简介
"The book is well organized and allows easy access to the various topics. Each major section summarizes its important aspects. The book has an excellent index and separate appendixes dealing with biochemical abbreviations and abbreviations of clinical terms. This outstanding book should prove useful to physicians, biochemists, chemists and anyone else with an interest in aspirin." - Biotechnology Advances , 2010 "...an up-to-date resource on the state of the art... has considerable value as a reference for more established information on the history, pharmacology, and clinical applications of aspirin therapy." - Australian Biochemist , 2009 "...plausible, fascinating and scientifically inspiring reading... an intellectual treat. Professor Schr_r has to be genuinely congratulated on this work." - Deutsche Apotheker Zeitung , 2009 (review in German) "This first edition of a book on Aspirin (Acetylsalicylic Acid) is more exciting reading than many historic novels, especially for pharmacologists, neurologists and cardiovascular specialists... The book is didactically well structured and easy to read despite the wealth of information provided. No question is left unanswered in this straight-forward presentation..." - Austrian Journal of Cardiology , 2009 (review in German) Written by a leading expert on Aspirin-related research, this is the first comprehensive treaty of the history, pharmacological effects and clinical applications of one of the most successful drugs ever. The text is written with a wide audience in mind and to be readily understandable for clinicians as well as biomedical researchers and pharmacologists alike. The content is up to date and includes the latest results of clinical and academic research, with a balanced view on the disputed properties of this famous drug. Key Features: A must-have for everyone working with Aspirin. An invaluable compendium for clinicians and biomedical researchers on one of the most successful drugs in history. Written by one of the leading experts on the drug with more than 350 publications. First comprehensive treaty of the history, pharmacological effects and clinical applications of this famous drug.
目录
Preface p. XI
1 General Aspects p. 3
1.1 History p. 5
1.1.1 Willow Bark and Leaves as Antipyretic, Anti-Inflammatory Analgesics p. 5
1.1.2 Salicylates as the Active Ingredient of Willow Bark and Other Natural Sources p. 6
1.1.3 Synthesis of Acetylsalicylic Acid and First Clinical Studies p. 7
1.1.4 Mode of Aspirin Action p. 12
1.1.5 Anti-Inflammatory/Analgesic Actions of Aspirin p. 14
1.1.6 Aspirin in the Cardiovascular System p. 15
1.1.7 Current Research Topics p. 17
1.2 Chemistry p. 25
1.2.1 Structures and Chemical Properties of Salicylates p. 25
1.2.1.1 Salicylates in Clinical Use p. 25
1.2.1.2 Aspirin Formulations p. 27
1.2.2 Determination of Salicylates p. 30
1.2.2.1 Gas-Liquid Chromatography p. 30
1.2.2.2 High-Performance Liquid Chromatography p. 30
