Tell me about aspirin tablets.

I believe many people know that aspirin is called a panacea. Clinically, it is widely used in patients with fever, which can reduce fever caused by colds, flu and other reasons. Aspirin is suitable for both the elderly and children. At the same time, it can reduce the probability of myocardial infarction, which is very popular among middle-aged and elderly people.

Most importantly, aspirin is widely used because of its outstanding preventive effect on cardiovascular and cerebrovascular diseases.

There are three main types of common coronary heart disease or ischemic stroke: angina pectoris caused by coronary artery spasm, hemorrhagic stroke and ischemic cardiovascular and cerebrovascular diseases caused by atherosclerosis.

Medical research shows that aspirin has a significant preventive effect on coronary heart disease or ischemic stroke caused by atherosclerosis.

Atherosclerosis will narrow the blood vessels in arteries, and the process is complicated. Simply put, it is because the low-density lipoprotein cholesterol in our body is in a high state for a long time. Under the influence of various inflammations, these cholesterol will pass through the subcutaneous layer of blood vessels, be oxidized and swallowed for a long time, and accumulate in the subcutaneous layer of blood vessels in large quantities over time, forming a pile of substances called "fat nuclei", thus forming plaques that protrude into the lumen of blood vessels, which is atherosclerotic plaques.

Under normal circumstances, new plaques are easy to rupture, and exposed internal substances come into contact with platelets in blood vessels, which will quickly activate platelets and form a well-known "thrombus" for a long time, which will destroy vascular circulation and lead to local vascular stenosis or infarction.

Why can aspirin effectively prevent coronary heart disease or ischemic stroke caused by atherosclerosis?

Aspirin can inhibit platelet aggregation, prevent thrombosis and prevent ischemic cardiovascular and cerebrovascular diseases in the face of plaque rupture.

At present, aspirin is often used in the primary prevention of coronary heart disease and stroke, and also plays a great role in the secondary prevention, that is, it is used to prevent patients who have already suffered from coronary heart disease or stroke from having atherosclerotic cardiovascular and cerebrovascular ischemia again.

Therefore, authoritative diagnosis and treatment guidelines at home and abroad are very optimistic about the efficacy of aspirin: if there is no taboo, aspirin enteric-coated tablets should be the first choice as the secondary prevention of cardiovascular and cerebrovascular diseases.

However, aspirin is not suitable for everyone to prevent. It is not a foolproof panacea, but also has some side effects that need to be avoided.

Taking aspirin for a long time will lead to some side effects, which usually lead to an increased risk of gastrointestinal tract, teeth, nose, conjunctiva or cerebral hemorrhage. Specifically, it has the following side effects:

Gastrointestinal side effects are the most common adverse reactions of aspirin, mainly manifested as nausea, vomiting, stomach pain and other gastrointestinal disorders. In this case, if the drug is not stopped in time for observation and inspection, it is easy to cause gastric ulcer, gastric bleeding and other phenomena, posing a threat to the health of patients.

The gastrointestinal reaction is caused because patients taking aspirin will decompose salicylate acetate in the body and stimulate the stomach.

At the same time, studies show that the side effects of aspirin are caused by its inhibition of cyclooxygenase (COX), a metabolite of arachidonic acid, which can be divided into two types, namely COX- 1 and COX-2. Inhibition of COX-2 can lower body temperature, while inhibition of COX- 1 can cause some side effects, such as epigastric discomfort, vomiting and nausea.

Especially taking it in large doses for a long time will obviously increase the incidence of adverse reactions, excessively inhibit platelet aggregation, damage gastrointestinal mucosa, lead to ulcers, gastric perforation, and even endanger life and health.

Allergic reaction is also a common phenomenon, such as measles: vascular edema and so on. Patients will have difficulty breathing and conjunctival congestion.

The allergic reaction mainly occurs because aspirin can inhibit the production of epoxide hydrolase and block the synthesis of prostaglandin in the body, thus increasing the content of leukotrienes and easily leading to bronchospasm.

Taking aspirin for a long time should also be alert to the symptoms of chronic salicylate poisoning. The average patient will have symptoms such as sweating, tinnitus and drowsiness.

