Coronary Artery DiseaseAspirin absorption rates and platelet inhibition times with 325-mg buffered aspirin tablets (chewed or swallowed intact) and with buffered aspirin solution☆
Section snippets
Subjects
Twelve healthy volunteers (6 women and 6 men) who had not taken ASA or nonsteroidal anti-inflammatory drugs (NSAIDs) within the previous 2 weeks participated in this 6-week, placebo-controlled, randomized, crossover study after giving their informed written consent. The study was approved by the Human Studies Committee of the Dallas VA Medical Center. ASA (other than on study days) and non-ASA NSAIDs were prohibited over the 6-week experimental period. Volunteers’ ages ranged from 21 to 64
Pharmacokinetics of aspirin
When an ASA tablet was chewed, mean plasma ASA concentrations increased rapidly and peaked at between 5,000 and 6,000 ng/ml at 20 minutes (Figure 1, left). Mean plasma salicylate concentration peaked at nearly 20,000 ng/ml at 1 hour (Figure 1, right). Although ASA was no longer detectable in the plasma 3 hours after dosing, salicylate remained detectable throughout the 12-hour experiment. ASA was detectable in the plasma of 10 subjects within 3 minutes of chewing a tablet and in all 12 by 5
Discussion
Other orally administered antiplatelet agents, such as the thienopyridines ticlopidine (Ticlid) and clopidogrel (Plavix), may require several days to inhibit platelet function.9 In contrast, oral ASA inhibits platelet function within a few minutes (see Figure 2). Peak ASA levels in blood were reached in 15 to 20 minutes, nearly identical to what has previously been reported.10
The current ACC/AHA guidelines for management of patients with acute myocardial infarction, based largely on results
Acknowledgements
We wish to thank Kristi Rushin and Kenneth Shewmake for expert technical assistance, Paul Grayburn, MD, Charles Landau, MD, and L. David Hillis, MD, for expert advice, and Vicky Robertson for preparation of the manuscript.
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This work was supported by the Department of Veterans Affairs and the Southland Financial Corporation Distinguished Chair in Geriatrics, Dallas, Texas.