1.2.2.3 Spectrophotometry p. 30
2 Pharmacology p. 33
2.1 Pharmacokinetics p. 35
2.1.1 Absorption and Distribution p. 36
2.1.1.1 Absorption p. 36
2.1.1.2 Particular Aspirin Formulations p. 40
2.1.1.3 Distribution p. 40
2.1.1.4 Modifying Factors p. 42
2.1.2 Biotransformation and Excretion p. 46
2.1.2.1 Biotransformation of Aspirin p. 46
2.1.2.2 Biotransformations of Salicylic Acid p. 48
2.1.2.3 Excretion of Salicylates p. 49
2.1.2.4 Modification of Biotransformations and Excretion of Salicylates p. 50
2.2 Cellular Modes of Action p. 53
2.2.1 Inhibition of Cyclooxygenases p. 54
2.2.1.1 Acetylation of Cyclooxygenases and Traditional NSAIDs p. 55
2.2.1.2 Modulation of COX-2 Gene Expression p. 61
2.2.1.3 Further Actions of Salicylates on Arachidonate Metabolism p. 62
2.2.2 COX-Independent Actions on Cell Function p. 66
2.2.2.1 Kinases p. 67
2.2.2.2 Transcription Factors p. 69
2.2.2.3 Oxidative Stress and Nitric Oxide p. 73
2.2.2.4 Immune Responses p. 75
2.2.3 Energy Metabolism p. 79
2.2.3.1 Fatty Acid 脽-Oxidation p. 80
2.2.3.2 Uncoupling of Oxidative Phosphorylation p. 82
2.2.3.3 Toxic Actions of Salicylates on the Liver p. 84
2.3 Actions on Organs and Tissues p. 88
2.3.1 Hemostasis and Thrombosis p. 89
2.3.1.1 Platelets p. 90
2.3.1.2 Endothelial Cells p. 95
2.3.1.3 Plasmatic Coagulation p. 98
2.3.1.4 Fibrinolysis p. 98
2.3.2 Inflammation, Pain, and Fever p. 105
2.3.2.1 Inflammation p. 106
2.3.2.2 Pain p. 110
2.3.2.3 Fever p. 113
2.3.3 Aspirin and Malignancies p. 120
2.3.3.1 COX-Related Antitumor Effects of Aspirin p. 120
2.3.3.2 Nonprostaglandin-Related Antitumor Actions of Aspirin p. 122
2.3.3.3 Nonspecific Actions of Salicylates p. 124
3 Toxicity and Drug Safety p. 129
3.1 Systemic Side Effects p. 131
3.1.1 Acute and Chronic Toxicity p. 132
3.1.1.1 Occurrence and Symptoms p. 132
3.1.1.2 Treatment p. 136
3.1.1.3 Habituation p. 139
3.1.2 Bleeding Disorders p. 142
3.1.2.1 Prolongation of Bleeding Time by Aspirin p. 142
3.1.2.2 Aspirin-Related Bleeding Risk in Surgical Interventions p. 144
3.1.2.3 Aspirin, Other Drugs, and Alcohol p. 146
3.1.2.4 Prevention and Treatment of Bleedings p. 146
3.1.3 Safety Pharmacology in Particular Life Situations p. 150
3.1.3.1 Pregnancy and Fetal Development p. 150
3.1.3.2 The Elderly Patient p. 153
3.2 Organ Toxicity p. 157
3.2.1 Gastrointestinal Tract p. 157
3.2.1.1 Pathophysiology of GI Injury p. 158
3.2.1.2 Prostaglandins and Gastric Mucosal Protection p. 160
3.2.1.3 Mode of Aspirin Action p. 161
3.2.1.4 Helicobacter pylori p. 164
3.2.1.5 Clinical Studies p. 166
3.2.1.6 Aspirin and Other Drugs p. 170
3.2.2 Kidney p. 179
3.2.2.1 Analgesic Nephropathy p. 179
3.2.2.2 Mode of Aspirin Action p. 180
3.2.2.3 Clinical Studies p. 181
3.2.3 Liver p. 187
3.2.3.1 Drug-Induced Liver Injury p. 187
3.2.3.2 Mechanisms of Aspirin Action p. 187
3.2.3.3 Aspirin and Other Drugs p. 188
3.2.4 Audiovestibular System p. 191
