Serious side effects of aspirin that you should be aware of
Aspirin is a medication belonging to the drug class, non-steroidal anti-inflammatory drugs (NSAIDs). It is available as a generic drug, and is prescribed for treating fever, pain, and inflammation in the body, prevention of blood clots, and reduction of the risk of strokes and heart attacks. Most people are using it often and don’t really think that this little and popular pill can have serious side effects. Common side effects of Aspirin include rash, gastrointestinal ulceration, abdominal pain, cramping, nausea, gastritis, and bleeding.
A patient who had a single dose of aspirin will have endoscopically identifiable gastric mucosal lesions. Clinically evident gastrointestinal bleeding has been reported in as many as 3% of the treated elderly patients. Anorectal ulceration and rectal stenosis have been reported in patients who abuse aspirin-containing rectal suppositories.
Gastrointestinal side effects have included epigastric distress (in 83% of patients treated with regular aspirin), abdominal discomfort or pain, endoscopically identifiable gastric mucosal lesions, nausea, and vomiting. More serious gastrointestinal effects include hemorrhage, peptic ulcers, perforation, small bowel enteropathy, and esophageal ulcerations.
The mechanism of an aspirin-induced decrease in renal function may be related to inhibition of renal prostaglandin synthesis with consequent decrease in renal blood flow. Renal side effects have included reduction in glomerular filtration rate in cases with patients who are sodium restricted or who exhibit diminished effective arterial blood volume (patients with advanced heart failure or cirrhosis), interstitial nephritis, papillary necrosis, elevations in serum creatinine, elevations in blood urea nitrogen, proteinuria, hematuria, and renal failure.
This means increased blood fibrinolytic activity. In addition, hypoprothrombinemia, thrombocytopenia, thrombocyturia, megaloblastic anemia, and pancytopenia have been reported rarely. Aplastic anemia and eosinophilia can also occur.
Aspirin-induced hypersensitivity may be related to an up-regulation of the 5-lipoxygenase pathway of arachidonic acid metabolism with a resulting increase in the products of 5-lipoxygenase. Hypersensitivity side effects include bronchospasm, rhinitis, conjunctivitis, urticaria, angioedema, and anaphylaxis.
Dermatologic side effects of aspirin include Stevens-Johnson syndrome and a lichenoid eruption. In certain isolated cases, there were unilateral aquagenic wrinkling of the palms and papuloerythroderma have been associated with aspirin therapy.
Aspirin can cause oncologic side effects which include reports of pancreatic cancer. Several epidemiologic studies have suggested that chronic aspirin use may decrease the risk of large bowel neoplasms. However, other studies have not found such a beneficial effect.
Dehydration and hyperkalemia may occur in this case. Respiratory alkalosis and metabolic acidosis, particularly during salicylate toxicity, have been reported. A case of hypoglycemia has been reported in a patient on hemodialysis. Salicylates have also been reported to displace triiodothyronine (T3) and thyroxine (T4) from protein binding sites.
There have been cases reported, where patients with migraines, tachycardia and orthopnea were treated with aspirin doses of 1500mg for a few days. Cardiovascular side effects have included salicylate-induced variant angina, ventricular ectopy, conduction abnormalities, and hypotension, particularly during salicylate toxicity. At least one case of fluid retention simulating acute congestive heart failure has been reported during aspirin therapy.
9 Nervous system
Central nervous system side effects include agitation, cerebral edema, coma, confusion, dizziness, headache, cranial hemorrhage, lethargy and seizures. Tinnitus and subjective hearing loss can be another side effect. Some investigators have reported that modest doses may result in decreased frequency selectivity and may therefore impair hearing performance, particularly in the setting of background noise. Patients with high frequency hearing loss may have difficulty perceiving tinnitus.
Finally, long aspirin dosage can cause respiratory side effects such as hyperpnea, pulmonary edema, and tachypnea. Aspirin desensitization has been used to decrease disease activity and reduce the need for systemic corticosteroids in patients with aspirin-exacerbated respiratory disease.