Aspirin has many therapeutic effects such as preventing platelet aggregation, preventing and treating thrombosis in blood vessels (such as thrombotic venous inflammation), and preventing myocardial infarction, as well as reducing the risk of colorectal and esophageal cancers. However, there are also many downsides to aspirin, and it should be avoided in certain cases.
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| Aspirin should be taken with food to avoid unfortunate complications (Image: greatbigstuff) |
The name of the drug “aspirin” was officially introduced in 1899. Initially, it was formulated in powder form, and a year later it was sold in tablet form. Today, aspirin is widely used and comes in many brand names and various forms: tablets, coated tablets, powder packets, effervescent tablets, and pH8 aspirin…
Aspirin and Reye’s Syndrome
Children and adolescents taking aspirin under certain circumstances may be at risk of Reye’s Syndrome. This syndrome is named after Australian pathologist Douglas Reye, who first described the disease in 1963 at a facility in Sydney. Reye’s Syndrome consists of two symptom groups: acute encephalopathy and fatty degeneration of organs (brain, kidneys, heart, especially the liver), and is a severe condition with a high mortality rate.
Statistics show that only 1 in 2 affected children can be saved, and those who survive often suffer severe brain damage. Most children experience fever due to influenza or chickenpox and are then given aspirin, which can lead to vomiting, loss of consciousness, and sometimes seizures, resulting in rapid death. Since the mid-1980s, the UK Committee on Safety of Medicines has issued a recommendation: “Do not use aspirin for children under 12 years of age, except in cases of rheumatic disease.”
In the Federal Republic of Germany, the Ministry of Health has decided to add warnings about the potential harms alongside the benefits of aspirin in its prescribing information. In Michigan (USA), starting in the 1980s, due to widespread media coverage about the risk of Reye’s Syndrome from children taking aspirin during chickenpox illness, the incidence of Reye’s Syndrome has significantly decreased, even though chickenpox still occurs annually.
Aspirin and Asthma Patients
Asthma patients should not use aspirin, as it can exacerbate asthma attacks and even pose a life-threatening risk. Aspirin can trigger asthmatic reactions through a non-immune mechanism, also known as pseudo-allergy or specific hypersensitivity. The exact mechanism by which aspirin induces asthma is not well understood; however, it is known to involve multiple factors, particularly an imbalance in arachidonic acid metabolism, increased release of mediators from bronchial mast cells, pro-inflammatory mediators, prostaglandins, and leukotrienes…
Aspirin-induced asthma typically occurs in individuals with a history of allergies (such as allergic rhinitis or those who have had stable asthma attacks) and presents acutely after aspirin use, with symptoms often appearing 2-3 hours after taking the drug, leading to severe manifestations, prolonged symptoms, or even death.
Other Important Considerations
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Chemical structure of Aspirin (Image: bris.ac.uk) |
– Due to its antiplatelet properties, which can increase bleeding, women who are menstruating should avoid aspirin, especially those experiencing menorrhagia or metrorrhagia, as it should not be taken to reduce fever or relieve pain. Individuals with bleeding disorders should also refrain from using it.
– Pregnant women in their third trimester should not take aspirin as it may prolong gestation and can be toxic to the fetus, causing bleeding in newborns and increasing the risk of postpartum hemorrhage. Nursing mothers should also avoid aspirin since the drug can pass through breast milk and may harm the infant.
– Individuals with peptic ulcers or duodenal ulcers should not take aspirin, as it can facilitate gastric acid and pepsin damage to the stomach lining once the protective barrier is weakened. It can exacerbate existing ulcerative lesions in the stomach, potentially causing bleeding or, in severe cases, perforation.
– Individuals with liver or kidney dysfunction, or those with certain types of anemia (due to aspirin reducing the lifespan of red blood cells) should not use aspirin. Those currently taking anticoagulants or methotrexate should absolutely avoid aspirin.
– When taking aspirin, alcohol should be avoided, as it increases gastric irritation caused by aspirin. Aspirin itself is acidic and can cause discomfort in the digestive system, so it is advisable to take the medication with food.
– Additionally, while aspirin is generally low in toxicity and easy to take, prolonged use may lead to symptoms such as nausea, vomiting, tinnitus, hearing loss, and confusion. When there is a need to reduce fever or relieve pain, individuals should not self-medicate with aspirin but should consult healthcare professionals for guidance on medication use.