3.2.4.1 Pathophysiology of Hearing and Equilibrium Disturbances p. 191
3.2.4.2 Mode of Aspirin Action p. 191
3.2.4.3 Aspirin, Arachidonic Acid, and Prostaglandins p. 193
3.2.4.4 Clinical Trials p. 193
3.3 Non-Dose-Related (Pseudo)allergic Actions of Aspirin p. 197
3.3.1 Aspirin Hypersensitivity (Widal's Syndrome) p. 197
3.3.1.1 Pathophysiology and Clinics p. 197
3.3.1.2 Mode of Aspirin Action p. 199
3.3.1.3 Clinical Trials p. 201
3.3.2 Urticaria/Angioedema, Stevens-Johnson and Lyell Syndromes p. 205
3.3.2.1 Urticaria/Angioedema p. 205
3.3.2.2 Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (Lyell Syndrome) p. 206
3.3.3 Reye's Syndrome p. 208
3.3.3.1 Clinics, Laboratory, and Morphological Findings p. 209
3.3.3.2 Etiology p. 209
3.3.3.3 Clinical Studies p. 212
3.3.3.4 Actual Situation p. 217
4 Clinical Applications of Aspirin p. 223
4.1 Thromboembolic Diseases p. 227
4.1.1 Coronary Vascular Disease p. 228
4.1.1.1 Thrombotic Risk and Mode of Aspirin Action p. 229
4.1.1.2 Clinical Trials: Primary Prevention in Individuals Without Risk Factors p. 231
4.1.1.3 Clinical Trials: Primary Prevention in Individuals with Risk Factors p. 235
4.1.1.4 Clinical Trials: Stable Angina Pectoris p. 237
4.1.1.5 Clinical Trials: Secondary Prevention p. 238
4.1.1.6 Clinical Trials: Percutaneous Coronary Interventions p. 243
4.1.1.7 Clinical Trials: Coronary Artery Bypass Graft Surgery (CABG) p. 244
4.1.1.8 Aspirin and Other Drugs p. 246
4.1.1.9 Actual Situation p. 250
4.1.2 Cerebrovascular Diseases p. 260
4.1.2.1 Thrombotic Risk and Mode of Aspirin Action p. 261
4.1.2.2 Clinical Trials: Primary Prevention p. 263
4.1.2.3 Clinical Trials: Secondary Prevention p. 265
4.1.2.4 Aspirin and Other Drugs p. 267
4.1.2.5 Actual Situation p. 270
4.1.3 Peripheral Arterial Disease p. 276
4.1.3.1 Thrombotic Risk and Mode of Aspirin Action p. 276
4.1.3.2 Clinical Trials: Primary Prevention p. 278
4.1.3.3 Clinical Trials: Secondary Prevention p. 279
4.1.3.4 Clinical Trials: Peripheral Transluminal Angioplasty (PTA) p. 281
4.1.3.5 Aspirin and Other Drugs p. 282
4.1.3.6 Actual Situation p. 283
4.1.4 Venous Thrombosis p. 287
4.1.4.1 Thrombotic Risk and Mode of Aspirin Action p. 287
4.1.4.2 Clinical Trials p. 287
4.1.4.3 Actual Situation p. 288
4.1.5 Preeclampsia p. 290
4.1.5.1 Thrombotic Risk and Mode of Aspirin Action p. 290
4.1.5.2 Clinical Trials p. 293
4.1.5.3 Clinical Trials in Pregnancy-Induced Hypertension: Reasons for Data Variability p. 294
4.1.5.4 Actual Situation p. 298
4.1.6 Aspirin "Resistance" p. 303
4.1.6.1 Definition and Types of Pharmacological Aspirin "Resistance" p. 304
4.1.6.2 Detection of Aspirin "Resistance" p. 304
4.1.6.3 Pharmacological Mechanisms of Aspirin "Resistance" p. 307
4.1.6.4 Clinical Trials p. 310
4.2 Pain, Fever, and Inflammatory Diseases p. 322
4.2.1 Aspirin as an Antipyretic Analgesic p. 322
4.2.1.1 Fever, Pain, and Antipyretic/Analgesic Actions of Aspirin p. 323
4.2.1.2 Clinical Trials p. 326
4.2.1.3 Aspirin and Other Drugs p. 327
