The mention of aspirin-induced adverse reactions is very disturbing to many people. And similar issues are particularly universal and of concern to many. Today Dr. Chang will talk about this issue.

Generally speaking, the dose and use of aspirin, which is generally used for antipyretic and analgesic purposes, rarely causes adverse reactions. Long-term oral aspirin use does require some special care with regard to side effects, as the incidence of adverse reactions is significantly higher once the drug's blood concentration exceeds 200ug/ml. It can be said that the higher the blood concentration of aspirin, the more common the adverse reactions. Below I have given you a list of the possible side effects of aspirin.

1、Gastrointestinal adverse reactions

Commonly, there is stomach upset, nausea, vomiting, etc. In severe cases, there can be gastrointestinal bleeding.

2. Blood system damage

It can lead to blood disorders such as thrombocytopenic purpura, and in severe cases can even inhibit bone marrow hematopoiesis.

3. Allergy

It can manifest as asthma, urticaria, angioneurotic edema, and even shock in severe cases.

4、Rarely seen adverse reactions

Herpetic epidermolysis bullosa drug rash, hearing damage, salivary gland enlargement, addiction, anemia, liver impairment, petechiae on extremities, bleeding gums, and more.

In fact, Dr. Zhang is also aware of these side effects above, as a long-term oral aspirin cardiovascular disease patients are more concerned. Because very few people take aspirin for a long time because of antipyretic and analgesic, mainly those patients with cardiovascular and cerebral vascular diseases will take for a long time, so it is also more concerned about the side effects of aspirin.

However, it should be objectively speaking, now about the long-term aspirin enteric-coated tablets for cardiovascular and cerebrovascular patients, its production process is getting better and better, and many of them can achieve the effect of precise enteric dissolution, so it also greatly reduces the chance of side effects. Many studies have shown that aspirin enteric-coated tablets can do not dissolve in the stomach, intestinal precise dissolution, slow release, maximum protection of gastric mucosa. It can be said that to do long-term oral also do not have to worry about, but this is not to say that there are no side effects occur, the necessary regular review is still needed.

Aspirin affects the stomach, liver, kidneys, blood, and bronchial tubes and can produce side effects in the appropriate areas.However, the risk of side effects can be effectively reduced by controlling the dosage of the medication and avoiding factors that may aggravate the side effects.

1. Symptoms and mechanism of action of aspirin

Aspirin, chemically known as acetylsalicylic acid, is a nonsteroidal anti-inflammatory drug with aAntipyretic, analgesic, anti-inflammatory和anti-coagulantThe role of the Mainly through theInhibition of human endocyclooxygenase (COX) activity and reduction of local tissue prostaglandins (PGs) and thromboxanesOnset of action, inhibition of COX-2 is the basis for efficacy, and the reduced prostaglandins are associated with inflammatory response, pain sensitivity, central thermoregulation, and thrombosis.

Aspirin is commonly used for:

• Cold and fever;
  

• Chronic dull pain, such as toothache, headache, neuralgia, muscle or joint pain, menstrual cramps;
  

• Reduces redness, swelling, heat and pain caused by inflammation;

• Rheumatoid arthritis.

It can also be used in small doses:

• Prevent blood clots from forming to prevent heart disease and stroke;
  

• Treatment of patients with ischemic heart disease and cerebral ischemia.

2. Side effects of aspirin

Usually, short-term use of aspirin in small doses is mildly reactive, but large-dose use and long-term use are associated with more and more severe adverse effectsand some people can't use aspirin.

It is currently believed that the side effects or toxicity of aspirin are primarily related to inhibition of the COX-1 enzyme, abnormal metabolism of salicylic acid produced by hydrolysis, and drug interactions.

(1) Side effects caused by inhibition of COX-1 enzyme and reduction of local tissue prostaglandins

COX-1 is found primarily in vascular, gastric, and renal tissues and synthesizes prostaglandins to regulate cellular physiological activity. Local tissue prostaglandins associated with aspirin action also have the following effects:

• Inhibits gastric acid secretion and protects the gastric mucosa (reduces gastrointestinal adverse reactions);
  

• Regulates renal blood flow and increases glomerular filtration rate (promotes kidney metabolism).
  

