Aspirin clinical applications

Aspirin is the oldest and most widely used NSAID, and other NSAIDs are compared with aspirin in terms of efficacy and safety. Hence, this discussion focuses primarily on the clinical applications of aspirin and the problems typically associated with aspirin. For the most part, clinical use and problems can also be applied to most nonaspirin NSAIDs. The major similarities and differences between aspirin and the other NSAIDs are discussed in Comparison of Aspirin with Other NSAIDs. ... 

All agonists in this therapeutic group decrease the sensation of painful stimuli, which is their main clinical application. They tend to subdue dull, persistent pain rather than sharp pain, but this difference is to some extent dose dependent. The major difference between the non-opioid analgesics such as aspirin and the opiates is that the former reduce the perception of peripherally mediated pain, by reducing the synthesis of local hormones that activate the pain fibres, whereas the latter attenuate the affective reaction to pain without affecting the perception of pain. This clearly suggests that the site of action of the opiate analgesics is in the central nervous system. 

Diagnosis of aspirin-induced asthma requires a detailed medical history. The definitive diagnosis is made by aspirin provocation tests, which may be done via different routes. An oral provocation test is used commonly where threshold doses of aspirin induce a positive reaction measured by a drop in forced expiratory volume in 1 second (FEVi) and/or the presence of symptoms. A nasal provocation test is done by the application of one dose of lysine-aspirin, and aspirin sensitivity is manifested with clinical symptoms of watery discharge and a significant fall in inspiratory nasal flow. When lysine-aspirin bronchoprovocation was compared with oral aspirin provocation, both methods were equally sensitive. ... 

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