Aspirin Tablets Research Articles

Comparative bioequivalence assessment of aspirin tablets marketed in Nigeria

Purpose: In the last few years, aspirin has become a life saver against cardiovascular accidents. This investigation was carried out to determine possible bioequivalence between regular aspirin and soluble aspirin tablets marketed in Nigeria. Methods: The in vivo bioavailability profiles of three commercial brands of aspirin tablets and soluble aspirin tablets were assessed in eight healthy subjects. Pharmacokinetic parameters including amounts of aspirin excreted up to 24h (E24h), maximum excretion rate (dE/dt)max and time for maximum excretion rate (Tmax) were compared for all the brands. Results: There was no significant difference (p > 0.05) in the maximum excretion rates among all the brands but the amount of soluble aspirin excreted up to 24 hours was a significantly different (p< 0.05) from one of the regular brands of aspirin. The soluble brand had significantly lower Tmax (p < 0.05) than all the three plain brands. There was no significant inter-subject variation among the subjects that participated in the study. Conclusion: Bioinequivalence exists between some regular aspirin and soluble aspirin marketed in Nigeria. Keywords: Soluble aspirin, aspirin, pharmacokinetic parameters, in vivo bioequivalence

Two cases of oral aspirin overdose

A 30-year-old woman and a 27-year-old man were found in a parked car after the man had telephoned his father to tell him of their suicide attempt. In spite of emergent hospitalization and intensive care, the woman died. Due to the possibility of his assisting her suicide, medicolegal autopsy and toxicological analysis were performed. On forensic autopsy, no external injuries or pathological findings were detected. The man recovered after 5 days of hospitalization. In spite of a negative toxicological screening test, the police investigation revealed that they may have taken 120 tablets (330 mg/tablet; 39,600 mg total dose) of aspirin (acetylsalicylic acid) orally; therefore, we analyzed the concentrations of acetylsalicylic acid and two kinds of metabolite in specimens obtained at autopsy and on emergent hospitalization using high performance liquid chromatography. Acetylsalicylic acid and/or the two metabolites were found in the woman’s specimens. These substances were also present in the man’s specimens. It is still unclear why the man survived in spite of what appeared to be a fatal aspirin overdose. It was very straightforward to diagnose aspirin poisoning in these cases; however, we have to be aware of poisoning by drugs which are not included in simple drug screening examinations.

Analgesic Use and Sex Steroid Hormone Concentrations in Postmenopausal Women

Prior epidemiologic studies suggest that regular use of analgesics may decrease risk of breast and ovarian cancer. We explored possible hormone-mediated mechanisms for these associations by examining the relationship between use of aspirin, nonaspirin nonsteroidal anti-inflammatory drugs (NSAID), and acetaminophen and sex steroid hormone concentrations among 740 postmenopausal women in the Nurses' Health Study. All women reported their analgesic use in 1988 or 1990 and provided a blood sample in 1989 to 1990. We calculated adjusted geometric mean estrogen and androgen levels for each category of analgesic use and calculated the P value for trend with increasing frequency of use. There was no association between days of use per month of aspirin, nonaspirin NSAIDs, or acetaminophen in 1990 and hormone levels (all P(trend) > or = 0.09). However, we observed significant inverse trends between the estimated number of aspirin tablets per month in 1988 and concentrations of estrone (P(trend) = 0.04) and estrone sulfate (P(trend) = 0.03). In analyses of total (aspirin and nonaspirin) NSAID use in 1990, women who used NSAIDs at least 15 days per month had significantly lower levels of estradiol compared with women with no NSAID use (P(trend) = 0.03). Frequency of use of all analgesics (aspirin, nonaspirin NSAIDs, and acetaminophen) in 1990 was inversely associated with concentrations of estradiol (P(trend) = 0.001), free estradiol (P(trend) = 0.01), estrone sulfate (P(trend) = 0.03), and the ratio of estradiol to testosterone (P(trend) = 0.04). Among postmenopausal women, regular users of aspirin and other analgesics may have lower estrogen levels than nonusers, which could contribute to a decreased risk of breast or ovarian cancer among analgesic users.

Death Due to Acute Salicylate Intoxication Despite Dialysis

Salicylate poisoning is a common problem with appreciable morbidity and mortality. We present a case of a patient with a large aspirin ingestion who expired despite aggressive hemodialysis (HD). A 35-year-old man arrived at the Emergency Department 7.5 h after ingesting 400 tablets of 325-mg aspirin. He was afebrile, the respiratory rate (RR) was 30 breaths/min, heart rate (HR) 120 beats/min, blood pressure (BP) 125/76 mm Hg, and oxygen saturation 99% on room air. His salicylate concentration was 89.6 mg/dL. His initial arterial blood gas: pH 7.48, pCO(2) 21 mm Hg, PaO(2) 97 mm Hg, and bicarbonate 15.8 mmol/L. His initial serum chemistry panel was normal. He received activated charcoal and intravenous hydration with sodium bicarbonate. Two hours after arrival, salicylate concentration was 91.6 mg/dL. The patient became agitated and HD was initiated; 22 h after presentation, repeat salicylate concentration was 88.4 mg/dL and his creatinine was 3.9 mg/dL. A second run of HD was performed. After this, his temperature had risen to 39.06°C (102.3°F), BP 122/64 mm Hg, HR 168 beats/min, RR 43 breaths/min, and oxygen saturation 95% (2 L nasal cannula). His confusion increased, and he died 40 h after his ingestion. HD is widely advocated in managing severe salicylate intoxications, however, no consensus exists for the duration and best mode of therapy. Patients with severe salicylate poisonings may require extended durations of HD to effectively mitigate toxicity. Additional study is warranted to determine optimal therapy in severe salicylate intoxications.