After taking aspirin for several months, it can also cause liver function damage and abdominal tenderness. Under normal circumstances, in order to avoid liver injury, clinical use of aspirin will choose a combined medication scheme to avoid damage to liver function, or shorten the medication time to avoid safety risks.

So, what are the precautions to prevent the adverse reactions caused by aspirin?

In order to reduce the direct injury of aspirin to gastric mucosa, intestinal solvent has obvious protective effect.

In other words, aspirin is coated with enteric-coated film through preparation process to make it acid-resistant and alkali-resistant. After oral administration, it needs to enter the small intestine with gastrointestinal peristalsis in alkaline environment, which will significantly reduce the incidence of gastrointestinal adverse reactions.

The medication time of enteric-coated aspirin is also particular.

If you take it before meals, the acidic environment in the stomach is relatively strong in the fasting state, the intestinal solvent is not easy to dissolve, and the gastric emptying speed is relatively fast, which can greatly reduce the damage of drugs to the gastric mucosa.

However, if we take it after meals, the food after meals will dilute the gastric acid, causing the stomach to be very close to the alkaline environment. If we take medicine at this time, it will accelerate the dissolution in the stomach and cause discomfort.

Moreover, the mixture of drugs and food will also prolong its residence time in the stomach and increase its release. So we'd better take aspirin enteric-coated tablets before meals in strict accordance with the instructions on the drug instructions.

Some side effects are inevitable, but some side effects can be avoided by some methods.

For example, nausea, vomiting, heartburn, indigestion and other gastrointestinal adverse reactions are common, so you can't stop taking medicine as soon as you have a reaction. The correct response is to see if aspirin is taken correctly. Do you take it half an hour before meals or three hours after meals?

If you take it wrong, correct it first, and then observe whether the bad symptoms of the digestive tract have been alleviated. You can take more stomach medicine to reduce gastrointestinal reaction.

If there is black stool or gastrointestinal bleeding, you should stop taking aspirin immediately and contact your doctor as soon as possible for corresponding examination.

Some people will have symptoms such as bleeding gums and ecchymosis when taking aspirin. In this case, the dosage needs to be adjusted appropriately.

Studies have shown that the bleeding rate after taking medicine is related to dosage, duration and patient's age. The larger the dose, the longer the time, the older the patient, the heavier the physical load, and the easier it is to bleed.

Many people take aspirin as soon as they find carotid plaque, some people take aspirin when the ECG T wave is low but there is no other heart disease basis, and some people take aspirin when they are atypical chest tightness ... These practices are unscientific.

Who should take aspirin and who shouldn't? This should be judged by the doctor, not himself.

Aspirin is a good medicine, but it is also a double-edged sword. Proper use can effectively prevent cardiovascular and cerebrovascular events, and improper use may also increase the risk of bleeding.

So, who should use aspirin?

If coronary heart disease, cerebral infarction or transient ischemic attack have been diagnosed, the carotid artery or lower extremity artery is obviously narrowed, and the degree of stenosis is generally above 50%. If there are no contraindications, it is recommended to take aspirin for a long time.

Whether people without cardiovascular and cerebrovascular diseases need to take aspirin depends on the specific situation.

People in their 40 s and 70 s should not take aspirin as long as they have no cardiovascular and cerebrovascular diseases.

No matter what age, aspirin should not be taken as long as there are high-risk factors of bleeding, such as the use of other drugs that increase the risk of bleeding, gastrointestinal bleeding, peptic ulcer or other bleeding history, thrombocytopenia, coagulation dysfunction, severe liver disease, stage 4-5 chronic kidney disease, Helicobacter pylori infection is not eradicated, and hypertension is not controlled. If cardiovascular and cerebrovascular diseases and carotid and lower extremity arterial diseases have not been diagnosed.

If you are between 40 and 70 years old, have no cardiovascular and cerebrovascular diseases, and do not have the above-mentioned high-risk factors for bleeding, you need to carefully evaluate whether to use aspirin for treatment.

The following seven factors need to be remembered: 1. Hypertension; 2. Diabetes; 3. dyslipidemia (TC 6.2 mmol/L or LDL-C 4. 1 mmol/L or HDL-C)