4.2.1.4 Actual Situation p. 328
4.2.2 Arthritis and Rheumatism p. 332
4.2.2.1 Pathophysiology and Mode of Aspirin Action p. 332
4.2.2.2 Clinical Trials p. 334
4.2.2.3 Aspirin and Other Drugs p. 335
4.2.2.4 Actual Situation p. 336
4.2.3 Kawasaki Disease p. 339
4.2.3.1 Pathophysiology and Mode of Aspirin Action p. 339
4.2.3.2 Clinical Trials p. 340
4.2.3.3 Aspirin and Other Drugs p. 341
4.2.3.4 Actual Situation p. 341
4.3 Further Clinical Indications p. 343
4.3.1 Colorectal Cancer p. 343
4.3.1.1 Etiology and Pathophysiology of Intestinal Adenomas, Colorectal Cancer, and Mode of Aspirin Action p. 344
4.3.1.2 Clinical Trials: Epidemiological Studies p. 346
4.3.1.3 Clinical Trials: Randomized Prospective Prevention Trials p. 349
4.3.1.4 Aspirin and Other Drugs p. 352
4.3.1.5 Actual Situation p. 352
4.3.2 Alzheimer's Disease p. 359
4.3.2.1 Pathophysiology and Mode of Aspirin Action p. 359
4.3.2.2 Clinical Trials p. 361
4.3.2.3 Aspirin and Other Drugs p. 363
4.3.2.4 Actual Situation p. 363
Appendix A p. 367
Appendix B p. 369
Index p. 371
1 General Aspects p. 3
1.1 History p. 5
1.1.1 Willow Bark and Leaves as Antipyretic, Anti-Inflammatory Analgesics p. 5
1.1.2 Salicylates as the Active Ingredient of Willow Bark and Other Natural Sources p. 6
1.1.3 Synthesis of Acetylsalicylic Acid and First Clinical Studies p. 7
1.1.4 Mode of Aspirin Action p. 12
1.1.5 Anti-Inflammatory/Analgesic Actions of Aspirin p. 14
1.1.6 Aspirin in the Cardiovascular System p. 15
1.1.7 Current Research Topics p. 17
1.2 Chemistry p. 25
1.2.1 Structures and Chemical Properties of Salicylates p. 25
1.2.1.1 Salicylates in Clinical Use p. 25
1.2.1.2 Aspirin Formulations p. 27
1.2.2 Determination of Salicylates p. 30
1.2.2.1 Gas-Liquid Chromatography p. 30
1.2.2.2 High-Performance Liquid Chromatography p. 30
1.2.2.3 Spectrophotometry p. 30
2 Pharmacology p. 33
2.1 Pharmacokinetics p. 35
2.1.1 Absorption and Distribution p. 36
2.1.1.1 Absorption p. 36
2.1.1.2 Particular Aspirin Formulations p. 40
2.1.1.3 Distribution p. 40
2.1.1.4 Modifying Factors p. 42
2.1.2 Biotransformation and Excretion p. 46
2.1.2.1 Biotransformation of Aspirin p. 46
2.1.2.2 Biotransformations of Salicylic Acid p. 48
2.1.2.3 Excretion of Salicylates p. 49
2.1.2.4 Modification of Biotransformations and Excretion of Salicylates p. 50
2.2 Cellular Modes of Action p. 53
2.2.1 Inhibition of Cyclooxygenases p. 54
2.2.1.1 Acetylation of Cyclooxygenases and Traditional NSAIDs p. 55
2.2.1.2 Modulation of COX-2 Gene Expression p. 61
2.2.1.3 Further Actions of Salicylates on Arachidonate Metabolism p. 62
2.2.2 COX-Independent Actions on Cell Function p. 66
2.2.2.1 Kinases p. 67
2.2.2.2 Transcription Factors p. 69
2.2.2.3 Oxidative Stress and Nitric Oxide p. 73
2.2.2.4 Immune Responses p. 75
2.2.3 Energy Metabolism p. 79
2.2.3.1 Fatty Acid 脽-Oxidation p. 80
2.2.3.2 Uncoupling of Oxidative Phosphorylation p. 82
2.2.3.3 Toxic Actions of Salicylates on the Liver p. 84
