Aspirin

(History) This product is an antipyretic and analgesic with a long history. March 6, 1999 is the 100th anniversary of the official birth of aspirin, and it is also the contribution made by the German company Bayer to humanity. As early as 1853, Charles Frederic Gérard (Gerhardt) synthesized acetylsalicylic acid from salicylic acid and acetic anhydride, but failed to attract people's attention; in 1898, German chemist Phil Hoffmann Felit Hoffmann synthesized it and treated his father's rheumatoid arthritis with excellent results. In 1899, Dreser introduced it to the clinic and named it aspirin. Our country started production in 1958. So far, it has been used for hundreds of years and has become one of the three classic drugs in the history of medicine. It is still the most widely used antipyretic, analgesic and anti-inflammatory drug in the world, and is also used as a standard preparation for comparison and evaluation of other drugs.

(Other names) Acetylsali-cylic Acid; Acetylsali-cylic Acid; Acetylsali-cylic Acid; Acetylsali-cylic Acid;

(Properties and Stability) This product is white crystal or crystalline powder; odorless or slightly acetic odor, slightly sour taste, easily soluble in ethanol, soluble in chloroform and ether, slightly soluble in water , unstable in nature, can slowly decompose into salicylic acid and acetic acid in humid air with a slightly sour smell, so it should be stored in a closed, dry place to prevent decomposition.

(In vivo process) This product is easily absorbed after oral administration, and is rapidly decomposed into free salicylic acid in the body and distributed throughout the body. The effective anti-inflammatory concentration in plasma is 150-300 micrograms per milliliter, while the toxic concentration is more than 200 micrograms per milliliter, so accumulation of poisoning must be prevented. This product is mainly metabolized in the liver and excreted by the kidneys. When taken together with sodium bicarbonate, the excretion of free drugs increases, the plasma drug concentration decreases, and the drug action time is shortened.

(Drug effect) This product has strong antipyretic and analgesic effects. It can lower the body temperature of fever patients and has almost no effect on normal body temperature. It can only relieve symptoms but cannot treat the cause. This product can also reduce the production of prostaglandins, substances with pain-sensitizing effects in inflammatory areas, so it has obvious analgesic effects. It has a good effect on chronic pain, but is ineffective on sharp pain or transient tingling.

This product also has strong anti-inflammatory and anti-rheumatic effects. It can reduce fever 24-48 hours after taking the medicine for acute rheumatic fever, and the symptoms of joint redness, swelling and pain are significantly reduced.

This product also has anti-platelet aggregation effect, prolongs bleeding time and prevents thrombosis.

(Adapted to symptoms) It is widely used for fever, headache, toothache, muscle pain, joint pain, low back pain, menstrual pain, and postoperative minor wound pain caused by various reasons.

For patients who have been diagnosed with rheumatic fever, active rheumatoid arthritis, juvenile arthritis, osteoarthritis and other diseases, this product can be used for maintenance treatment.

Low-dose medicine (40-50 mg daily) is used to prevent thrombosis after transient cerebral ischemic attacks, myocardial infarction or other surgeries.

(Adverse reactions and precautions) 1. The most common reactions are: gastrointestinal dysfunction, manifested as nausea, vomiting, and abdominal pain. Long-term use of large doses can cause gastritis, hidden bleeding, and aggravate ulcer formation. and gastrointestinal bleeding, etc. If taken with an appropriate amount of calcium carbonate after meals, the occurrence of reactions can be reduced. However, it should not be taken with sodium bicarbonate, because the latter can accelerate the excretion of this product and reduce the efficacy.

