Caused by aspirin

Prevention of gastric ulcers caused by aspirin or NSAID use (unlabeled use)... 

Tinnitus is the perception of sound, such as buzzing, hissing or pulsating noises, in the ears. Tinnitus may be caused by aspirin overdosage, furosemide or gentamicin toxicity. Tinnitus may also be an accompanying symptom of senile deafness, otosclerosis and Meniere s disease. 

The antipyretic and analgesic actions of aspirin are believed to occur in a certain area of the brain. It is also thought by some that the salicylates exert their analgesia by their effect on water balance. Aspirin is anti-inflammatory because it inhibits the biosynthesis of chemicals called prostaglandins. The irritation of the stomach lining caused by aspirin can be alleviated with the use of mild bases such as sodium bicarbonate, aluminum glycinate, sodium citrate, aluminum hydroxide, or magnesium trisilicate (a common trademark for this type of aspirin is Bufferin ). 

For patients with ulcers caused by aspirin or other NSAIDs, either H2 antagonists or proton pump inhibitors provide rapid ulcer healing so long as the NSAID is discontinued however continued use of the NSAID impairs ulcer healing. In patients with NSAID-induced ulcers who require continued NSAID therapy, treatment with a once- or twice-daily proton pump inhibitor more reliably promotes ulcer healing. 

What is the basic underlying biochemical effect caused by aspirin, and how does this lead to the various symptoms observed ... 

The irritation of the stomach lining caused by aspirin can be alleviated with the use of mild bases such as sodium bicarbonate, aluminum glyci-nate, sodium citrate, aluminum hydroxide, or magnesium trisilicate (a trademark for this type of aspirin is Bufferin ). 

Wittmers et al. (1990) used intragastric inulin as a measure of mucosal damage caused by aspirin. The... 

Therefore when deciding to use aspirin in primary prophylaxis, one should take account of the relative utihty of the different outcomes that are prevented or caused by aspirin. 

Similar results were found in another study in volunteers who took aspirin for 2 weeks mucosal adaptation to the injury caused by aspirin was clearly impaired in the presence of H. pylori and was restored after H. pylori eradication (83). 

In addition to skin eruptions aspirin can cause a syndrome referred to as aspirin exacerbated respiratory disease (AERD) in which the classic triad of asthma, rhinitis, and aspirin sensitivity was first described by Sam ter. It is important to note that AERD has as its precursor an underlying respiratory disease such as asthma that is exacerbated by aspirin but not caused by aspirin. Briefly, the natural history of this disease indicates that the patient first develops an upper respiratory tract inflammation that persists rather than subsides. Sinusitis develops, which progresses to pansinusitis with nasal polyps and asthma noted. At some point the patient takes aspirin or some other COX-1 inhibitor and an AERD reaction occurs. Although this is truly an idiopathic reaction to NSAIDs, adult patients with chronic sinusitis and nasal polyps should be observed carefully for the potential development of AERD. 

This phenomenon is not a true allergy, nor is it specifically caused by aspirin. It is the result of decreased synthesis of bronchodilatory prostanoids in the lung. In susceptible individuals, prostaglandin synthesis inhibitors may inhibit the synthesis not only of inflammatory prostanoids, but also of those prostanoids that contribute to patent airways. Thus, sensitivity to prostaglandin synthesis inhibitors can precipitate bronchoconstriction and blockade of airways. These events can arise from increased dosing of NSAIDs, increased frequency of dosage, or concurrent administration of more than one drug (e.g.. naproxen with ibuprofen). 

Enhances risk of bleeding caused by aspirin, heparin, or other anticoagulants. 

Misoprostol (Cytotec) Prostaglandin E analog which increases HCO3 and mucin release. Also reduces acid secretion. Prevention of ulcers caused by aspirin and other NSAIDS. Abortion (uterine contraction), diarrhea, abdominal pain, nausea, flatulance. 

A small increase in the gastrointestinal blood loss caused by aspirin occurs in patients if they drink alcohol, but any increased damage to the lining of the stomach is small and appears usually to be of minimal importance in most healthy individuals. However, heavy drinkers who r ularly take aspirin should be warned of the increased risk of gastric bleeding. Some limited information su ests that aspirin can raise or lower blood alcohol levels. 

Information about the increase in blood alcohol levels caused by aspirin after food is very limited and contradictory, and of uncertain practical importance. However, no practically relevant interaction has been seen with other drugs (such as the H2-receptor antagonists , (p.64)), which have been extensively studied, and which appear to interact by the same mechanism. The pattern for these drugs is that the increases in blood alcohol levels are appreciable with small doses of alcohol, but usually they become proportionately too small to matter with larger doses of alcohol (i.e. 

The manufaeturers say that population pharmacokinetic analysis suggests that aspirin had no effeet on vardenafil pharmacokinetics. In addition, vardenafil 10 mg and 20 mg did not potentiate the bleeding time caused by aspirin 162 mg. No additional preeautions therefore seem necessary on eoneurrent use. 

Nanra, R.S. and Kincaid-Smith, P. (1970). Papillary necrosis in rats caused by aspirin-containing mixtures. Br. Med. ]., 3, 559—61... 

Pseudoallergic reactions resemble allergic reactions clinically but are not immunologically mediated. Examples include asthma and rashes caused by aspirin and maculopapular erythematous rashes due to ampicillin or amoxicillin in the absence of penicillin hypersensitivity. Few other entities that can initiate this reaction are sulfonamides, anticonvulsants (phenytoin, carbamazepine and phenobarbital), NSAIDs (aspirin, naproxen, nabumetone and keto-profen), antiretroviral agents and cephalosporins [1 ]. 

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