Aspirin adverse effects

Overall no evidence was found to support the claim that anticoagulants offer a net advantage over aspirin in patients with acute ischemic stroke. There was evidence, however, to suggest that combination anticoagulant and aspirin therapy was associated with a small increase in the number of deaths at the end of follow-up, equivalent to 20 more deaths per 1000 patients treated. This adverse effect can probably be attributed partly to the 10 extra sICHs, and the 5 extra major extracranial hemorrhages per 1000 patients treated with combination anticoagulant/ aspirin therapy. 

COX-2 inhibitors such as celecoxib are associated with adverse effects such as nephrotoxicity and a potential increased risk of myocardial infarction (see Chaps. 55 and 15 for additional information). Combination of COX-2 inhibitors with alcohol may increase GI adverse effects. All NSAIDs should be used with caution in patients with aspirin-induced asthma.31... 

Pharmacology The study of the beneficial and adverse effects of drugs Benefits of aspirin or caffeine... 

Silagy CA, McNeil JJ, Donnan GA, Tonkin AM, Wor-sam B, Campion K. Adverse effects of low-dose aspirin in a healthy elderly population. Chn Pharmacol Ther 1993 54(l) 84-9. 

Some side effects, or adverse effects, of drugs can be fatal. Adverse drug reactions are one of the top 10 causes of death in hospitalized patients in the United States—as many as 100,000 deaths per year Even aspirin at low doses, recommended to prevent heart attacks and stroke, can kill under the right conditions Fatal bleeding can occur in patients who have an undetected clotting disorder and take aspirin r ularly. 

The drugs like ibuprofen, flurbiprofen, ketoprofen etc. possess antiinflammatory property similar to aspirin but toxicity and adverse effects are fewer and of lesser intensity. These preparations alone and in combination with other NSAIDs are used for treatment of inflammatory disorders. 

Adverse effects of ticlopidine include nausea, dyspepsia, and diarrhea in up to 20% of patients, hemorrhage in 5%, and, most seriously, leukopenia in 1%. The leukopenia is detected by regular monitoring of the white blood cell count during the first 3 months of treatment. Development of thrombotic thrombocytopenic purpura has also been associated with the ingestion of ticlopidine. The dosage of ticlopidine is 250 mg twice daily. It is particularly useful in patients who cannot tolerate aspirin. Doses of ticlopidine less than 500 mg/d may be efficacious with fewer adverse effects. 

Since aspirin, the original NSAID, has a number of adverse effects, many other NSAIDs have been developed in attempts to improve upon aspirin s efficacy and decrease its toxicity. 

In addition to the common side effects listed above, aspirin s main adverse effects at antithrombotic doses are gastric upset (intolerance) and gastric and duodenal ulcers. Hepatotoxicity, asthma, rashes, gastrointestinal bleeding, and renal toxicity rarely if ever occur at antithrombotic doses. 

Adverse effects have been reported with a frequency comparable to that of placebo. These include nausea, headache, stomach upset, diarrhea, allergy, anxiety, and insomnia. A few case reports noted bleeding complications in patients using ginkgo. In a few of these cases, the patients were also using either aspirin or warfarin. 

Aspirin (Figure 15.12) is one of the most frequendy used painkillers in the world. It is also able to reduce inflammation and fever and a low dose taken on a daily basis over the age of 50 may prevent heart attacks. It is derived from another acid, salicylic acid, which can be obtained from willow bark. Salicylic acid has the same medicinal properties as aspirin and has been known since 1829. Salicylic acid, however, caused stomach bleeding. The conversion of salicylic acid to aspirin reduced these problems, but aspirin still has some adverse effects on the stomach if taken in excess. 

Although the use of aspirin in treating fever in children is contraindicated (because of the association with Reye syndrome see Problems and Adverse Effects of Aspirinlike Drugs ), aspirin remains the primary NSAID used in treating fever in adults.9 Ibuprofen is also used frequently as a nonprescription antipyretic NSAID in both adults and children. 

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