12. What’s the need to inhibit synthesis of “prostaglandins”….?
Actions of PROSTAGLANDINS Actions Of ASPIRIN
1. Sensitize spinal nerves to pain.
2. Regulate inflammatory mediation.
3. Act on thermoregulation centers in
hypothalamus to produce fever.
4. Act on glomerular cells to increase
filtration rate.
5. Act on parietal cells in stomach to
inhibit acid secretion.
Removes PAIN
Removes
INFLAMMATION
Prevents FEVER
Decrease filtration
rate, can cause Renal
Insufficiency
More ACID
secretion,
can cause GI-
Toxicity
Thromboxane causes platelet aggregation. Aspirin prevents blood clot formation by
inhibiting thromboxane synthesis. Therefore ASPIRIN is used by cardiac patients to prevent
heart attack. These patients have a slogan “An Aspirin A Day, Keeps The Doctor Away”.
13. Aspirin toxicity or SALICYLISM is acute or
chronic poisoning with overdose of aspirin.
o10-30 mg/d L: Therapeutic level (No
Poisoning)o>30 mg/d L : 1st
Sign of toxicity
o if >100mg/d L: Early hemodialysis should be considered
•Uncoated tabs (therapeutic doses): 15-20 mins.
• Enteric coated tabs: 18-24 hours
Salicylate
Levels
Absorption
Aspirin
Toxicity
15. August 12, 1977
Theodore Hirschberg vs. State Of
NY
New York Court Of Claims
•No doctors
available
psychiatrist
•Examination revealed toxicity
symptomology but doctor
couldn't diagnose.
•No diagnostic tests done.
•Transfer advice.
•No physical examination.
•No test.
•Physician thought his
colleague had seen the patient.
•Gave patient anti-psychotic
and put him on suicide alert.
•Later investigations revealed
that the doctor was not
licensed.
$ 35,000/-•Suicide Attempt….why?
•Because the person faces
hallucinations/convulsions.
Symotomology does reveal;
FEVER, TINNITUS, NAUSEA,
TACHYPNEA etc.
17. Salicylates inhibit
Krebs Cycle and
uncouple oxidative
phosphorylation
Glucose cannot be
metabolized,
Decreased ATP
concentration
Cellular metabolic
activity increases
to synthesize more
ATPs
Increased uptake
of GLUCOSE from
plasma by cells
Hypoglycemia
Formation of
KETONE BODIES
as alternate energy
source
AMS
(Altered
Mental Status)
Metabolic
Acidosis
Results in respiratory alkalosis
as compensation for metabolic
acidosis
Biochemistr
y