So.The following side effects or toxic effects may occur as a result of prostaglandin reduction after COX-1 is inhibited by aspirin。

Gastrointestinal side effects:

• The drug stimulates the gastric mucosa and the medulla oblongata emetic chemosensory area, and the person develops epigastric discomfort, heartburn, nausea, and vomiting;
  

• Gastrointestinal mucosal erosion, ulceration, bleeding, perforation, or gastrointestinal obstruction may occur with prolonged use at high doses.
  

Renal side effects;

• Symptoms of impaired tubular function such as edema and polyuria may occur;
  

• Occasionally, interstitial nephritis, nephrotic syndrome, or even renal failure may occur.
  

Allergic reactions:

• It can induce asthma attacks in some asthmatics, which is associated with the inhibition of prostaglandin biosynthesis leading to an increase in certain lipoxygenase metabolites and the predominance of bronchoconstrictors;
  

• A few people may develop urticaria, angioneurotic edema, and anaphylaxis.
  

(2) Platelet cyclooxygenase is inhibited and platelet synthesis of thromboxane A2 is reduced

Platelet coagulation is inhibited, making the blood less likely to clot, which can exacerbate bleeding tendencies that occur:

• Nosebleeds, bruises;
  

• Bleeding is prolonged.
  

(3) Salicylic acid reaction, poisoning

During and after absorption, aspirin is rapidly hydrolyzed by esterases in the gastric mucosa, plasma, erythrocytes, and liver to salicylic acid, which can enter systemic tissues including joint cavities, cerebrospinal fluid, and the placenta. Most of the salicylic acid is oxidatively metabolized in the liver and the metabolites are excreted in the urine.

• At too high a dose (aspirin 5 g/d), a salicylic acid reaction or toxicity can result:
  

• Headache, vertigo, nausea, vomiting, ringing in the ears, vision and hearing loss;
  

• In severe cases, hyperventilation, high fever, dehydration, acid-base imbalance, and even insanity can occur. ''
  

(4) Acute hepatic steatosis-encephalopathy syndrome

Also called Reye's syndrome and Reye's syndrome, it presents as liver failure combined with encephalopathy, which is rare but has a very poor prognosis. It occurs mainly in children with viral illnesses when aspirin is used to reduce fever. Such diseases include influenza, chickenpox, and mumps. The exact mechanism is not fully understood.

(5) Drug interaction side effects

• Combination with the oral anticoagulant bicoumarin is likely to cause bleeding;
  

• Combination with adrenocorticotropic hormones induces ulcers and bleeding;

• Combination with sulfonylurea oral hypoglycemic agents causes hypoglycemic reactions;

• Combining with weakly alkaline drugs such as valproic acid, furosemide, penicillin, and methotrexate can increase the concentration of the drug in the blood.

In addition to these types of side effects, patients may experience vomiting with blood, black stools, rapid heartbeat and coma.

3. Contraindications to the use of aspirin

Aspirin is contraindicated in the following conditions:

• Severe liver disease;
  

• Diseases with a tendency to bleed, such as hemophilia;
  

• Maternity and pregnancy;
  

• Contraindicated 1 week prior to surgery in surgical patients;
  

• Patients with asthma, nasal polyps and chronic urticaria;
  

• Have coagulation disorders such as hypoprothrombinemia and vitamin K deficiency.

• Older;
  

• Alcohol abuse, consuming more than 2 alcoholic beverages per day;
  

• Patients with chronic acid reflux or ulcers;
  

• Kidney or liver disease;

• Children with viral infections;
  

• Use of other NSAIDs (e.g., ibuprofen, ketoprofen, and naproxen);
  

• Use of other blood-thinning medications or supplements (including fish oil and ginkgo).

