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Aspirin: Benefits, Mechanism of Action, Contraindications, and Health Concerns

Aspirin, also known as acetylsalicylic acid, is a widely-used medication for pain relief, reducing inflammation, and lowering fever. In low doses, it also serves as a blood thinner, helping prevent blood clots and reducing the risk of heart attack and stroke in certain individuals.

How it works in the body:

Aspirin works by inhibiting the enzyme cyclooxygenase (COX), which is responsible for the production of prostaglandins, hormone-like substances that play a role in pain, inflammation, and fever. By blocking the COX enzyme, aspirin effectively reduces pain, inflammation, and fever. Additionally, aspirin inhibits the formation of thromboxane A2, a substance that promotes platelet aggregation and blood clotting, making it effective as a blood thinner in low doses.

Contraindications:

While aspirin is generally safe for most individuals, there are situations where its use may be contraindicated or should be approached with caution:

  1. Allergy or hypersensitivity: Individuals who are allergic or hypersensitive to aspirin, other salicylates, or any component of the medication should avoid using it.
  2. Asthma: Aspirin may cause or exacerbate asthma symptoms in some individuals, particularly those with a history of aspirin-exacerbated respiratory disease (AERD).
  3. Bleeding disorders or active bleeding: People with bleeding disorders, such as haemophilia or von Willebrand disease, or those with active bleeding (e.g., peptic ulcers, intracranial haemorrhage) should avoid aspirin due to its blood-thinning effects.
  4. Kidney or liver disease: Aspirin is metabolised in the liver and excreted by the kidneys, so individuals with severe kidney or liver disease should use it with caution or avoid it altogether.
  5. Pregnancy and breast-feeding: High doses of aspirin during pregnancy can increase the risk of complications, such as bleeding or premature closure of the ductus arteriosus in the fetus. Aspirin is generally not recommended during the third trimester of pregnancy or while breastfeeding.
  6. Children and teenagers: Aspirin should not be given to children or teenagers with viral infections, as it has been associated with Reye’s syndrome, a rare but serious condition that can cause liver and brain damage.

Potential health concerns:

  1. Overdose: Excessive use of aspirin can lead to an overdose, resulting in symptoms such as ringing in the ears, dizziness, rapid breathing, nausea, vomiting, and confusion. Severe overdoses can cause seizures, coma, and even death. Seek immediate medical attention if you suspect an overdose.
  2. Gastrointestinal effects: Long-term or high-dose aspirin use can cause gastrointestinal side effects, such as stomach irritation, ulcers, or gastrointestinal bleeding. To minimise these risks, take aspirin with food or use enteric-coated aspirin formulations, which are designed to dissolve in the small intestine instead of the stomach.
  3. Drug interactions: Aspirin can interact with certain medications, such as anticoagulants (e.g., warfarin), nonsteroidal anti-inflammatory drugs (NSAIDs),
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