II. Mechanism
- History
- Willow bark and wintergreen leaves contain Salicin (Salicylic acid)
- Used for thousands of years for pain and fever
- Salicylic acid was first lab synthesized in the 1840s
- Salicylic acid was acetylated to the more palatable Acetylsalicylic Acid (Aspirin) in the 1850s
- Salicylates have been used for pain, fever and rheumatic diseases for more than 100 years
- Willow bark and wintergreen leaves contain Salicin (Salicylic acid)
- Salicylates have antipyretic, Analgesic and anti-inflammatory properties
- Blocks cyclooxygenase (COX, esp. COX1)
- Inhibits conversion of Arachidonic Acid to Prostaglandin precursors
- Decreasing Prostaglanding levels results in decreased fever, pain and inflammation
- Salicylates (esp. Aspirin) also have antiplatelet activity
III. Medications
-
Acetylsalicylic Acid (Aspirin)
- Analgesic Dosing: 500-1000 mg every 4-6 hours
- Other less commonly used Salicylates
- Trisalicylate (Trilisate)
- Dosing 1000-1500 mg every 8-12 hours
- Diflunisal (Dolobid) 500 mg every 8-12 hours
- Risk of Acute Interstitial Nephritis
- Compared with Aspirin, lower risk of Gastrointestinal Bleeding, Tinnitus
- Salsalate (Disalcid)
- Arthritis (OA, RA): 3000 mg/day divided every 8 to 12 hours
- Trisalicylate (Trilisate)
- Other Salicylates not in use medically
IV. Adverse Effects
- Gastrointestinal upset
- Gastrointestinal Bleeding
- Tinnitus
- Hypersensitivity
- Serious skin reactions (e.g. Stevens-Johnson Syndrome)
V. Safety
- Avoid Salicylates in general in Lactation
- Most Salicylates, as with NSAIDs are legacy system Pregnancy category C (except Category D in third trimester)
- Aspirin is used in pregnancy for Preeclampsia Prevention
- However Salicylates and NSAIDs have significant risks in pregnancy
- See NSAID for pregnancy-related risks that also apply to Salicylates
- Salicylates have specifically been found to have adverse effects in pregnancy
- Anemia
- Anti-partum Hemorrhage
- Post-partum Hemorrhage
- Prolonged gestation
- Complicated deliveries
- Perinatal mortality
- Collins (1975) Lancet 2(7930):335-8 +PMID: 51142 [PubMed]
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Definition (MSH) | The salts or esters of salicylic acids, or salicylate esters of an organic acid. Some of these have analgesic, antipyretic, and anti-inflammatory activities by inhibiting prostaglandin synthesis. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D012459 |
SnomedCT | 9203006, 350312004 |
LNC | LP16276-5, MTHU005042 |
English | Salicylates, salicylates, salicylates (medication), Salicylates [Chemical/Ingredient], products salicylates, Salicylate (product), Salicylate, Salicylate product, Salicylate product (product), Salicylate, NOS, Salicylate (substance), Salicylate product (substance) |
Swedish | Salicylater |
Czech | salicylany, salicyláty |
Finnish | Salisylaatit |
Russian | SALITSILATY, САЛИЦИЛОВЫЕ КИСЛОТЫ, SALITSILOVYE KISLOTY, САЛИЦИЛАТЫ |
Spanish | salicilato, salicilato, producto (producto), salicilato (producto), salicilato, producto, salicilato (sustancia), salicilato, producto (sustancia), Salicilatos |
Polish | Salicylany, Kwasu salicylowego pochodne |
Croatian | SALICILATI |
Norwegian | Not Translated[Salicylates] |
French | Salicylates |
German | Salicylate |
Italian | Salicilati |
Portuguese | Salicilatos |