Pharmacology, Pharmaceutics and Clinical Use of Aspirin: A Narrative Review

Abstract

Background: Aspirin is one of the most frequently used and cheapest drugs in medicine. Since its first synthesis in 1897, several medicinal roles and mechanisms of action of Aspirin have become apparent, the latest among these being its role in cancer prevention and treatment. Objective: We present a review of Aspirin's biochemistry and pharmacology, as well as the clinical use of Aspirin. The communiqué also suggests possible strategies for maximizing the gain of Aspirin as a wonder-drug of the future. Methods: The  literature  search  strategy  covered  printed  and  online  sources,  including  manual  library search (PubMed), Embase, Medline, and Cochrane Library. For papers written in English and published in the last ten years.  A  systematic  analysis  of  available  data  was  subsequently  performed  based  on  the review questions. An  estimated  155  articles  were  found  online,  and  twenty-eight  articles  utilized  in  the  final analysis. Discussion: Aspirin belongs to the non-steroidal anti-inflammatory drugs with a wide range of pharmacological activities, including analgesic, antipyretic, and antiplatelet properties. Discovery of antiplatelet effects led to the increasing use of Aspirin as an anti-thrombotic agent in the prevention of cardiovascular diseases from the 1980s, and firm evidence supporting its usefulness has continued to accumulate. Aspirin irreversibly inhibits platelet function by acetylating cyclooxygenase (COX), which is involved in the production of a potent platelet stimulator, thromboxane A2. The inhibition of COX-2 by Aspirin forms the basis of its anticipated role in preventing colorectal cancer and Alzheimer's disease and the inhibition of the progression of these diseases. It has been pointed out that the incidence of cardiovascular events tends to be high among patients who are Aspirin resistant, but the reason for this increased incidence remains unclear. Conclusion: The emerging future interest is to accrue evidence in favor of Aspirin as the novel therapeutic drug for combating severe acute inflammation and thrombosis associated with the cytokine storm in COVID-19 patients. Notably, a randomized clinical trial, to test a range of potential treatments for COVID-19, includes low-dose Aspirin as anti-inflammatory and antiplatelet treatment. Keywords: Aspirin; Anti-platelet; Nonsteroidal Anti-inflammatory Drug; Pharmaceutic; Pharmacodynamic; Pharmacokinetic.