2.3 Actions on Organs and Tissues p. 88
2.3.1 Hemostasis and Thrombosis p. 89
2.3.1.1 Platelets p. 90
2.3.1.2 Endothelial Cells p. 95
2.3.1.3 Plasmatic Coagulation p. 98
2.3.1.4 Fibrinolysis p. 98
2.3.2 Inflammation, Pain, and Fever p. 105
2.3.2.1 Inflammation p. 106
2.3.2.2 Pain p. 110
2.3.2.3 Fever p. 113
2.3.3 Aspirin and Malignancies p. 120
2.3.3.1 COX-Related Antitumor Effects of Aspirin p. 120
2.3.3.2 Nonprostaglandin-Related Antitumor Actions of Aspirin p. 122
2.3.3.3 Nonspecific Actions of Salicylates p. 124
3 Toxicity and Drug Safety p. 129
3.1 Systemic Side Effects p. 131
3.1.1 Acute and Chronic Toxicity p. 132
3.1.1.1 Occurrence and Symptoms p. 132
3.1.1.2 Treatment p. 136
3.1.1.3 Habituation p. 139
3.1.2 Bleeding Disorders p. 142
3.1.2.1 Prolongation of Bleeding Time by Aspirin p. 142
3.1.2.2 Aspirin-Related Bleeding Risk in Surgical Interventions p. 144
3.1.2.3 Aspirin, Other Drugs, and Alcohol p. 146
3.1.2.4 Prevention and Treatment of Bleedings p. 146
3.1.3 Safety Pharmacology in Particular Life Situations p. 150
3.1.3.1 Pregnancy and Fetal Development p. 150
3.1.3.2 The Elderly Patient p. 153
3.2 Organ Toxicity p. 157
3.2.1 Gastrointestinal Tract p. 157
3.2.1.1 Pathophysiology of GI Injury p. 158
3.2.1.2 Prostaglandins and Gastric Mucosal Protection p. 160
3.2.1.3 Mode of Aspirin Action p. 161
3.2.1.4 Helicobacter pylori p. 164
3.2.1.5 Clinical Studies p. 166
3.2.1.6 Aspirin and Other Drugs p. 170
3.2.2 Kidney p. 179
3.2.2.1 Analgesic Nephropathy p. 179
3.2.2.2 Mode of Aspirin Action p. 180
3.2.2.3 Clinical Studies p. 181
3.2.3 Liver p. 187
3.2.3.1 Drug-Induced Liver Injury p. 187
3.2.3.2 Mechanisms of Aspirin Action p. 187
3.2.3.3 Aspirin and Other Drugs p. 188
3.2.4 Audiovestibular System p. 191
3.2.4.1 Pathophysiology of Hearing and Equilibrium Disturbances p. 191
3.2.4.2 Mode of Aspirin Action p. 191
3.2.4.3 Aspirin, Arachidonic Acid, and Prostaglandins p. 193
3.2.4.4 Clinical Trials p. 193
3.3 Non-Dose-Related (Pseudo)allergic Actions of Aspirin p. 197
3.3.1 Aspirin Hypersensitivity (Widal's Syndrome) p. 197
3.3.1.1 Pathophysiology and Clinics p. 197
3.3.1.2 Mode of Aspirin Action p. 199
3.3.1.3 Clinical Trials p. 201
3.3.2 Urticaria/Angioedema, Stevens-Johnson and Lyell Syndromes p. 205
3.3.2.1 Urticaria/Angioedema p. 205
3.3.2.2 Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (Lyell Syndrome) p. 206
3.3.3 Reye's Syndrome p. 208
3.3.3.1 Clinics, Laboratory, and Morphological Findings p. 209
3.3.3.2 Etiology p. 209
3.3.3.3 Clinical Studies p. 212
3.3.3.4 Actual Situation p. 217
4 Clinical Applications of Aspirin p. 223
4.1 Thromboembolic Diseases p. 227
4.1.1 Coronary Vascular Disease p. 228
4.1.1.1 Thrombotic Risk and Mode of Aspirin Action p. 229
4.1.1.2 Clinical Trials: Primary Prevention in Individuals Without Risk Factors p. 231
4.1.1.3 Clinical Trials: Primary Prevention in Individuals with Risk Factors p. 235
