate at doses of 15 mg per week or more; the concomitant use of methotrexate in doses less than 15 mg per week requires special care. Otherwise, your bone marrow may be damaged;
  • anticoagulants, thrombolytic drugs (that dissolve the clot) and inhibit platelet aggregation (clumping), which may increase the risk of prolonged bleeding time and haemorrhage;
  • risk of ulceration and gastrointestinal bleeding if used concomitantly with corticosteroids, other non-steroidal anti-inflammatory drugs, including other high-dose salicylates, or if alcohol is consumed during treatment; When you stop taking systemic corticosteroids (with the exception of hydrocortisone used as replacement therapy in Addison's disease), the risk of salicylate overdose increases;
  • digoxin (a drug used to treat heart diseases), as it increases its plasma concentration;
  • anti-diabetic drugs, e.g. insulin, sulfonylureas;
  • toxic of valproic acid (a drug used, among others, in epilepsy), which in turn increases the anti-aggregating effect of the acidacetylsalicylic acid;
  • toxic of valproic acid (a drug used, among others, in epilepsy), which in turn increases the anti-aggregating effect of acetylsalicylic acid.

Acetylsalicylic acid reduces the effect:

  • anti-addictive drugs used to treat gout, increasing the excretion of uric acid from the body (e.g. benzbromarone, probenecid), which may worsen the symptoms of gout
  • diuretics,
  • some antihypertensive drugs (angiotensin converting enzyme inhibitors), especially if acetylsalicylic acid is used in high doses.

Drugs containing acetylsalicylic acid include: aspirin and polopyrin.

Important

Check drug ingredients

Acetylsalicylic acid is found in many painkillers, anti-inflammatory and antipyretic drugs that we reach for colds. Therefore, before taking any drug, you should check its composition. If you regularly take a preparation containing acetylsalicylic acid, e.g. for cardiological reasons, an additional dose of the drug may cause serious he alth complications.

The article uses materials from Anna Jarosz from the monthly "Zdrowie".

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