4. Ways to minimize aspirin side effects

The following measures can help minimize the occurrence of aspirin side effects:

• Taking the drug with a meal or with an antacid may reduce gastrointestinal reactions;
  

• Combining misoprostol may reduce the chance of gastric ulcers;
  

• Take aspirin with a full glass of water;
  

• Not shared with other NSAIDs such as ibuprofen, ketoprofen, or naproxen;
  

• If you take aspirin daily, you should limit the amount of alcoholic beverages and preferably abstain from alcohol.It is strictly forbidden to take drugs with alcohol；
  

• If occasional side effects occur with aspirin, try other medications;
  

• Don't take aspirin every day to prevent heart disease without a doctor's supervision;

• Circumvent possible drug interactions, see above for side effects from drug interactions.

Seek immediate medical attention for the following serious symptoms：

• Stomach pain, vomiting blood, weakness, hives, rash, shortness of breath, rapid heartbeat, confusion or unconsciousness.
  

• A large overdose of aspirin can be fatal, so if you or someone overdoses, call an emergency number or go to the emergency room immediately.
  

When you visit your doctor, ask him or her the following questions:

• Would a different analgesic and anti-inflammatory medication help?
  

• Does the efficacy of taking aspirin outweigh the side effects for me?
  

• If I need to continue taking aspirin, how can I alleviate its side effects?
  

• How can I tell if I'm allergic to aspirin?
  

• How can I tell if I'm allergic to salicylic acid?

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All medications have side effects to a greater or lesser extent, and aspirin is no exception; we often hear of cases of aspirin causing stomach bleeding, which is the most common side effect of aspirin.

Common Aspirin Side Effects.

1, cause gastrointestinal bleeding, easily lead to peptic ulcer of the stomach, bleeding and perforation; at the same time, low-dose long-term application can also lead to damage of the esophagus, small intestine, colorectum, ulcers, bleeding, intestinal lumen narrowing and perforation.

2, cause systemic bleeding, aspirin is anti-platelet aggregation, prevention of thrombosis, since it is the prevention of thrombosis disease, simply put, let the blood thinner, not easy to coagulate, that naturally increases the risk of bleeding, not only the digestive tract bleeding, the whole body organs and the skin have a risk of bleeding, the patient manifested in the skin bruising or bleeding points, and even bleeding gums or nosebleeds, elderly women are particularly common. Of course, if the blood pressure control: not good, will also increase the risk of cerebral hemorrhage.

3, long-term use of aspirin in some patients with headache, dizziness, nausea, vomiting, tinnitus, hearing and vision loss and other symptoms, small-dose aspirin will also cause elevated uric acid.

Although aspirin has these side effects, this does not negate the fact that aspirin is a good drug, because until now, aspirin is still the best drug to prevent and control cardiovascular diseases. This requires us to know how to use aspirin, the right aspirin cures the disease, the wrong aspirin kills.

First of all, we must strictly grasp the indications for aspirin, should eat eat, should not eat don't eat blindly, at present clear to eat aspirin diseases including coronary heart disease, angina pectoris, myocardial infarction, stenting, bypass surgery, cerebral infarction, severe peripheral vascular atherosclerotic lesions and so on.

For aspirin prophylactic administration, it must be evaluated by a physician, that is, there is no diagnosis of cardiovascular disease, but there are risk factors such as hypertension, diabetes, hyperlipidemia, smoking obesity, and so on, may also need to take aspirin, and this part of the population needs to be strictly scored. For those who have a tendency to appear, or those who come over the age of 70 without a diagnosis of cardiovascular disease, there is no need to take aspirin for prevention.

In order to minimize the side effects of aspirin, in addition to the indications to be grasped as described above, it is necessary to.

1, pay attention to observe whether there are changes in the stools, stools black should be suspected of gastrointestinal bleeding;

2, this aspirin is enteric-coated tablets, must be taken on an empty stomach, so that the side effects are small;

3. Remember to review routine blood and stool tests;

4, if the body skin is blue and purple is also a side effect of aspirin, to come to the review, bleeding in other parts of the body must also be seen;

5, blood pressure can not be too high, blood pressure is too high, aspirin will cause brain hemorrhage, so remember to take antihypertensive drugs.

