Thursday, April 30, 2009

In My First Aid Kit: Aspirin



I have a mini first aid kit in my purse with 4 Bayer aspirin wrapped in
plastic wrap in it. Why ? I just may need to chew on one if I think I may be having a heart attack (I am at risk becuase of my age and heredity and cholesterol levels).

Here is what I found out:

People who think they may be having an attack need 325 mg of aspirin, and they need it as quickly as possible. For the best results, chew a single full-sized 325-mg tablet, but don’t use an enteric-coated tablet, which will act slowly even if chewed. And don’t forget to call 911, then your doctor. It’s a contemporary update on the old reminder to take two aspirin and call in the morning — and it’s good advice to chew over.

Most heart attacks develop when a cholesterol-laden plaque in a coronary artery ruptures. Relatively small plaques, which produce only partial blockages, are the ones most likely to rupture. When they do, they attract platelets to their surface. Platelets are the tiny blood cells that trigger blood clotting. A clot, or thrombus, builds up on the ruptured plaque. As the clot grows, it blocks the artery. If the blockage is complete, it deprives a portion of the heart muscle of oxygen. As a result, muscle cells die — and it’s a heart attack.

Aspirin helps by inhibiting platelets. Only a tiny amount is needed to inhibit all the platelets in the bloodstream; in fact, small amounts are better than high doses. But since the clot grows minute by minute, time is of the essence.

To find out how aspirin works fastest, researchers in Texas asked 12 volunteers to take a standard 325-mg dose of aspirin in three different ways: by swallowing a tablet with 4 ounces of water, by chewing the tablet for 30 seconds before swallowing it, or by drinking 4 ounces of water with Alka-Seltzer. Each subject tried all three methods on an empty stomach on different days. The scientists monitored blood levels of aspirin and its active ingredient, salicylate, at frequent intervals, and they also measured thromboxane B2 (TxB2), an indicator of platelet activation that drops as platelets are inhibited.

By all three measurements, chewed aspirin worked fastest. It needed only five minutes to reduce TxB2 concentrations by 50%; the Alka-Seltzer took almost 8 minutes, and the swallowed tablet took 12 minutes. Similarly, it took 14 minutes for the chewed tablet to produce maximal platelet inhibition; it took Alka-Seltzer 16 minutes and the swallowed tablet 26 minutes (see graph below).

https://www.health.harvard.edu/fhg/updates/update0505a.shtml

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