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“НАШЕ ЖИТТЯ”, СІЧЕНЬ 2014 WWW. UNWLA.ORG 33 SO YOU THINK YOU KNOW EVERYTHING ABOUT ASPIRIN? Ihor Magun, MD, FACP Aspirin ( chemical name : acetylsalicylic a c- id) has been manufactured since 1897. The orig i- nal indications for use were treatment of elevated body temperature and as an anti - inflammatory agent/a nalgesic to relieve minor pain. It was not until 1985 that an indication for treatment and secondary prevention of heart attacks was added. In 1998, it was officially approved to b e admini s- tered to individuals who are having a heart attack. Aspirin is perhaps the most commonly i n- gested medication in the world. It is inexpensive, readily available , and frequently taken too often. It is very possible that if aspirin w e re i n- trod uced to the market today, it would be a pr e- scription medication. The risk of gastrointestinal bleeding due to aspirin, even in low doses, is high. In fact , it is seen daily in emergency - room se t- tings. The standard dose, 325 mg , is associated with a significant ly greater risk of bleeding than the low adult strength, 81 mg (also referred to as baby aspirin). Both doses, even the lower one, are associated with an increase d risk of ga s- trointestinal bleeding that is twice as high as without any aspirin. So am I impl ying that o ne should not take any aspirin? My point is that any medication ca r- ries with it risks and benefits , and proper use o f this medication is paramount. Outside of the ind i- cations for fever and muscular issues, there are many questions that still rem ain unanswered — pertaining to its use for cardiac issues and stroke pre vention as well as to the proper d oses for women and the elderly. The initial trials included few women and the elderly to make a statistically significant recommendation. C urrent ongoing research is actively investigating aspirin use in these groups. The most up - to - date guidelines by t he American Heart Association are as follows: Aspirin 81 mg (daily) is recommended for wo m- en who have a high risk of heart disease or stroke (check with your physician), or women aged 65 or older if hypertension is controlled and benefit for stroke or myocardial infarction prevention is greater than the risk of bleeding. Aspirin 81 mg (daily) is recommended for all patients with known coronary arter y disease. Higher doses do not provide any additional benefit. Aspirin 81 mg (daily) is recommended for di a- betic women, unless there is a specific contrai n- dication. A spirin is sold in enteric coating and without one. Although the enteric - coated variety sound s better (and certainly is slightly more e x- pensive) it may not be a wiser choice. The mech a- nism of action and side effects are related to the effects of the aspirin and not based on the coating , which protects the key ingredient. So what shou ld one do in the event of heart attack chest pain s and the possible associa t- ed symptoms of shortness of breath and diaphoresis? Heart attacks are dynamic events where plaque can break off and block a r- teries , which attract platelets. Pl atelets trigger blood clotting. As the clot grows, it can occlude a blood vessel. Aspirin prevent s platel ets from sticking to each other. Clots grow by the minute , so time is of the essence. So here is the advice: if you or someone else is having a possible heart attac k , chew a 325 mg or four 81 mg doses of non - enteric - coated aspirin immediately (even if a l- ready taking 81 mg of aspirin daily). If you only have enteric - coated aspirin , then , by all means , use that. Do not wait! Let us then change the old adage “take two a spirin and call me in the morning ” to “ chew 325 mg of aspirin immediately when you suspect a heart attack and call 911 right away . ” For all other uses, exercis e caution when inges t- ing aspirin , or any other medication. F or all you know , taking the wrong do se of it may really make you call the doctor in the morning! __________________________________________ _____ ____________________ Smile! A chemist walks into a p harmacy and asks the pharmacist : "Do you have any acetylsalicylic acid?" "You mean aspirin?" asked the pharmacist. "That's it, I can never remember that word."
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