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Facts of the Matter

BY RICHARD BRILL

Sunday, September 15, 2002



Aspirin is still the
world’s wonder drug


For more than 100 years, the safest, most effective, least expensive drug has been available to ease headaches, stop inflammation and lower fever. It has been implicated in reducing the risk of heart attack and strokes, cancers of the pancreas, colon and ovaries, and in mediating sunburn. It was the first synthetic drug and is so powerful that if it were introduced today, it would probably be by prescription only.

This wonder drug is aspirin. Despite the potential for stomach upset and damage to stomach linings, it is the most widely used drug in the world. The aspirin produced yearly is enough to make a chain of tablets that would stretch from the earth to the moon and back. The United States consumes 80 billion tablets annually.

Aspirin as we know it was developed by German chemist Felix Hoffmann in 1897 as a treatment for his father's arthritis. Nearly 40 years earlier, a French chemist made some but didn't see much use for it. Long before that, the Sumerians and Egyptians used it, but in a different form.

The Ebers papyrus, a collection of medicinal recipes from the second millennium B.C., prescribed a tea of dried myrtle leaves for pain. In the fifth century B.C., Hippocrates, the father of modern medicine, used ground willow bark to ease pain. Willow bark and myrtle contain salicylates, a class of chemicals with analgesic properties. Aspirin (acetylsalicylic acid) and wintergreen oil (methyl salicylate) are the two most familiar salicylates.

From early in the 19th century, salicylic acid and its chemical relatives were used to treat arthritis and fevers, but they were used at high doses and caused upset and bleeding in the stomach and digestive tract. Hoffmann worked to develop a mild form of the drug.

It wasn't until 1971 that an English physician, Sir John Vane, discovered that aspirin works by inhibiting the body's production of a hormonelike chemical called prostaglandin, for which he received the 1981 Nobel Prize. Prostaglandin is one of the biochemicals the body uses to call attention to injury by causing pain.

Cells in damaged tissues make prostaglandin using an enzyme called cyclooxygenase 2 (COX-2). Aspirin doesn't stop the problem that's causing the pain, but it does lower the volume on the pain signals by blocking the COX-2 enzymes.

Aspirin also blocks the production of thromboxane -- another prostaglandin that causes platelets to form a blood clot. This is good if it stops clots from forming in the arteries and capillaries of the heart, lungs, and brain, but bad if you get a cut or need surgery.

In some people, side effects can be extreme. Aspirin given to children with flu, chickenpox or other viral infections may cause Reye's syndrome. Aspirin also changes the way the kidneys make urine, places stress on liver function and can cause ringing in the ears or asthma attacks. Chronic use can result in anemia.

Chemicals have been found that have some of aspirin's good effects and lack some of its bad effects. Ibuprofen and naproxen also treat pain, swelling and fever, but they do not affect clotting. Acetaminophen, which lowers fevers/pain, doesn't affect either inflammation or the stomach. But none of these has the range of effectiveness of aspirin.




We could all be a little smarter, no? Richard Brill picks up
where your high school science teacher left off. He is a professor of science
at Honolulu Community College, where he teaches earth and physical
science and investigates life and the universe.
He can be contacted by e-mail at rickb@hcc.hawaii.edu



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