How Does Aspirin Therapy Work?
Aspirin has gained its fame as a pain relief wonder medication. It alleviates headaches, decreases fevers, and lowers swelling. Moreover, research proves that daily doses as low as 81 milligrams - the amount in a baby aspirin – is able to decrease the odds of heart attacks and strokes in people who are at high risk. Nearly twenty five million American citizens take aspirin to protect themselves from heart disease every day.
However, there is a catch. Similarly to other medications, aspirin brings also several dangers. When it is taken regularly, it may lead to bleeding of the stomach and intestine - particularly in sensitive people. It can also interact with over-the-counter pain relievers, resulting in adverse side effects. But still, many people are not aware of this. Some of them take aspirin as casually as they pop a daily multivitamin.
"People tend to have this skewed impression that over-the-counter drugs are absolutely safe," claims Curtis Barr, PharmD, associate professor of pharmacy practice at the Creighton University School of Pharmacy and Health Professions in Omaha, Neb.
That goes double as far as daily aspirin is concerned. "People usually think, ‘It’s just baby aspirin after all,’" claim Byron Cryer, MD, a spokesman for the American Gastroenterological Association. "’So how bad could it be?’"
But still, it’s a potent medication, and every year low-dose aspirin helps send tens of thousands to the hospital with bleeding.
Therefore, you must never begin daily aspirin without the approval of your physician. If you have been prescribed a daily dose of aspirin, you have to be aware of your risks - before you next reach for a bottle of painkiller.
The Pros and Cons of Aspirin
Whilst aspirin may be best known as a painkiller, it also acts as a blood thinner. Heart attacks and the majority of strokes are caused by blood clots in the heart or brain. Aspirin reduces the natural tendency of the blood to clot, allowing it to flow more easily — lowering the risks of serious complications.
But there’s the problem. For the same reason that aspirin is helpful in preventing strokes and heart attacks - decreasing the blood’s inclination to clot - it also increases the risk of bleeding in other parts of the body. This bleeding can result from the lowered ability of blood to clot.
Aspirin has also a very special influence on the gastrointestinal tract. It works by blocking the effects of certain hormone-like substances, known as called prostaglandins. These chemical substances protect the stomach and gastrointestinal tract from getting damaged. Aspirin can strip away this protection. Natural acids and enzymes in the stomach, that help digest food, can then injure the lining of the gastrointestinal tract. This can lead to ulcers and bleeding. It doesn’t make any difference whether the aspirin is buffered or coated. And due to the fact that aspirin prevents clotting as well, the bleeding is worse than usually.
Regrettably, even small doses of aspirin bring about such effect, claims Cryer, who is also an associate professor of medicine at the University of Texas Southwestern Medical School in Dallas. He used to work on research that attempted to find a dose of aspirin that was low enough to avoid these side effects.
"We discovered that even just 10 milligrams - which is too low to bring any positive cardiovascular effect - caused the same risk of gastrointestinal damage as doses that were over 30 times higher," Cryer explains.
Compounding Aspirin’s Risks
Aspirin belongs to a class of medications known as nonsteroidal anti-inflammatory medicines (NSAIDs.) This includes such painkillers as:
* Ibuprofen (Advil, Motrin IB)
* Ketoprofen (Ordus KT)
* Naproxen sodium (Aleve)
* Prescription medications such as Celebrex, Daypro, Indocin, Lodine, Relafen and Voltaren
While other NSAIDs do not have aspirin’s cardiovascular positive effects, they share the same risks. Aspirin and other NSAIDs are able to:
*Increase the risk of particular strokes. While the majority of strokes are caused by clots, some of them result from bleeding in the brain. Thinning the blood raises this risk.
*Increase the risk of damage to the kidneys and liver. Generally, kidney or liver damage is only a risk while using high doses of NSAIDs regularly. However, people who already have kidney or liver disease should consult their physicians before using them.
*Trigger allergic reactions. A lot of people are allergic to NSAIDS. People suffering from asthma are particularly at risk.
However, the most common risk from NSAIDs is damage to the gastrointestinal tract. The American Gastroenterological Association reports that 103,000 people are hospitalized each year due to these side effects; 16,500 people die. And of all the patients diagnosed with GI bleeding resulting from an NSAID, a whopping 40 per cent are taking low-dose aspirin, claims Cryer.
What is worse, if you take aspirin together with another NSAID regularly, you greatly raise the risk.
"Taking at least two NSAIDs - like baby aspirin to protect heart and ibuprofen to relieve pain - raises your risk of gastrointestinal bleeding by nine times," claims Cryer.
Safe Pain Relief When You’re on Aspirin Therapy
So if you do take daily aspirin, what options you have the next time you pull a muscle or get a headache? Fortunetely, you don’t have to grin and bear it.
One of the over-the-counter options is acetaminophen, which is sold as Panadol and Tylenol. It doesn’t belong to the group of NSAIDs: it acts differently and brings about different hazards.
According to Cryer, for much stronger pain you could turn to prescription narcotics. These include such drugs as: ? OxyContin, Percocet, and Vicodin.
However, these medications have also drawbacks. First of all, none of them will solve the problem of swelling. High doses of acetaminophen regularly can lead to serious liver damage. Narcotics taken regularly can result in other side effects, such as constipation and a risk of addiction.
However, what if you have arthritis and a risk of heart attack? What if you require both a daily aspirin and an NSAID for pain and swelling?
And then there’s another option, claims Cryer. You could also take a proton pump inhibitor. These medications, for instance, prescription Aciphex, Nexium, Prevacid, Prilosec, and Protonix and the over-the-counter Prilosec OTC - lower the amount of acid in your stomach. This decreases the risk of ulcers or bleeding, even if you are taking aspirin and another NSAID.
Aspirin Therapy: Working With Your Physician
Cryer and Barr agree that we should not lose sight of aspirin’s positive effects.
"Having enumerated all these negative things concerning aspirin," claims Cryer, "I would like to point out that it’s an excellent medication for the proper people. Everyone just has to recognize that there are both hazards and benefits."
"In spite of the risks, I think that more people should perhaps be on daily aspirin therapy," explains Barr. "A lot of people at risk of cardiovascular disease - men over forty years of age, postmenopausal women, people with high blood pressure, high cholesterol or particularly diabetes - should be getting low-dose aspirin, but aren’t."
If you take aspirin every day or you are considering it, here are some tips.
*Make sure your healthcare provider (or providers) knows about every other medication you take. This is the crucial thing if you see multiple specialists, claims Barr. For example, you might be prescribed an NSAID for your arthritis by a rheumatologist, but your cardiologist might suggest low-dose aspirin. Each physicians must know what the other is doing. Otherwise, you could have serious problems.
*Pay attention to other products containing NSAIDs. NSAIDs, including aspirin, are common ingredients. They can pop up in places you might not expect, explains Barr. For example, some cold and flu medications, sleeping pills, and even antacids contain aspirin and other NSAIDs.
*Watch out for signs of gastrointestinal bleeding. Such symptoms include vomiting blood or dark stools. Unluckily, these are frequently the first symptoms that something is wrong, claims Cryer. Sometimes, stomach upset or pain may constitute an early warning.
*Never start taking daily aspirin without the approval of your healthcare provider. It could do you more harm than good.
Cryer hopes that some hazards related to aspirin will be decreases in the not so distant future.
"What we really need is the safer version of aspirin," he explains to WebMD. "That’s what the pharmaceutical companies are currently working on." However, according to Cryer this hypothetical safer aspirin is a ways off - if it’s coming at all.
For now, he claims that we need to make do with the imperfect wonder medication we’ve got.
