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Acetylsalicylic Acid

ISBN: 978-3-527-32109-4
390 pages
January 2009, Wiley-Blackwell
Acetylsalicylic Acid (3527321098) cover image


Written by a leading expert on Aspirin-related research, this is the first comprehensive treaty of the history, pharmacological effects and clinical applications of one of the most successful drugs ever.
The text is written with a wide audience in mind and to be readily understandable for clinicians as well as biomedical researchers and pharmacologists alike. The content is up to date and includes the latest results of clinical and academic research, with a balanced view on the disputed properties of this famous drug.
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Table of Contents

Preface XI

1 General Aspects 3

1.1 History 5

1.1.1 Willow Bark and Leaves as Antipyretic, Anti-Inflammatory Analgesics 5

1.1.2 Salicylates as the Active Ingredient of Willow Bark and Other Natural Sources 6

1.1.3 Synthesis of Acetylsalicylic Acid and First Clinical Studies 7

1.1.4 Mode of Aspirin Action 12

1.1.5 Anti-Inflammatory/Analgesic Actions of Aspirin 14

1.1.6 Aspirin in the Cardiovascular System 15

1.1.7 Current Research Topics 17

1.2 Chemistry 25

1.2.1 Structures and Chemical Properties of Salicylates 25

1.2.2 Determination of Salicylates 30

2 Pharmacology 33

2.1 Pharmacokinetics 35

2.1.1 Absorption and Distribution 36

2.1.2 Biotransformation and Excretion 46

2.2 Cellular Modes of Action 53

2.2.1 Inhibition of Cyclooxygenases 54

2.2.2 COX-Independent Actions on Cell Function 66

2.2.3 Energy Metabolism 79

2.3 Actions on Organs and Tissues 88

2.3.1 Hemostasis and Thrombosis 89

2.3.2 Inflammation, Pain, and Fever 105

2.3.3 Aspirin and Malignancies 120

3 Toxicity and Drug Safety 129

3.1 Systemic Side Effects 131

3.1.1 Acute and Chronic Toxicity 132

3.1.2 Bleeding Disorders 142

3.1.3 Safety Pharmacology in Particular Life Situations 150

3.2 Organ Toxicity 157

3.2.1 Gastrointestinal Tract 157

3.2.2 Kidney 179

3.2.3 Liver 187

3.2.4 Audiovestibular System 191

3.3 Non-Dose-Related (Pseudo)allergic Actions of Aspirin 197

3.3.1 Aspirin Hypersensitivity (Widal.s Syndrome) 197

3.3.2 Urticaria/Angioedema, Stevens–Johnson and Lyell Syndromes 205

3.3.3 Reye.s Syndrome 208

4 Clinical Applications of Aspirin 223

4.1 Thromboembolic Diseases 227

4.1.1 Coronary Vascular Disease 228

4.1.2 Cerebrovascular Diseases 260

4.1.3 Peripheral Arterial Disease 276

4.1.4 Venous Thrombosis 287

4.1.5 Preeclampsia 290

4.1.6 Aspirin ‘‘Resistance’’ 303

4.2 Pain, Fever, and Inflammatory Diseases 322

4.2.1 Aspirin as an Antipyretic Analgesic 322

4.2.2 Arthritis and Rheumatism 332

4.2.3 Kawasaki Disease 339

4.3 Further Clinical Indications 343

4.3.1 Colorectal Cancer 343

4.3.2 Alzheimer.s Disease 359

Appendix A 367

Appendix B 369

Index 371

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Author Information

Karsten Schrör is Professor and Chairman of the Department of Pharmacology and Clinical Pharmacology at the Heinrich-Heine-University in Düsseldorf, Germany. He obtained his M.D. at Martin-Luther-University Halle-Wittenberg (Germany) and carried out postdoctoral studies at the Universities of Halle, Mainz, Köln, the Jefferson Medical College, Philadelphia (USA) and the Wellcome Research Laboratories in Beckenham (UK). He held guest professorships at the Medical University of South Carolina at Charleston (USA) and the Department of Internal Medicine, Division of Hematology, University of Texas Medical Center, Houston (USA). Karsten Schrör is member of the German National Academy of Science (Leopoldina) and President of the German Society for Pharmacology. He has published extensively in the area of aspirin and prostaglandin research with focus on platelet function and the clotting system and serves on several national and international review panels and advisory committees on thrombosis research and drug development.
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"This outstanding book should prove useful to physicians, biochemists, chemists and anyone else with an interest in aspirin." (Biotechnology Advances, March 2010)

"An up-to-date resource on the state of the art ... .Has considerable value as a reference for more established information on the history, pharmacology, and clinical applications of aspirin therapy." (Australian Biochemist)

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