2. Less common reactions include: (1) Effect on the coagulation system: Long-term use of large doses can inhibit the synthesis of thrombin and increase the tendency of bleeding. Since this product irreversibly inhibits platelet aggregation and prolongs bleeding time, patients who are taking heparin and coumarin anticoagulants, as well as patients with severe liver disease or bleeding lesions (such as hemophilia) should not use this product. (2) Allergic reactions: A small number of patients with foreign body constitution may have allergic reactions such as urticaria, mucous membrane congestion, and asthma. Among them, allergic asthma is more common and manifests as dyspnea and wheezing within minutes after taking the medicine. In severe cases, it can be life-threatening. Therefore, this product is contraindicated in patients with a history of asthma.

(3) Poisoning reaction: Long-term and large-scale application of this product can cause headache, dizziness, tinnitus, visual and hearing loss, drowsiness, sweating and other reactions. This is a manifestation of chronic salicylate poisoning, which is more common in the treatment of rheumatism. In severe cases, If there is mental disorder, acid-base imbalance and bleeding, the drug should be stopped immediately and various symptomatic treatment measures should be taken. (4) Damage to liver and kidneys: Children with juvenile arthritis and adult patients with systemic lupus who have been treated with this product for a long time often have changes in liver function tests, but they can still recover after stopping the drug.

3. Patients suffering from gastric and duodenal ulcers should be careful not to use this product at work. Patients with poor liver and kidney function should use this product with caution or disable it. Pregnant and lactating women should use this product with caution or should not use it.

4. Children should be used under the guidance of a physician, especially after the patient is infected with chickenpox or influenza, and should be closely observed.

(Drug overdose and treatment) Salicylate poisoning: Oral dosage of this product exceeding 5 grams per day can cause salicylate reaction. Excessive dosage can cause salicylate poisoning. Oral administration of 10 -30 grams can cause death in adults. The most common initial signs of poisoning in adults are reversible tinnitus, ear fullness and deafness, but for children and some elderly patients, it is not a reliable indication of poisoning, and even higher doses may not cause tinnitus; the original Hearing-impaired people cannot use this as a basis for judgment. The initial signs of overdose in children are hyperpnea, episodic tachypnea and lethargy.

Poisoning at the starting dose: manifests as nausea, vomiting, abdominal pain, diarrhea, and in severe cases, hemorrhagic gastritis and toxic hepatitis and symptoms.

Acute poisoning: headache, dizziness, tinnitus, deafness, visual disturbance, double vision, restlessness, inability to speak, fear, manic delirium, tetany, tremors, convulsions, high fever, profuse sweating; accompanied by As poisoning progresses, central excitement is gradually suppressed, leading to stupor, coma, wheezing breathing, cyanosis, and finally respiratory and circulatory failure.

Stop the drug immediately and infuse it intravenously with glucose solution containing sodium bicarbonate to accelerate drug excretion; if bleeding occurs, blood transfusion or vitamin K supplementation should be given. Hemodialysis and peritoneal dialysis may be considered in patients with severe overdose.

(Drug interactions) (1) Ethanol can aggravate the damaging effect of this product on the gastric mucosa.

(2) If used in combination with coumarin anticoagulants, it may increase bleeding tendency.

(3) This product can inhibit the uric acid excretion-stimulating effect of probenecid and benzotrione, especially in large doses.

(4) If taken together with other non-steroidal anti-inflammatory drugs, gastrointestinal adverse reactions will increase and the anti-inflammatory effect will be reduced.

(5) Glucocorticoids can stimulate gastric acid secretion and reduce the resistance of gastric and duodenal mucosa to gastric acid. If the two are used together, gastrointestinal bleeding can be aggravated.

(6) This product can increase the effects and toxicity of tolbutamide hypoglycemic drugs, methotrexate, barbiturates, phenytoin, etc.

(Usage and Dosage) Take orally. For antipyretic and analgesic, adults take 300-600 mg once, 3 times a day or when necessary. Children 1-2 years old, 75 mg once; 2-4 years old, 150 mg once; 4-6 years old, 225 mg once; 6-9 years old, 300 mg once; 9-11 years old, 375 mg once; 11-12 years old , 450 mg once, 3 times a day.

