Aspirin
Overview
Aspirin is a salicylate, a similar molecule, salicin, was originally extracted from the bark of willow trees, and has a broad range of clinical uses - from pain relief, to survival benefits in heart attacks. It can be consumed orally or applied topically. Overdose can cause significant metabolic disturbances, and is life threatening.
Clinical Uses
Contraindications
Pregnancy
During pregnancy, the foetal circulation depends on the presence of prostaglandins to maintain added pathways between the right and left sides of the heart. Aspirin will block these prostaglandins and can cause the foetus to die.
Bleeding disorders or significant active bleeding
Aspirin has some anti-platelet activity, which can slow clotting. Generally the effect is mild, but careful consideration should be given to those patients for whom bleeding is likely, or where active bleeding is posing a risk to their life.
Gastric ulcers or vomiting blood (haematemesis)
Used frequently, aspirin can predispose patients to the formation of gastric ulcers, and should ideally be taken alongside food to help limit this side effect.
Kidney failure
While difficult to measure directly in a post-modern medicine situation, patients with signs of kidney failure should receive reduced doses and frequency, ideally avoiding the drug where possible. There is a risk of the drug metabolites building up in the body, which can cause toxicity.
Children (<16 years)
There is a risk of Reye's syndrome, which causes brain and liver swelling, and has a high mortality rate. Especially avoid aspirin in children recovering from a viral illness.
Dosing
Pain relief (oral)
240-300 mg (milligrams) THREE times daily, aim to limit use to maximum of 3 days to minimise side effects on stomach + kidneys
Migraine
900 mg ONCE only as a single dose.
(exquisite diagnostic caution should be taken to avoid other malignant headaches, such as subarachnoid haemorrhage or intracerebral haemorrhage, as aspirin would worsen bleeding)
Extraction
Needs expansion...