Aspirin

Where does aspirin get absorbed?
The absorption of aspirin has been studied extensively. The drug in soluble and dispersible tablets is absorbed much more rapidly than from the standard tablet. Muir et al.reported that five minutes after ingestion of a soluble form, the levels of aspirin in the plasma were about 15 times the level after ingestion of the same dose in a plain tablet. Feldman found a 50% inhibition of thromboxane A2 within five minutes after a 325 mg tablet is chewed and swallowed. (Enlarge Image) There is uncertainty about the dose of aspirin that is appropriate if the drug is taken during infarction. Dabaghi et al. reported almost complete (97%) inhibition of aggregation to arachidonic acid 15 minutes after ingesting an 81 mg soluble tablet of aspirin and others have reported similar rapid inhibition of plasma thromboxane, and platelet thromboxane after small doses of aspirin. There is evidence, however, that absorption can be impaired during the acute phase of infarction and a relatively high dose may be advisable.Yet in an examination of data from recent randomised trials, there was no difference in the very early mortality following initial doses of…

2 mg and 325 mg aspirin, but there was a slightly greater incidence of bleeding after the larger dose. Further to all this, most patients with an infarct are likely to receive thrombolytic therapy. There is a marked heightening of platelet activity after thrombolysis,and prior treatment with aspirin abolishes the excess in re-infarction that otherwise follows fibrinolysis. In order to achieve fibrinolysis as early as possible, treatment has been delegated to paramedics, although increasingly where percutaneous coronary intervention (PCI) is available in a timely manner, this has become the preferred intervention. Self-administration of aspirin by a subject at the time of calling an ambulance would, however, be appropriate whatever the subsequent interventions.

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