magazine article about aspirin tolerance and withdrawal causing headaches



from an exhibit The relief of Pain and Suffering at the UCLA Darling Biomedical library

A drug with a long history. Willow bark tea was a headache and fever treatment described by Hippocrates.The story is that aspirin was derived from the active ingredient by Felix Hoffman of the Bayer chemical company.

It seems however it was really discovered by Arthur Eichengruen whose Jewishness was inconvenient to Nazi belief at the time the above story was being concocted



NSAIDS are responsible for well over 16,000 deaths per year according to the New England Journal of Medicine. In addition Acetaminophen accounts for 50% of liver failures.FDA to start educating about Acetaminophen Dangers



The many effects of aspirin result from its inhibition of specific enzymes, the cyclooxygenases which make prostaglandins. Prostaglandins can be thought of as locally acting short lived hormones that effect specific tissues.

The enzyme cyclooxygenase (COX) is involved in their synthesis. Aspirin inserts into the active site and blocks the reaction so that the prostaglandins aren't formed.




 Scientific American Article

 Reyes Syndrome

COX1 COX2 inhibitors




COX 3 inhibitor


COX2 inhibitors





Bottom Line AHA recommendations:

The first medication would usually be acetaminophen or aspirin at the lowest effective dose, or certain other low-risk drugs. Only if those fail should doctors progress to riskier drugs, starting with naproxen and then perhaps ibuprofen, both available over the counter. A cox-2 inhibitor should be prescribed only as a last resort. The overall message is that one should use the lowest effective dose of the safest drug for the shortest period of time. That is always good advice, but it tends to be forgotten in an age when drugs are so heavily promoted.