In conclusion, although aspirin has side effects, aspirin should not be rejected because it causes side effects!

Use aspirin as a rule, review it regularly, and monitor it over time to make it work better for us!

[Dr. Cardiovascular Wang formally authorized original protection, such as theft must be held legally responsible.]

[If you have any cardiovascular, hypertension or hyperlipidemia problems, you can write to me privately and I will get back to you as soon as possible].

Aspirin, as one of the most widely used drugs in the clinic, is now widely used in the prevention and treatment of ischemic cardiovascular and cerebrovascular diseases, mainly with the role of anti-platelet aggregation and prevention of thrombosis. However, aspirin also has some side effects in addition to its therapeutic effects, so we must take aspirin under the guidance of a professional doctor, and pay attention to monitoring changes in the condition and regular review.

Aspirin side effects are: ① gastrointestinal discomfort, because aspirin will directly stimulate the mucosa of the gastrointestinal tract, then cause gastrointestinal discomfort; ② bleeding, aspirin will increase the risk of bleeding, such as skin, mucous membranes, gastrointestinal tract, and rare intracranial hemorrhage; ③ liver and kidney function damage, common in the overdose, can lead to liver enzyme elevation or renal function abnormalities; ④ allergy, aspirin Aspirin belongs to the salicylic acid class of drugs, and there is a risk of allergy after taking it; ⑤ Others, such as dizziness, headache, and so on.

The use of aspirin must strictly grasp the indications, in general, aspirin is mainly applicable to existing ischemic cardiovascular and cerebrovascular disease (such as coronary heart disease, ischemic stroke, etc.) or cardiovascular and cerebrovascular surgery (such as after stenting, after blocking surgery, etc.) or have the age of size of 50 years old, hypertension, diabetes mellitus, hyperlipidemia, obesity, ischemic cardiovascular and cerebrovascular family history of at least three of the above risk factors. It should be noted that aspirin should be contraindicated for those with active gastrointestinal bleeding, allergy to aspirin, bleeding constitution, severe cardiac, hepatic and renal impairment, and the last trimester of pregnancy, and should not be combined with methotrexate.

We hope that you correctly understand that aspirin needs to be monitored for the occurrence of any side effects during its use and regularly reviewed to stabilize the control of the condition and reduce the occurrence of complications.

Thanks for reading, this article was originally written by @General Practice Sweeper, welcome to like, comment, reprint, follow the author, get more health knowledge. Please correct any deficiencies. Images are from the internet and are for reference only.

For a long time, the daily intake of a small amount of aspirin, can prevent coronary heart disease, stroke or other cardiovascular diseases, aspirin is one of the best-selling drugs in the world. Thus, aspirin is slowly taken as a "miracle drug". However, in last year's annual meeting of the European Cardiology, from Harvard University and Oxford University clinical research report shows that, for people without cardiovascular disease, long-term use of aspirin to prevent cardiovascular disease can not offset the side effects it brings.

What are the main side effects of aspirin?

In recent years, as the number of people taking aspirin has increased, so has the medical community's research into the preventive functions of aspirin. Among the many side effects, the most lethal risk is the induction ofGastrointestinal bleeding and cerebral hemorrhage. Long-term use of aspirin can damage the lining of the gastrointestinal tract, causing damage to the mucosa of the gastrointestinal tract and leading to the risk of duodenal ulcers, gastric ulcers, and intestinal perforation. In addition, taking aspirin can prevent platelet aggregation, with a certain anticoagulant effect, therefore, aspirin can increase the risk of cerebral hemorrhage and gastrointestinal bleeding, especially the elderly. In addition to these two side effects, long-term use of aspirin can lead to kidney damage, cataracts, hearing impairment and other risks.

What can I do to reduce the side effects of aspirin?