4.1.1.4 Clinical Trials: Stable Angina Pectoris p. 237
4.1.1.5 Clinical Trials: Secondary Prevention p. 238
4.1.1.6 Clinical Trials: Percutaneous Coronary Interventions p. 243
4.1.1.7 Clinical Trials: Coronary Artery Bypass Graft Surgery (CABG) p. 244
4.1.1.8 Aspirin and Other Drugs p. 246
4.1.1.9 Actual Situation p. 250
4.1.2 Cerebrovascular Diseases p. 260
4.1.2.1 Thrombotic Risk and Mode of Aspirin Action p. 261
4.1.2.2 Clinical Trials: Primary Prevention p. 263
4.1.2.3 Clinical Trials: Secondary Prevention p. 265
4.1.2.4 Aspirin and Other Drugs p. 267
4.1.2.5 Actual Situation p. 270
4.1.3 Peripheral Arterial Disease p. 276
4.1.3.1 Thrombotic Risk and Mode of Aspirin Action p. 276
4.1.3.2 Clinical Trials: Primary Prevention p. 278
4.1.3.3 Clinical Trials: Secondary Prevention p. 279
4.1.3.4 Clinical Trials: Peripheral Transluminal Angioplasty (PTA) p. 281
4.1.3.5 Aspirin and Other Drugs p. 282
4.1.3.6 Actual Situation p. 283
4.1.4 Venous Thrombosis p. 287
4.1.4.1 Thrombotic Risk and Mode of Aspirin Action p. 287
4.1.4.2 Clinical Trials p. 287
4.1.4.3 Actual Situation p. 288
4.1.5 Preeclampsia p. 290
4.1.5.1 Thrombotic Risk and Mode of Aspirin Action p. 290
4.1.5.2 Clinical Trials p. 293
4.1.5.3 Clinical Trials in Pregnancy-Induced Hypertension: Reasons for Data Variability p. 294
4.1.5.4 Actual Situation p. 298
4.1.6 Aspirin "Resistance" p. 303
4.1.6.1 Definition and Types of Pharmacological Aspirin "Resistance" p. 304
4.1.6.2 Detection of Aspirin "Resistance" p. 304
4.1.6.3 Pharmacological Mechanisms of Aspirin "Resistance" p. 307
4.1.6.4 Clinical Trials p. 310
4.2 Pain, Fever, and Inflammatory Diseases p. 322
4.2.1 Aspirin as an Antipyretic Analgesic p. 322
4.2.1.1 Fever, Pain, and Antipyretic/Analgesic Actions of Aspirin p. 323
4.2.1.2 Clinical Trials p. 326
4.2.1.3 Aspirin and Other Drugs p. 327
4.2.1.4 Actual Situation p. 328
4.2.2 Arthritis and Rheumatism p. 332
4.2.2.1 Pathophysiology and Mode of Aspirin Action p. 332
4.2.2.2 Clinical Trials p. 334
4.2.2.3 Aspirin and Other Drugs p. 335
4.2.2.4 Actual Situation p. 336
4.2.3 Kawasaki Disease p. 339
4.2.3.1 Pathophysiology and Mode of Aspirin Action p. 339
4.2.3.2 Clinical Trials p. 340
4.2.3.3 Aspirin and Other Drugs p. 341
4.2.3.4 Actual Situation p. 341
4.3 Further Clinical Indications p. 343
4.3.1 Colorectal Cancer p. 343
4.3.1.1 Etiology and Pathophysiology of Intestinal Adenomas, Colorectal Cancer, and Mode of Aspirin Action p. 344
4.3.1.2 Clinical Trials: Epidemiological Studies p. 346
4.3.1.3 Clinical Trials: Randomized Prospective Prevention Trials p. 349
4.3.1.4 Aspirin and Other Drugs p. 352
4.3.1.5 Actual Situation p. 352
4.3.2 Alzheimer's Disease p. 359
4.3.2.1 Pathophysiology and Mode of Aspirin Action p. 359
4.3.2.2 Clinical Trials p. 361
4.3.2.3 Aspirin and Other Drugs p. 363
4.3.2.4 Actual Situation p. 363
Appendix A p. 367
Appendix B p. 369
Index p. 371
Acetylsalicylic acid /
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