Aspirin

Synonyms in a broader sense

ASS, acetylsalicylic acid, (COX inhibitors, NSAIDs, non-steroidal anti-inflammatory drugs, non-steroidal analgesics, non-opioid analgesics, NSAIDs). The name of the synthetically produced active ingredient usually contained in Aspirin®, “acetylsalicylic acid”, comes from the origin of the mother substance “salicylic acid” from the leaves and flowers of plants – the main source is the pastureland scientifically called “salix”. The analgesic and also antipyretic (medically: antipyretic) effect of willow has been known since ancient times and was used by the Germanic and Celtic peoples, for example, by chewing the bark of the trees.

However, the mechanism of action was not elucidated until 1970, some seventy years after the first synthesis was successful (1896, by Felix Hoffmann). At 13,000 tons per year, Aspirin® is the most frequently taken painkiller worldwide. Aspirin® belongs to the group of analgesics, i.e. drugs that suppress or alleviate the sensation of pain (from Greek algos, pain).

To be more precise, they are so-called non-steroidal analgesics, as Aspirin® and related drugs are not chemically structured like cortisone, which belongs to the steroidal group (which also has an anti-inflammatory and pain-relieving effect). With approximately 70 million prescriptions per year and a turnover of almost € 2 billion, analgesics occupy the top position among drugs in Germany. They are therefore used even more frequently than drugs for the treatment of high blood pressure (medical: arterial hypertension) and drugs for the treatment of mental disorders and diseases (psychotropic drugs).

The term “antiphlogistics”, which is also often used, refers to the effect of Aspirin®s not only in pain but also in inflammation (from the Greek phlogizein = to ignite or phlogistos = inflammable). Aspirin® is prescribed for the treatment of various painful conditions, e.g. tooth and headaches. It is also used for migraines.

In addition, the antipyretic effect of Aspirin® is used; however, paracetamol (trade name: e.g. ben-u-ron) and ibuprofen (trade name: e.g. Aktren) are preferable for children, as these can also be given as suppositories (paracetamol) or as juice and Aspirin® must not be used in children (see below). In the form of a combined preparation Aspirin® Complex is often used for colds.

Another application of Aspirin® is the treatment of tumor pain. Only when the analgesic effect of this “non-opioid analgesic” is no longer sufficient is it first used with weakly effective opiates (e.g. codeine or tramadol) and then with strongly effective opiates (morphine, levomethadone). In lower doses than necessary for the analgesic effect, Aspirin® is used to prevent blood coagulation disorders such as thrombosis and embolism.

These blood clots can obstruct pulmonary vessels (pulmonary embolism) or a vessel in the brain (stroke). Aspirin® is rarely used against rheumatic diseases such as rheumatoid arthritis or osteoarthritis, because the anti-inflammatory effect only occurs when high doses are taken, but the undesirable effects of Aspirin® are also very pronounced. For this reason, Coxibe (see below, e.g.

Celebrex), Diclofenac (trade name e.g. Voltaren) or Ibuprofen (trade name e.g. Aktren) are preferred for the basic treatment of rheumatic diseases. (For long-term treatment, glucocorticoids such as cortisone, methotrexate, which is also used in cancer therapy, and other cytostatic drugs are used).