Series VI: Medical Sciences – SUPPLEMENT ... - Krongres

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A. BALESCU et al: The Aspirin- The First Drug Obtained by Synthesis - Frequently Used Currently 147 • Antipyretic; • Anti-inflammatory – the treatment of acute articular rheumatism and other acute inflammatory diseases; after 1950, by discovering other drugs with analgesic, antipyretic and antiinflammatory actions the aspirin had major competitors; • As an antithrombotic agent – in the prophylaxis of acute myocardial infarction, acute angina, transitory acute angina and ischemic cerebrovascular stroke; in 1971 the pharmacist John Robert Vane proves the effects of the aspirin on prostaglandins [2] and the antithrombotic effect of the aspirin, fact that determines the use in the prophylaxis of cardiovascular diseases, this being the moment of the commercial revival of the aspirin; at the European Society of Cardiology Congress, in Barcelona, 2009, were described the results of studies done in Scotland on 29000 persons with ages between 50 and 75 followed for 8 years; the conclusions suggest that the aspirin should not be prescribed to the general population because the healthy persons that take aspirin do not reduce their cardiac risk but increase their hemorrhagic risk [4]. • As antithrombotic agent – in the treatment of cardiovascular cerebrovascular diseases; it is ascertained the favorable effect in the secondary prevention of those diseases; but in the case of the primary prevention the benefit from administering aspirin are annulled by the high risk of cerebral hemorrhage [3]. Recently it was confirmed that the aspirin has n important role also in: • Pancreatic cancer prevention – the results of some epidemiologic studies suggested that aspirin can reduce the risk of pancreatic cancer, but this conclusion is not fully endorsed; research conducted on 987,590 persons with a evolution followed for 18 years (1982-2000) demonstrated that the sue of aspirin with the purpose to reduce the pancreatic cancer incidence or the mortality caused by it does not have a significant effect [1]. • The prevention of hepatic diseases caused by alcohol and medication overdose – a study done by Yale University shows that daily use of aspirin is preventing hepatic diseases; for prevention a daily dose of aspirin is recommended and if the lesions are already present it is recommended the administering of immune stimulant substances; • Decrease of relapse risk for colon and rectal cancers [3]; the mechanism of action of the aspirin on tumor development is not well known, it is considered that some aspirin doses act at endothelial level, controlling the development of the blood vessels and implicit the development of the tumor; these test have been done only at a laboratory level and are necessary studies to confirm this hypothesis; • The prevention of some types of cataract – research done by the Yale University shows that the salicylic acid is capable to prevent or delay the onset of the cataract, acting on an enzyme involved in the sorbitol creation in the crystalline; • Prevention of severe migraines; • Prevention of obesity; • Effects on arterial tension – aspirin administered in the morning increases the arterial tension and in the evening decreases the arterial tension; • The association of aspirin with caffeine and ephedrine can have a positive influence on the
148 Bulletin of the Transilvania University of Bra�ov • Vol. 2 (51) - 2009 • Series VI development of the muscular mass and the reduction of the fatty tissues; this association has the advantage of lipolysis stimulation and decrease of protein use in the energy production with the disadvantage of heart rate increase and muscular tremor [5]. The efficiency and safety of aspirin administering in cardiovascular prevention has been evaluated by including in the study a population group with apparently healthy persons and persons with myocardial infarction or stroke. On patients with occlusive vascular disease the individual studies and randomized trials showed that small doses (75-162 mg/day) decrease the risk of serious cardiovascular events with 25% [3]. Studies on a group of 95000 persons with low to medium risk confirm that the preventive use of aspirin reduces with a fifth the myocardial infarction risk without significantly influencing the stroke risk and the stroke mortality. There are studies that show the effect of the aspirin being dependent on age and sex. Research in aspirin intake for primary prevention significantly reduces the myocardial infarction risk in men without reducing the vascular risk. In women, the aspirin lowers the vascular risk but has no significant influence on myocardial infarction risk. The variations dependent on sex on the secondary prevention have not been demonstrated [3]. In general elderly people and women have higher hemorrhagic risk but this predisposition is not influencing alone the personal safety when administering aspirin. The association with other drugs (statins and anti thrombosis drugs) can decrease the risk of cardiovascular events. The benefits of associating aspirin with other drugs in the secondary prevention of cardiovascular events are ascertained [3]. Some studies show that associating aspirin with vitamin C is an efficient treatment against viral infections but administering aspirin during flu can be harmful. Using aspirin and other salicylate based drugs in treating flu can lead to Reye syndrome. This syndrome affects children between 4 and 16 years of age and when the flu is epidemic. The 20 th century was surnamed the aspirin century. Aspirin represented the subject of over 3000 scientific papers. The annual quantity of aspirin is 50000 tons (20 tablets /person). The daily use of aspirin is 100000000 tablets. References: [1]. Jacobs, E.J., Connel, C.J., Rodriguez, C. Et al: Aspirin use and pancreatic cancer mortality in a large United States cohort. In: Journal of the National Cancer Institute Vol. 96(7), 2004, p. 524-8. [2]. Jeffryes, D.: Aspirin - The Extraordinary Story of a Wonder Drug, Bloomsbury Publishing PLC, 2005. [3]. Montalescot, G.: The major risk of aspirin as with all NSAIDs, is bleeding,. In: ESC Congress Barcelona, 2009. [4]. Patrono, C.: While the benefits of aspirin exceed the risk/benefit ratio is marginal in low-risk populations. In: ESC Congress Barcelona, 2009. [5]. �erban D.: Efedrina + Cofeina + Aspirina = Combina�ie reu�it� în eliminarea masei adipoase �i în dezvoltarea muscular�. Available at: http://www.doctor.info.ro/eca.html. [6]. x x x- Agenda medical�. Editura Medical� Bucure�ti, 2007.
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Series VI: Medical Sciences – SUPPLEMENT ... - Krongres

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