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Session Two of TIP Assignment

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1 Session Two of TIP Assignment
Aspirin Session Two of TIP Assignment

2 History Behind Aspirin Development
Pain relief is something that has been sought after since the ancient Greeks and Egyptians used bark and dried leaves of the poplar tree to treat back and abdominal pain. As early as 1850 B.C. the Ebers papyrus recorded the use of plant remedies for the treatment of pain and inflammation. A published Report in 1763 identified willow bark as having analgesic properties. The active component of willow bark was later identified as salicin, which is metabolized to salicylate. In 1832, the French chemist Charles Gerhardt experimented with salicin, generating salicylic acid, and in 1860 Kolbe and Lautemann developed a highly efficient method for the synthesis of salicylic acid from phenol, which led to the use of the compound in the general population as an antiseptic and antipyretic. In 1897, Felix Hoffman from the Bayer Company developed a more palatable form of salicylate by synthesizing acetylsalicylic acid, which was called “aspirin” and distributed by Bayer in tablet and powder form in 1899. TIP 2009 Gephart

3 Aspirin as a drug Salicin of willow bark was used medicinally. Active ingredient was found to be salicylic acid. Salicin is hydrolyzed to saligenin and glucose by β-glucosidase. Saligenin is then slowly oxidized to salicylic acid in the liver. More immediate effect achieved by ingestion of salicylic acid or its salts. Na salts of salicylic acid was used as a pain killer in the 19th Century despite causing stomach irritation. Acetyl salicylic acid was synthesized as a less irritating derivative. (Glaser, 2001) TIP 2009 Gephart

4 Functional groups GI effects seems to be caused by carboxyl group.
Reducing the acidity of this group (e.g., converting to an amide, salicylamide) maintains the analgetic actions of salicylic acid derivatives but eliminates the anti-inflammatory properties. Substitution on either the carboxyl or phenolic hydroxyl groups may affect potency and toxicity. Benzoic acid itself has only weak anti-inflammatory activity. Placing the phenolic hydroxyl group meta or para to the carboxyl group abolishes this activity. Substitution of halogen atoms on the aromatic ring enhances potency and toxicity Substitution of aromatic rings at the 5-position of salicylic acid increases anti-inflammatory activity. TIP 2009 Gephart

5 Crystalline structure and hydrogen bonding of aspirin
H-Bonding (Glaser, 2001) TIP 2009 Gephart

6 Absorption and Metabolism of aspirin
Salicylates are weak acids (acetylsalicylic acid pKa = 3.5), absorption generally takes place primarily from the small intestine and, to a lesser extent, from the stomach by the process of passive diffusion of un- ionized molecules across the epithelial membranes of the GI tract. Thus, gastric pH is an important factor in the rate of absorption of salicylates. Any factor that increases gastric pH (e.g., buffering agents) will slow its rate of absorption, because more of the salicylate will be in the ionized form. Tablet formulations consisting of small particles are absorbed faster than those of larger particle size. Salicylates are highly bound to plasma protein albumin, with binding being concentration dependent. At low therapeutic concentrations of 100 µg/mL, approximately 90% of aspirin is plasma protein bound, whereas at higher concentrations of approximately 400 µg/mL, only 76% binding is observed TIP 2009 Gephart

7 Absorption and metabolism of aspirin continued
Aspirin is rapidly absorbed largely intact from the stomach and upper small intestine on oral administration but is rapidly hydrolyzed by plasma esterases. Peak plasma levels usually are achieved within 2 hours after administration. Increasing the pH of the stomach by the addition of buffering agents may affect absorption, because the degree of ionization will be increased. TIP 2009 Gephart

8 Metabolism of salicylic acid derivatives
(Lemke, Williams, Roche, & Zito, 2008) TIP 2009 Gephart

9 Mechanism of action of aspirin
In 1971, Vane discovered that aspirin interferes with the biosynthesis of prostaglandins (Won Nobel Prize in 1982). The biosynthesis of prostaglandins depends on the enzymes cyclooxygenase 1 (COX-1, aka PGH2 synthase 1) and cyclooxygenase 2 (COX-2, aka PGH2synthase 2), Aspirin is an inhibitor of COX-1 and COX-2 Aspirin, however, is 10 to 100 times more potent against COX-1 than against COX-2 COX-1 is employed for normal, physiological prostaglandin synthesis, and COX-2 makes prostaglandins in inflammatory cells TIP 2009 Gephart

10 Side effects disturbances of the GI tract
Gastric bleeding induced by salicylates generally is painless but can lead to fecal blood loss and may cause a persistent iron deficiency anemia The mechanism by which salicylates cause gastric mucosal cell damage may be caused by a number of factors, including gastric acidity, ability of salicylates to damage the normal mucosal barrier that protects against the back diffusion of hydrogen ions, ability of salicylates to inhibit the formation of prostaglandins (particularly those of the PGE series, which normally inhibit gastric acid secretion), and inhibition of platelet aggregation (leading to an increased tendency toward bleeding). Reye's syndrome is an acute condition that may follow influenza and chickenpox infections in children from infancy to their late teens, with the majority of cases occurring between the ages of 4 and 12 years. the U.S. Food and Drug Administration (FDA) has proposed that aspirin and other salicylates be labeled with a warning against their use in children younger than 16 years with influenza, chickenpox, or other flu-like illness. TIP 2009 Gephart

11 Drug Interactions Acetylsalicylic acid is a weak acid that is highly bound to plasma proteins (50–80%), and it will compete for these plasma protein binding sites with other drugs that are highly bound to these sites. The plasma concentration of free anticoagulant increases in the presence of salicylates, necessitating a possible decrease in the dosage of anticoagulant required to produce a beneficial therapeutic effect Salicylates may inhibit the synthesis of prothrombin by antagonizing the actions of vitamin K The incidence and severity of GI ulcerations may be increased if corticosteroids, salicylates, and NSAIDs are administered together. TIP 2009 Gephart

12 Aspirin dosage Usual dose Effect 80 – 160 mg Antiplatelet
Analgesic, antipyretic 325 mg – 6 grams Anti-inflammatory, tinnitus 6 – 10 grams Respiratory alkalosis 10 – 20 grams Fever, dehydration, acidosis > 20 grams Shock, coma TIP 2009 Gephart

13 Aspirin Summary Analgesic Anti- inflammatory
Benefits in addition to analgesia Inhibits COX Irreversible inhibitor of COX Nonselective inhibitor of COX (adverse effects) Drug-drug interactions Reye’s syndrome TIP 2009 Gephart

14 References Much of the text in this PowerPoint has been adapted from the following resources: Glaser, R. (2001). Aspirin. An ab Initio Quantum- Mechanical Study of Conformational Preferences and of Neighboring Group Interactions. Journal of Organic Chemistry , 66 (3), 771–779. Lemke, T. L., Williams, D. A., Roche, V. F., & Zito, S. W. (2008). Foye's Principles of Medicinal Chemistry . Philadelphia: Wolters Kluwer TIP 2009 Gephart


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