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This video is about aspirin. Before starting this video I'd like to wish you
all a Merry Christmas. Aspirin is a non-steroidal anti-inflammatory drug. Now
when you fall down or sustain any sort of injury, there will be release of various
inflammatory mediators especially prostaglandins at the site of
inflammation and these are responsible for carrying out the inflammatory
reactions such as burning sensation. Now have you ever heard of this enzyme
called as COX which is cyclooxygenase. This is the enzyme which is responsible
for the production of prostaglandins from arachidonic acid. Now aspirin
effectively inhibits cyclooxygenase enzyme, by doing so they decrease prostaglandin
synthesis and thereby decreasing inflammation. The cyclooxygenase enzyme has
two isoforms cyclooxygenase 1 and cyclooxygenase 2 which is responsible for
inflammatory reactions. Now aspirin being a non-selective COX inhibitor, inhibits
both the isoforms. The COX 1 isoform is responsible for physiological
activities whereas COX 2 isoform is responsible for inflammatory reactions
Aspirin is usually given by oral route. It is absorbed from the gastric mucosa as
well as intestinal mucosa. Aspirin is absorbed only in the unionized form in
which it will be diffusible. When aspirin enters the gastric mucosal cells it can
get converted into ionized form when it becomes non diffusible. When aspirin
becomes non diffusible, that is in the ionized form it cannot leave the gastric
mucosal cell and so it gets trapped inside the gastric mucosal cell leading
to ion trapping. This increases the gastric mucosal damage. In addition to
that aspirin also blocks a physiologically important enzyme which
is COX 1 which is responsible for maintenance of gastric mucosal integrity
and by blocking the COX 1 enzyme aspirin increases the risk of
mucosal damage. Aspirin is metabolized by liver and excreted by kidneys
About 80 percent of aspirin in the plasma is bound to plasma proteins and
it displaces drugs such as warfarin, naproxen and many other drugs from
plasma proteins. By doing so they increase the plasma levels of these
drugs and increase the toxicity associated with these drugs.
The pharmacological actions of aspirin. In lower doses, aspirin acts as an
analgesic drug and that's by desensitizing the peripheral pain receptors to the
action of prostaglandins and by doing so pain perception is reduced. Aspirin
also act as antipyretic drug by resetting the hypothalamic thermostat and by doing
so it increases sweating and cutaneous vasodilatation and various other
mechanisms to increase heat loss from the body. At higher doses aspirin acts as
a very good anti-inflammatory drug and that's by decreasing prostaglandin
synthesis by blocking the cyclooxygenase enzyme which i've already explained
before. Aspirin also inhibits platelet aggregation. Now
this effect is well observed in lower doses of aspirin. It does that by
decreasing thromboxane A2 synthesis which is also a product produced by the
cyclooxygenase enzyme. Aspirin causes hyperventilation
in higher doses leading to acidotic breathing and in very toxic doses
aspirin causes respiratory failure and even death. Aspirin is more often
associated with various acid-base imbalance disorders such as compensated
respiratory alkalosis in higher doses and uncompensated metabolic acidosis in
very toxic doses due to renal failure.
Aspirin can also increase the cardiac output to meet for the increased
peripheral oxygen demand produced by aspirin. As I've explained earlier aspirin
can cause gastric mucosal damage, ulceration and gastric bleeding. Uses of
aspirin. Aspirin can be used as analgesic as well as antipyretic in low doses but
however for this purpose better alternatives such as paracetamol can be
used which is associated with lesser side-effects.
Aspirin is very commonly used in the treatment of acute rheumatic fever where
it helps in symptomatic control of the disease it is also used for rheumatoid
arthritis but for this purpose better alternatives are available. It is most
commonly used in post myocardial infarction and post stroke patients to
prevent recurrence of the disease.
Aspirin is also used in patent ductus arteriosus in which case it is used to
bring about closure of the patent ductus arteriosus without the need for surgery.
Let's see about the toxicity of aspirin. Aspirin in lower doses are usually
associated with milder side effects such as mild GI distress,
epigastric pain, nausea, vomiting, etc., However when higher doses of aspirin are
given, this can lead to a syndrome known as salicylism in which there be
various clinical manifestations ranging from hyperventilation and acidotic
breathing, reversible hearing loss and vision loss, tinnitus, vertigo,
nausea, vomiting and so many other features. Hypersensitivity and associated
anaphylactic reactions is rare in the case of aspirin and there is this thing
called as acute salicylate poisoning when you give over doses of aspirin at a
time. There will be severe manifestations such as respiratory depression, coma and
uncompensated metabolic acidosis due to the accumulation of various metabolic
acids in the body and can lead to death of the patient. The various
contraindications for aspirin. In children, especially who are infected
with influenza, chickenpox and various other viral infections, it's better to
avoid aspirin as it can cause Reye's syndrome in these patients. This is
actually manifested by encephalopathy as well as liver damage.
It should be avoided in patients with heart diseases because this can increase
the workload of the heart and can lead to precipitation of congestive cardiac
failure. It can cause gastric ulcers as I've already told you, so it should
be prevented in patients with gastric ulcers. Most importantly it should be avoided
in pregnant women, because it can cause prolonged labor and it can also
cross the placental barrier to reach the fetus and very importantly it should be
prevented in persons with bleeding disorders because this increases the
risk of bleeding. Check out the New Year merch. The link is in description of
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comment below if you're watching this video till the end and subscribe to my
channel for more videos. Most importantly Merry Christmas to everyone. Thank you
for watching, I'll see you in my next video.
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