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Aspirin: The first NSAID

 Aspirin: The first NSAID


The origin of aspirin can be traced back to the era of Hippocrates, where historical records indicate the use of extracts of willow bark and spirea for relief of headache, pain and fever.
Many years later, in the mid to late 1800s, chemists in France and Germany identified and then synthesized the active component of these extracts: Salicylic acid.  Hence, modern day aspirin was born!

In the years that followed, aspirin gained popularity in use for pain and fever reduction. In the late 1950s, acetaminophen became a popular alternative for pain and fever, while aspirin gained popularity as an anti platelet agent for prevention of heart attack and stroke. In later years, other NSAID(Non-Steroidal Anti-Inflammatory Drug) and the COX- 2 inhibitors came onto the marketplace for treatment of pain, fever and inflammation. Aspirin is still widely used for prevention of clot formation by many patients, and chronic pain patients are no exception to the rule. While we all are familiar with aspirin, some examples of NSAIDs include ibuprofen, naproxen, and diclofenac. Currently the only COX-2 inhibitor on the US marketplace is celecoxib.

It is important to keep this in mind-- that there are three general side effects of aspirin that are of concern. It is perfectly fine to use aspirin for a clot prevention when taking NSAIDs or COX-2 drugs for pain, but the side effect profiles are are very similar and taking both drugs simultaneously will increase the risk of those side effects.  It is probably best to use NSAIDs or COX-2 drugs as needed, keeping in mind that "less is more."  Here are the three main reasons of concern:

1) Gastrointestinal issues: All NSAIDs including aspirin are capable of causing GI disturbances.  In addition to upset stomach, more serious issues, such as ulcers, can occur.
COX-2 drugs are gentler to the GI tract than the other classes of drugs.

2) Bleeding issues:  All NSAIDs ,including aspirin and COX-2 inhibitor drugs can cause bleeding issues because they all have some anti platelet activity.

3) Kidney and Liver issues:  All NSAIDs, including aspirin, and COX-2 inhibitor drugs have the potential to cause kidney or liver damage.  This is especially important for people who have hypertension, heart disease, or preexisting kidney or liver damage.

Sources: Wikipedia,,Nursing Times


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