Since the side effects of aspirin are mainly in the gastrointestinal tract, especially the damage to the gastric mucosa is relatively large, for patients who have to take aspirin it is recommended to take aspirin enteric-coated tablets (e.g., Bay Aspirin), which are usually taken on an empty stomach due to the fact that its antacidic coating can be dissolved in the intestines instead of in the stomach. Also to avoid increased risk of bleeding, coagulation should be checked regularly.

I hope that my answer will help you! Give me a like if you like it!

Thank you for inviting Wu Yibo, a member of the Chinese Popular Science Writers Association, to answer your questions.

Simply put, aspirin has side effects during its use, and it depends on how you use it, when you use it, and how much you use it.

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In recent years more and more of aspirin's effects have been discovered, but they are also accompanied by unavoidable side effects.The most common side effects are damage to the gastric mucosa, damage to the liver and kidneys, and allergic reactions.

First, the most common is gastric mucosal damage.Aspirin causes gastric mucosal erosions bleeding and ulcers. The acidity of aspirin when taken orally directly destroys the gastric mucosa, and prostaglandins have recently been found to have a role in the maintenance of the gastric mucosa, while aspirin has been shown to prevent the synthesis of prostaglandins and increase the extent of ulceration. For this reason.Aspirin should be taken preferably with a meal or at the same time as an antacid, and should be used with caution or even not used in ulcer patients.

The second is liver damage.Aspirin-induced liver impairment may not be due to the drug itself, but may be related to hepatocyte toxicity or the occurrence of an allergic reaction.

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Again, there is kidney damage.The results of clinical trials have shown that animals on long-term aspirin administration develop the development of interstitial nephritis, renal papillary necrosis, renal insufficiency, or renal hypoplasia.

In addition, allergic reactions may occur.It is not entirely certain that this reaction is everyone's, and it may be that it occurs only in certain specific body types. Nearly 20% of people with these body types who take aspirin will develop a rash, angioneurotic edema, asthma, or other allergic reactions.

Overall, aspirin has certain side effects, you need to pay attention to the dosage when using it, take it on time and in accordance with the amount, try not to overdose and take it before meals, to avoid the effects of aspirin side effects on the body.

Questions Answered by Shi Tong, School of Pharmacy, Shandong University Reviewed by Wu Yibo

Thanks for the invitation, natural (saffron) activates blood circulation and removes blood stasis many times more than aspirin, and no side effects, you have to take chemicals?

Also taking aspirin, some people avoided death from cancer and heart disease, while others were ineffective.

Our genes are different, one medication won't work for everyone, and the side effects of medications affect everyone to a different degree.

A side effect is a physiological reaction that occurs in conjunction with a therapeutic effect, and any kind of medication can have side effects. In addition, the lack of effect of a medication can be caused by other unpredictable factors, such as lifestyle habits like diet, smoking, and exercise levels. These factors can mask the positive benefits of treatment. It is important to note that some of these factors are genetically related, such as addiction and metabolic levels.

So it's not unusual for an over-the-counter drug like aspirin to produce different therapeutic effects and side effects in different people because we're all born genetically different.

Aspirin is one of the most widely used medication drugs worldwide. Aspirin reduces the risk of heart attack and stroke by preventing blood clots from forming on the surface of ruptured atherosclerotic plaques. However, aspirin needs to be taken under the supervision of a medical professional as it also has many side effects.

What are the side effects of aspirin?

1, digestive tract injury , is the most common adverse reaction to aspirin. Aspirin has a direct stimulating effect on the mucosa of the digestive tract, and the common lesions of digestive tract injury include erosion of the mucosa of the digestive tract, ulcers, life-threatening gastrointestinal hemorrhage and perforation, as well as rare intestinal stenosis and so on. Manifestations include nausea, vomiting, epigastric discomfort or pain, diarrhea, vomiting blood, and black stools. The most frequent stage of GI injury is within 12 months after taking the drug and peaks at 3 months. You need to be careful to monitor and observe GI discomfort and bleeding, especially during the first 12 months of medication, focusing on patients with risk factors. The presence of dark stools or unexplained anemia needs to be noted.