To prevent thrombosis and myocardial infarction, 75-325 mg once a day.

(Limited dosage forms) Tablets, water-soluble tablets, enteric-coated tablets, suppositories, powders, sustained-release tablets, and compound preparations.

(Available marketed preparations) Aspirin: tablets, each tablet contains 0.3g and 0.5g of aspirin, taken orally, the usage is the same as above. Store in an airtight container at room temperature.

Aspirin suppository: suppository, produced by Guangzhou Jingxiutang Pharmaceutical Factory. Each tablet contains aspirin 0.1, 0.3, 0.45, 0.5 grams. External use, rectal administration, adults 0.3-0.5 grams once, 3 times a day; children 1-3 years old, 0.1 grams once, 3-6 years old 0.1-0.15 grams once, children over 6 years old, 0.15-0.3 grams once a day —2 times. Store in a closed, dry place.

Bayer aspirin chewable tablets: tablets, produced by Bayer AG in Germany. Each tablet contains 400 mg of aspirin and 240 mg of vitamin C. Orally administered, adults take 1-2 tablets at a time, up to 8 tablets a day, children over 3 years old take 0.5-1.5 tablets at a time, up to 4 tablets a day.

Aspirin enteric-coated tablets: tablets, produced by the Pharmaceutical Factory of Shenyang Medical College. Each tablet contains 40 mg of aspirin, and each bottle contains 100 tablets for oral administration. Store in an airtight container at room temperature.

Aspirin enteric-coated tablets: tablets, each tablet contains 0.3 grams of aspirin, 100 tablets per bottle, for oral administration. It has little gastrointestinal irritation and is suitable for those who take medicine for a long time. Store in an airtight container at room temperature.

Bamir (acetylsalicylic acid water-soluble tablets): tablets, produced by Astra (Wuxi) Pharmaceutical Co., Ltd. Each tablet contains 0.1g of aspirin, 20 tablets per plate; each tablet contains 0.3g, 0.5g, 10 tablets per plate, taken orally. Store in an airtight container at room temperature.

Antipyretic and Analgesic Tablets (APC): tablets, produced by Jiamusi Chemical Pharmaceutical Factory in Heilongjiang Province. Each tablet contains 0.22g aspirin, 0.15g acetaminophen, and 0.035g caffeine, taken orally. Store in an airtight container at room temperature.

Aphenyl tablets: tablets, produced by Mudanjiang Pharmaceutical Factory, Datong Pharmaceutical Factory, etc. Each tablet contains 0.1 g of aspirin and 0.01 g of phenobarbital. It is taken orally. Suitable for children to reduce fever. Store in an airtight container at room temperature.

Becton (acetylsalicylate calcium urea powder): powder, produced by Beijing Sixth Pharmaceutical Factory and DSM Company of the Netherlands. Each bag is 600 mg, equivalent to 472 mg of aspirin, 10 bags per box, taken orally with warm water, no more than 6 bags within 24 hours. Store in an airtight container at room temperature.

Xidening: effervescent tablets, produced by French company Upsa. Each tablet contains 0.33 grams of aspirin and 0.2 grams of vitamin C. Take orally, adults take 1-3 tablets at a time, 4 times a day; children aged 4-10 years old take 0.5-1 tablet at a time, and children aged 10-15 years old take 1-2 tablets at a time, 4 times a day. The interval between taking the medicines is at least 4 hours. Dissolve the tablets. Take after soaking in water. Store in a closed, cool and dry place.

Axing: Capsules, produced by Xinchang Pharmaceutical Factory. Each capsule contains 300 mg of zinc acetylsalicylate. It is mainly used to treat symptoms such as fever, headache, runny nose, nasal congestion, sore throat, and body aches caused by common colds and influenza. Take orally, 1-2 capsules at a time for adults, 3 times a day, and the dosage may be reduced for children. Store in a closed, dry place.