[Acetylsalicylic acid does not prevent cardiovascular disease. Poor scientific support for therapeutic guidelines according to primary prevention studies].
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Numerous papers have emphasized the damaging effect of salicylic acid compounds on the stomach mucosa. The investigations here reported aimed at examining the effect on gastric and duodenal morphology of a moderate dose of aspirin. Oxidative enzymes were evaluated histochemically. To rats in groups of 16, aspirin tablets, placebo tablets, or the same with additional 1 cc of 0.1 N HCl, were administered twice a day for 6 weeks. Approximately 160 mg/kg/24 hrs. were ingested. Microscopy revealed severe hyperaemia along with focal gastritis in the aspirin treated animals. Chronic gactric ulcers were observed in 18 rats in the aspirin treated groups, particularly in the group where HCl was added. Ulcerations in the area of the pyloricgland occurred in the latter group only. A reduction in mucopolysaccharides was demonstrated and involved the acid as well as the neutral ones. NADH-reductase and cytochrome oxidase were inhibited not only in the surface cells but also in those in the deeper layers. The reduction in oxidative enzymes in otherwise undamaged areas suggests an interference with the cellular metabolism, probably processes in the respiratory chain which might lead to reduction in energy-rich phosphate bonds.
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Heparin/acetylsalicylate complexes (1:9 and 10:1) were obtained in vitro. Single or chronic (7-8 days) per os administration to white rats of 0.1% solution of the heparin/acetylsalicylate complex (0.3 ml/200 g body weight) enhanced anticoagulative properties of blood plasma, increased the fibrinolytic activity in respect of stabilized fibrin, and diminished the thrombin-induced platelet aggregation.
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Salicylates do induce functional and morphological changes of the gastric mucosa: increased H+-back-diffusion, increased Na+-influx, and increased blood loss. Several functional parameters of the gastric mucosal barrier correlate with the transmural electrical potential difference (PD) which can be used as a sensitive, but unspecific parameter to detect functional changes of the gastric mucosal barrier. The effect of a salicylate alone and in presence of a liquid antiacid (Gastropulgit Gel) on transmural PD was measured in healthy volunteers. The presence of an antacid prevented the salicylate-induced drop of transmural PD. The tested antacid seems to exert a protective effect towards acute damage of the gastric mucosa induced by salicylates.
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Male Wistar rats were dosed daily by gavage for 200 days with either (1) aspirin, 200 mg/kg; (2) acetaminophen, 200 mg/kg; (3) aspirin and acetaminophen, 200 mg/kg of each; (4) aspirin and acetaminophen, 100 mg/kg of each or (5) vehicle alone. None of the treatments produced any marked signs of toxicity and no drug related deaths were observed. The full dose combination (3) did significantly reduce the weight compared to the control group (5). When urinary lactic dehydrogenase and alkaline phosphatase were measured, all treatments caused some increase in activity but those containing aspirin had the greatest effect. Urinary pH and osmolarity were not effected by the treatments. Complete pathological examination of the animals failed to detect any significant changes when compared to the controls. It is concluded that there is no evidence of a toxic interaction between aspirin and acetaminophen in the rat.
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