Ácido acetil salicílico, dosis correcta
La tradicional aspirina que tomábamos de niños y que ahora se ha rescatado por sus efectos antiagregantes o antiplaquetarios, es objeto de muchas controversias. Aprende, de la mano de dos expertos, cómo hay que tomar el ácido acetilsalicílico y sus efectos a distintas dosis.
Uno de los fármacos más antiguos de los que disponemos en nuestro arsenal terapéutico es el ácido acetilsalicílico (AAS). Su efecto como analgésico, antiinflamatorio y antipirético lo ha convertido en uno de los fármacos más conocidos y utilizados hace años, aunque su uso se ha venido reduciendo paulatinamente en favor de otros como el paracetamol o el ibuprofeno. Actualmente, según explica el farmacéutico Iván Espada en un video explicativo de Portalfarma, el canal que el Consejo General de Colegios Oficiales de Farmacéuticos (CGCOF) tiene en Youtube, “el descubrimiento de nuevos efectos farmacológicos asociados a este fármaco está relanzando su utilización”.
Antiagregante plaquetario
Según explica Iván Espada, entre estos efectos, se ha demostrado que “el ácido acetilsalicílico es capaz de disminuir la agregación de las plaquetas, elementos de nuestra sangre que tienden a unirse formando coágulos y trombos que taponan las posibles rupturas de nuestros vasos sanguíneos”. De ahí que se emplee para prevenir enfermedades causadas por la aparición de trombos, como la angina de pecho, infartos de miocardio e ictus no hemorrágicos.
Ácido acetil salicílico: dosis correcta
El doctor Fernando Fernández Bueno, experto en cirugía oncológica y doctor en la Universidad Rey Juan Carlos de Madrid, explica que, a dosis bajas, de 100 a 300 mg funciona como antiagregante plaquetario, muy inferior a la dosis analgésica. Aumentar la dosis no se ha asociado a un mayor efecto antiagregante, pero sí con mayor incidencia de reacciones adversas.
Por encima de 500 mg actúa como antiinflamatorio y analgésico (para el alivio sintomático de los dolores ocasionales leves o moderados de cabeza, dentales, menstruales, musculares o de espalda), al igual que como antipirético para reducir la fiebre. A elevadas dosis, al ser antiinflamatorio, “nos va a producir un mayor número de problemas gastrointestinales, dolor, ardor de estómago, etc., y si la tomamos de forma continuada y sin protector, el ácido acetilsalicílico puede estar involucrado en la aparición de úlceras gástricas y duodenales”, explica el doctor Fernández Bueno. En cualquier caso, nunca debe exceder los 4 g diarios, en adultos y mayores de 16 años. Los niños menores de 16 años no deben tomar este medicamento, ya que el uso de ácido acetilsalicílico se ha relacionado con el Síndrome de Reye, enfermedad poco frecuente pero grave.
Distintas presentaciones
Según explica Espadas, en la farmacia se puede encontrar en forma de comprimidos gastrorresistentes, que deben tomase enteros, sin masticar y con gran cantidad de agua. Su efecto es prolongado, pero lento, por lo tanto, no va a ser útil en casos de urgencia, por ejemplo, en un paciente que esté experimentando síntomas de un infarto, en cuyo caso, puede ser recomendable masticar el comprimido para acelerar sus efectos.
Contraindicaciones e interacciones
· Debido a su capacidad para favorecer la aparición de hemorragias, no debe emplearse en caso de alteraciones de la coagulación o en patologías que puedan dar lugar a una hemorragia interna, como puede ser una úlcera gastroduodenal. Tampoco puede utilizarse en caso de padecer hemofilia.
· El AAS también puede dar lugar a espasmos de los bronquios por lo que no es recomendable su utilización si tienes asma.
· No debe utilizarse en caso de padecer enfermedades del riñón y/o del hígado (insuficiencia renal y/o hepática).
· Entre sus interacciones puede potenciar los efectos de otros fármacos anticoagulantes como pueden ser el acenocumarol o el clopidorel, sin embargo, estas asociaciones se emplean habitualmente en la práctica clínica, por lo que debe haber un control del médico. Por lo tanto, debes respetar las dosis indicadas por el médico y no suspender tratamiento sin su recomendación. también puede incrementar el daño al estómago en caso de combinarlo con fármacos antiinflamatorios como ibuprofeno o con sustancias como el alcohol.
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