**5. Pharmacological action of aspirin**

#### **5.1 Therapeutic effects**

Beneficial clinical impaction of aspirin is mainly anti-inflammatory and anti-pyretic action. Evidence suggests that aspirin is a better analgesic than salicylic acid [37, 38]. The analgesia produced by aspirin is dose-dependent, although the response does not parallel serum aspirin concentrations [39]. The dose of aspirin required for its antipyretic action is less than that required for analgesia [40].

The generally accepted therapeutic plasma concentration range of salicylate for the treatment of chronic inflammatory disease is 15–30 mg/100 ml (150–300 mg/L or 1–2 mmol/L), requiring daily doses in excess of 3 g [41].

Other indications for aspirin use are angina pectoris, angina pectoris prophylaxis, ankylosing spondylitis, cardiovascular risk reduction, colorectal cancer, ischemic stroke, ischemic stroke (prophylaxis), myocardial infarction, myocardial infarction (prophylaxis), osteoarthritis, revascularization procedures (prophylaxis), rheumatoid arthritis and systemic lupus erythematosus [42].

#### **5.2 Adverse effects**

The most common side effect of aspirin is gastrointestinal upset ranging from gastritis to gastrointestinal bleed. Other adverse effects are as followed:

#### *5.2.1 Hypersensitivity*

Excessive sensitivity to NSAIDs is normal among everyone. The rate is about 1–2%. Unwanted effects could be as gentle as a simple rash to angioedema and hypersensitivity. In case of asthmatic or interminable rhino-sinusitis patients, the predominance of these allergic susceptible indications could be as high as 26%. In the event that this is joined by nasal polyps and inflammation of the respiratory tract with eosinophils, it is known as aspirin triad. NSAID-exacerbated respiratory malady (NERD) is new term related with this disorder because of upper just as lower respiratory mucosal inflammation [43].