2, bleeding, aspirin increases the risk of bleeding, including bleeding during surgery, hematoma, epistaxis, genitourinary bleeding, bleeding gums, bleeding skin mucous membranes, and rarely, gastrointestinal bleeding, cerebral hemorrhage.

3, allergic reactions, the most common for skin allergic reactions, manifested as rash, itching and so on. In addition may lead to bronchospasm caused by severe asthma attack, mostly in a few minutes or hours after the drug, manifested in the drug first nasal khat symptoms, followed by asthma, accompanied by mucous membrane congestion, cyanosis, profuse sweating, sitting breathing, irritability, known as aspirin asthma, mostly severe.

4, salicylic acid reaction, long-term large amount (> 3 g / d) of aspirin can produce headache, dizziness, tinnitus, vision and hearing loss, drowsiness, sweating and other reactions, known as the salicylic acid reaction, most commonly in the treatment of rheumatism, serious mental disorders, acid-base imbalance, etc..

5, teratogenic effects, aspirin can pass through the placenta, animal experiments have confirmed that the application of the first three months of pregnancy can lead to teratology, such as spina bifida, craniosynostosis, facial cleft, leg deformities and the central nervous system, internal organs and skeletal underdevelopment.

Therefore, you should consult your doctor as to whether you need to take aspirin, and in what amount. You should consult your doctor and go to the hospital immediately if you experience any side effects while taking it.

[ Aspirin Adverse Reaction ]

1. Gastrointestinal effects Gastrointestinal reactions are the most common. Oral can directly stimulate the gastric mucosa, causing epigastric discomfort, nausea, vomiting sodium salicylate is particularly likely to occur. Large doses of long-term use (such as anti-rheumatic therapy) can cause gastric ulcer or gastric hemorrhage. Gastric bleeding caused by salicylates is sometimes painless and not easy to detect. Studies have shown that 4-5 g of oral aspirin per day can result in 3-8 ml of blood loss per day from the feces.

2. The role of the immune system, a small number of patients may appear urticaria, angioneurotic edema anaphylaxis and other allergic reactions. Set this asthma patients taking aspirin or other antipyretic and analgesic drugs can trigger asthma, called "aspirin asthma". Its pathogenesis is not yet clear, may be related to increased synthesis of leukotrienes. Therefore, asthma nasal polyps and other patients prohibited aspirin.

3. Nervous system effects Large doses of salicylic acid drugs have toxic effects on the central nervous system. Generally, the first excitement (even convulsions) and then inhibit. Early manifestations of headache and dizziness, nausea and vomiting, tinnitus and hearing loss, etc., always known as the salicylic acid reaction. In severe cases, hyperventilation, acid-base balance imbalance, and even mental disorders and even coma can occur.

4. Respiratory system effects Salicylic acid can directly stimulate the respiratory center, leading to obvious hyperventilation, respiratory depth and frequency are increased, the patient's ventilation per minute increased significantly, can cause respiratory alkalosis.

5. Cardiovascular system effects When high doses of sodium salicylate or aspirin are used to treat rheumatic fever, circulating blood volume can increase by 20% due to increased cardiac output, which may cause congestive heart failure or pulmonary edema in patients with myocarditis, and the risk is even higher in elderly patients who have been using salicylates for a long time.

6. Hepatic and renal effects Liver injury associated with elevated aminotransferase activity occurs in about 5% of patients with rheumatic diseases treated with high doses of salicylates. In addition, Reye's syndrome, which manifests itself as severe liver injury and encephalopathy, may occur when salicylic acid-based drugs are used to treat varicella virus infection or other viral infections (including influenza virus) in children. Although the relationship between salicylic acid and Reye syndrome is unknown epidemiologic evidence suggests a correlation. Therefore, varicella and influenza virus infections in children and adolescents are contraindications to salicylic acid-based drugs.