Which popular drug item is small, comes in various shapes, colours and strengths, is available over-the-counter at a relatively cheap price, and is used to relieve the pain of migraines, arthritis, sore throat, toothache, menstruation, swellings, to relieve fever and to prevent heart attacks and strokes? Acetyl salicylic acid which is commonly known as aspirin is your answer. Ask any pharmacist and she or he will tell you that aspirin is amongst the most commonly dispensed items in the pharmacy.

Pain and fever relief

There are chemical messenger systems in the body, including hormones called prostaglandins, which transmit pain information to the brain, regulate body temperature, and produce redness and swelling (inflammation) with injuries and infections. So, the production of prostaglandins helps us to experience pain, fever, swelling, and so on. There is a critical enzyme required for prostaglandins themselves to be produced; it is called cyclooxygenase (COX), and aspirin stops its production.

So aspirin lowers the production of COX, which lowers the amount of prostaglandins produced, which leads to relief from conditions like pain, fever, and menstrual cramps. No COX, no prostaglandins, no pain.

An anti-platelet drug

But COX enzyme also promotes production of another type of hormones called thromboxanes. Thromboxane-A2 causes blood platelets to stick together in the blood to form blood clots, especially at locations in the heart and blood vessels where there is a disruption called an atheroma (fatty deposit). People who have cardiovascular disease such as hypertension, angina, congestive heart failure, atherosclerosis, and risk factors such as long-term high cholesterol levels and diabetes, have a strong tendency to produce atheromas (fatty deposits) in major blood vessels.

Blood clots in the heart or blood vessels where there are atheromas will cause cardiovascular events such as heart attack or stroke. This is where aspirin plays a vital role (as an anti-platelet drug). Aspirin suppresses the COX-1 enzyme which suppresses production of thromboxane-A2, which reduces clotting of blood platelets, which reduces the likelihood of heart attacks, strokes and death. The blood becomes thinner and less sticky.

No COX enzyme, no thromboxanes, no blood clot formation, reduces the likelihood of cardiovascular events. An aspirin a day is prescribed for persons who have already had such an event, and for those who are at high risk of having one.

Adult Dosage

For relief of pain and fever in adults and children over 12 years, 300 - 900 mg is taken every four to six hours as needed after food. Maximum daily dose is 4000mg. For prevention of blood clots 75mg once daily after food is prescribed. Aspirin should be used for blood clot prevention, only under the supervision of a medical doctor.

In children, aspirin can cause a rare but sometimes fatal condition called Reye's syndrome. Therefore, aspirin should not be given to children under 16 years.

Possible side effects of aspirin include:

Ulceration or bleeding in the stomach.

Allergic reaction to cause asthma attack, skin rash, swollen face, lips, tongue and throat.

Increased bleeding time, so if you need surgery let your surgeon know that you take aspirin. You may need to stop aspirin for a short time.

Ringing in the ears.

Precautions

Aspirin should not be used, or should be used with caution, by:

Persons with bleeding or blood clotting disorders, stomach ulcers or liver disease.

Persons who are using similar pain-killers like ibuprofen, anticoagulants, blood-thinning drugs, vitamin E, ginger and garlic supplements.

Asthmatics.

Ask your pharmacist about aspirin!