Acetylsalicylic acid, ASS, Aspirin®Acetylsalicylic acid is used in the low dose of 100 mg to inhibit blood clotting. It ensures that the thrombocytes, i.e. blood platelets, can no longer attach and clump together as they would in normal blood clotting. The ASS 100 is therefore therapeutically well suited to prevent blood clots from forming, as well as in the preventive treatment of heart attacks and strokes.
ASS 100 has an inhibitory effect on the physiological process of blood coagulation, which can be divided into primary and secondary haemostasis. Primary haemostasis is responsible for stopping bleeding and secondary haemostasis is responsible for the actual coagulation of the blood. Acetylsalicylic acid develops its effect by inhibiting hemostasis.
If a vascular injury occurs, the tissue around the wound first contracts. Via various glycoprotein receptors, blood platelets (thrombocytes) now bind to exposed collagen fibres at the site of the injury. Through this so-called “adhesion” of the platelets, they are activated and release various mediators, including calcium, serotonin, ADP and thrombboxane A2.
More thrombocytes are attracted and the otherwise flat platelets change shape. The now spherical and spiky state allows them to clump together easily. This results in loose wound closure, which is finally consolidated by the secondary haemostasis.
Acetylsalicylic acid is an irreversible cyclooxygenase inhibitor (COX inhibitor). The COX is located in the thrombocytes where it is responsible for the production of thrombboxane A2 from arachidonic acid. If the COX is inhibited, no thrombboxane can be released and its effect, the narrowing of the tissue and clumping of the thrombocytes, can no longer take place properly.
Inhibited cyclooxygenase cannot be replicated by the thrombocytes. The anticoagulant effect lasts until enough new platelets have formed which again contain a fully functional cyclooxygenase. The life span of blood platelets is about 7-12 days, and the effect of ASS 100 lasts for that time.
ASS 100 is not subject to prescription and can be purchased in tablet form from the pharmacy. It is taken after the intake of food together with a glass of water. Care should be taken to swallow the tablet whole.
Acute heart attacks are an exception to this rule: the first tablet should be swallowed chewed. For patients with unstable angina pectoris (“chest tightness”, caused by circulatory disorders of the coronary vessels) and an acute heart attack, the recommended daily dose is 1x 100mg. To prevent another heart attack, a dose of 3x 100 mg daily is administered.
After operations and vascular surgical examinations, a dose of 1x 100mg a day is recommended, also to prevent a stroke. In general, ASS 100 should be used for long-term therapy, but the exact duration is determined by the treating physician. ASS 100 is not effective against jokes.
Higher dosages (ASS 500) are required for the analgesic component of ASS. However, if the headache is caused by a circulatory disorder, ASS 100 can already relieve the pain. These headaches can be caused by a narrowing of a vessel (stenosis) or by blood that is too thick.
Due to the anticoagulant properties of ASS 100, headaches can be relieved. Among the frequent side effects of ASS 100 are complaints of the gastrointestinal tract with occasional rare side effects are very rare a cerebral haemorrhage can occur. – Abdominal pain
- Nausea
- Diarrhoea
- Vomiting
- Heartburn
- Bleeding or ulcers in the gastrointestinal tract (hidden bleeding can manifest itself as iron deficiency anaemia (anaemia).
- Black stool
- Allergic reaction on the skin
- Severe hypersensitivity reactions (skin rash)
- Facial Swelling
- Shortness of breath
- Nosebleeds
- Gum bleeding and skin bleeding can occur
Stomach pains should not occur with a permanent intake of ASS 100. These stomach pains, which indicate an inflammation of the mucous membrane of the stomach (gastritis) or a gastric ulcer (peptic ulcer), usually only occur after taking ASS 500. This is due to an increased production of gastric acid.
These complaints can be alleviated by the additional intake of a proton pump inhibitor, such as omeprazole or pantoprazole. Due to the risk of ulcer formation, ASS 500 should not be used over a longer period of time, unlike ASS 100. If stomach pain persists, a doctor should definitely be consulted.
The existence of a gastric ulcer can lead to a perforation of the stomach and thus to strong internal bleeding. The gastric ulcer can certainly only be secured by gastroscopy, but can also be treated with proton pump inhibitors. ASS 100 should not be taken if there is a known allergy to the active substance.
In addition, in the case of existing gastrointestinal ulcers, an increased tendency to bleed, severe liver and kidney dysfunction and an intake of more than 15 mg methotrexate (a cytostatic drug for the treatment of malignant tumours) per week. Higher doses of ASS 100 (>150 mg) should be avoided during pregnancy and lactation. In the first 6 months of pregnancy, the use of the drug should be discussed with the treating physician in any case.
Strictly controlled treatment should be carried out if other painkiller allergies are known, in the case of chronic respiratory diseases, additional coumarin therapy (e.g. with Marcumar®), dysfunction of the liver and/or kidney and in the case of upcoming operations (increased risk of bleeding). The intake of ASS 100 has no influence on conception. ASA can therefore also be used safely if you wish to have children.
There is a widespread opinion on the Internet that ASA promotes conception. However, there are no studies that prove this. What is certain, however, is that ASS 100 has no negative effects on the desire to have children.
ASS 100 is harmless during pregnancy. In a low dosage ASS is used to inhibit blood clotting. This is necessary in case of an increased tendency to form blood clots (thrombosis) or after a heart attack.
It is also used to treat angina pectoris and coronary heart disease (CHD). In higher doses (ASS 500), however, ASS has analgesic, antipyretic and anti-inflammatory effects. ASS 500 should not be taken in the last trimester of pregnancy.
High doses of ASA lead to premature closure of the ductus arteriosus botalli, the connection between the pulmonary artery and the aorta (main artery). In the unborn child, this leads to pulmonary hypertension (pulmonary hypertension) and affects the heart’s pumping capacity. There are studies that prove that ASA 100 reduces the risk of pre-eclampsia in pregnancy and that there are fewer growth retardations and intrauterine deaths.
This even suggests a beneficial effect during pregnancy. When taking ASA, the Ductus Arteriosus Botalli should be regularly examined by a gynaecologist using ultrasound in the last trimester. A few days before the birth, ASA should be discontinued during the birth due to an increased tendency to bleed.