Aspirin Associated Liver Toxicity – The Optimal Dose of Aspirin in Liver Insufficiency

Abstract

Abstract. Acetylsalicylic acid (Aspirin) belongs to nonsteroidal anti-inflammatory drugs (NSAIDs). Numerous studies have proven that aspirin reduces the signs and symptoms of inflammation and exhibited a broad range of pharmacological activities, including analgesic, antipyretic and antiplatelet properties. Previous studies suggested that beside the pharmacological activities aspirin was also associated with the side effects and toxicity of various doses and in various formulations. The present study is performed to explore the effects of aspirin in various doses (75mg (EC), 100mg, 150 (EC)mg and 300mg) in different preparation (enteric coated (EC), non-enteric coated) on liver enzymes (Serum glutamic oxaloacetate transaminase (SGOT) and Serum glutamic pyruvic transaminase (SGPT)) followed by daily administration for 10 days and for 30 days. We found that the SGOT level was increased by all doses of aspirin after 30 days of treatment, this effect was most significant at 75mg (EC) and 100mg dose, whereas at 150mg (EC) and 300mg was not very significant. The level of SGPT was decreased by all doses regardless of duration of treatment, only 75mg (EC) dose increased its level after 30 days of treatment, suggesting 75mg (EC) aspirin could be hepatotoxic due to lessen of anti-oxidant effects, furthermore suggests that patients with hepatic insufficiency should not receive 75mg (EC) dose of aspirin.

Clinical and Histopathological Study of Diclofenac SodiumAcetylsalicylic Acid Toxic Effect on Liver of Mice

“…(27) who found that histopathological study explained seriousness expanded of sores with expanded medication dosage, vacuolation with direct diffuse degeneration, peri-acinar rot with mellow to direct invasion of gateway zones and mononuclear cells in hepatic tissues analyzed of rats adminstrated diclofenac sodium for 14 days at doses of 100 and 150 mg/kg and this agreement with present study. (21) was found in histopathologically slides treated by aspirin explained that found a mild to moderate portal inflammation, focal cellular swelling, micro vesicular steatosis with cytolysis and this agreement with present study.…”

“…Liver transaminases (ALT with ALP) are benift biomarkers of liver injury in a patient has some degree of healthy liver function, since ALP can be increased in other affecting organs diseases, ALT is more considered specific for hepatotoxicity (21) .…”

“…Oxidative stress which caused by nitroxide and quinone imine-related redox cycling or putative diclofenac cation radicals and mitochondrial injury (opening of the permeability transition pore and protonophoretic activity) in combination or alone have been appeared in toxicity of diclofenac. For some cases, from a number of experiments demonstrating T cell sensitization and immune mediated liver injury is involved, inferred from unintended re-challenge data (21) . NSAID (non-steroidal anti-inflammatory drug) like diclofenac, using as antipyretic agent and an analgesic.…”