In a sense, we have always known about aspirin. The bark of the willow tree contains an aspirin-like compound and has recorded to have been used as far back as the ancient Egyptians and the Greeks. This tree bark was described as being pain relieving and anti-inflammatory by both and has been used as a medicine throughout history until modern chemistry developed.
Fast Forward thousands of years and the first aspirin like drug was extracted in 1826 and by 1853, acetylsalicylic acid was first synthesised but it was not until 1897 that the world-renowned pharmaceutical company Bayer first called it Aspirin. Surprisingly, Bayer was not interested in aspirin and wanted to focus on their new cough medicine, Heroin, a highly addictive substance.
Aspirin’s ability to prevent heart attacks was first described by the doctor Lawrence Craven, who first noticed that patients who had taken aspirin regularly did not suffer heart attacks. Following years of observations, in 1953, Dr Lawrence Craven set in motion a cascade of scientific research into the mechanism of action of aspirin when he published his final medical paper regarding this matter and made some astonishingly accurate hypothesise, despite being restricted by limited scientific knowledge and capabilities of that era. In 1989, following years of research into aspirin, a large clinical trial was undertaken on patients and led to the confirmation of Dr Lawrence Craven’s hypothesis, who ironically died from a heart attack a decade earlier. Today Aspirin is one of the cheapest medicines available. It is recognised to be a part of a class of drugs called Non-Steroidal Anti-Inflammatory drugs and is a staple medicine and its use has potentially saved millions of lives.
Aspirin works in several ways;
- It is a pain killer
- It prevents the blood from clotting
- It reduces inflammation
- It reduces a high temperature or fever
Aspirin stops an enzyme called cyclo-oxygenase (COX) from working. This vital enzyme, COX, produces substances which helps the blood clot, promote inflammation and also modulate pain and temperature. COX also produces some protective substances. These substances help the stomach neutralise acids and also help maintain the blood-flow to the kidneys. The good news is that the risks of taking aspirin occur at high doses with prolonged periods of use. The bad news is that taking aspirin can cause ill health and the side effects can be adverse in certain people. After many years of research, the following individuals should speak to a doctor or their pharmacist before using Aspirin:
- Patients with asthma or lung disease – Aspirin is in a class of drugs which can induce asthma
- Patients with reduced kidney function, including those with only one kidney.
- Patients who take medicines which are removed from the body the body though the kidneys. There is a risk of interaction
- Patients who have any issue regarding severe indigestion, active stomach ulcers or a history of stomach ulcers
- Patients who have previously experienced an allergic reaction to aspirin or any product containing aspirin
- Patients who are taking any blood-thinning or antiplatelet medication
Aspirin should be taken with or just after food to help reduce the incidence of indigestion. When taken to prevent blood clots, a dose of 75mg daily is enough. For pain relief you can take up to 3g total daily dose, in divided doses. A final note to mention, aspirin should not be your first choice of medicine for pain relief, a fever or inflammation. Ideally there are other medicines that should be use first such as paracetamol and other NSAIDS.
By Ibrahim Toufeeq