Generalized regression neural networks in prediction of drug stability

This study had two aims. Firstly, we wanted to model the effects of the percentage of Eudragit RS PO and compression pressure as the most important process and formulation variables on the time course of drug release from extended-release matrix aspirin tablets. Secondly, we investigated the possibility of predicting drug stability and shelf-life using an artificial neural network (ANN). Ten types of matrix aspirin tablets were prepared as model formulations and were stored in stability chambers at 60 degrees C, 50 degrees C, 40 degrees C and 30 degrees C and controlled humidity. Samples were removed at predefined time points and analysed for acetylsalicylic acid (ASA) and salicylic acid (SA) content using stability-indicating HPLC. The decrease in aspirin content followed apparent zero-order kinetics. The amount of Eudragit RS PO and compression pressure were selected as causal factors. The apparent zero-order rate constants for each temperature were chosen as output variables for the ANN. A set of output parameters and causal factors were used as training data for the generalized regression neural network (GRNN). For two additional test formulations, Arrhenius plots were constructed from the experimentally observed and GRNN-predicted results. The slopes of experimentally observed and predicted Arrhenius plots were tested for significance using Student's t-test. For test formulations, the shelf life (t(95%)) was then calculated from experimentally observed values (t(95%) 82.90 weeks), as well as from GRNN-predicted values (t(95%) 81.88 weeks). These results demonstrate that GRNN networks can be used to predict ASA content and shelf life without stability testing for formulations in which the amount of polymer and tablet hardness are within the investigated range.

Hypoglossal-Nerve Palsy Caused by Carotid Dissection

HomeCirculationVol. 121, No. 3Hypoglossal-Nerve Palsy Caused by Carotid Dissection Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBHypoglossal-Nerve Palsy Caused by Carotid Dissection Detlef G. Mathey, Andreas Wandler and Michael Rosenkranz Detlef G. MatheyDetlef G. Mathey From the Medical Care Center Prof. Mathey, Prof. Schofer and Hamburg University Cardiovascular Center (D.G.M.), Radiologische Allianz Hamburg (A.W.), and Department of Neurology, University Medical Center Hamburg-Eppendorf (M.R.), Hamburg, Germany. Search for more papers by this author , Andreas WandlerAndreas Wandler From the Medical Care Center Prof. Mathey, Prof. Schofer and Hamburg University Cardiovascular Center (D.G.M.), Radiologische Allianz Hamburg (A.W.), and Department of Neurology, University Medical Center Hamburg-Eppendorf (M.R.), Hamburg, Germany. Search for more papers by this author and Michael RosenkranzMichael Rosenkranz From the Medical Care Center Prof. Mathey, Prof. Schofer and Hamburg University Cardiovascular Center (D.G.M.), Radiologische Allianz Hamburg (A.W.), and Department of Neurology, University Medical Center Hamburg-Eppendorf (M.R.), Hamburg, Germany. Search for more papers by this author Originally published26 Jan 2010https://doi.org/10.1161/CIRCULATIONAHA.109.908186Circulation. 2010;121:457A 56-year-old man presented with severe left-sided headache unresponsive to several aspirin tablets. Although the headache subsided within 3 days, he noted progressive difficulties in articulation and a deviation of his tongue to the left (Figure 1). Download figureDownload PowerPointFigure 1. Deviation of the tongue to the left.A magnetic resonance image of the head and neck showed a thickened wall of the left internal carotid artery resulting from an intramural hematoma in the subcranial segment (Figure 2). The vessel lumen was not compromised, suggesting a diagnosis of subadventitial carotid artery dissection. Download figureDownload PowerPointFigure 2. A, Horizontal magnetic resonance image showing intramural hematoma (arrow) of subcranial segment of left internal carotid artery. B, Sagittal magnetic resonance image showing intramural hematoma (arrow) of subcranial segment of left internal carotid artery.The subcranial segment of the carotid artery is predisposed to injury from sudden neck movements. No trauma was apparent in our patient, so other causes of dissection such as hereditary connective-tissue disorders were considered but could be ruled out. In our case, the dissection may have been triggered by an emotional eruption during a quarrel. The left-sided headache was likely due to the arterial tear and an expansion of the outer vessel wall. This, in turn, compressed the adjacent hypoglossal nerve, resulting in nerve palsy. The hypoglossal nerve innervates the ipsilateral muscles of the tongue. A deviation of the protruded tongue to the left side indicates left-sided dysfunction of the hypoglossal nerve because the contralateral genioglossal muscle pushes the tongue forward and, in the case of contralateral palsy, toward the affected side. Cranial-nerve palsies are seen in 12% of patients with carotid artery dissection. Most dissections heal spontaneously. In our patient, tongue movement returned to normal within a few weeks.DisclosuresNone.FootnotesCorrespondence to Detlef G. Mathey, MD, Medical Care Center Prof. Mathey, Prof. Schofer, Wördemanns Weg 25-27, 22527 Hamburg, Germany. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Mes M, Palczewski P, Szczudlik P, Łusakowska A, Maj E and Gawel M (2018) Hypoglossal nerve palsy as an isolated syndrome of internal carotid artery dissection: A review of the literature and a case report, Neurologia i Neurochirurgia Polska, 10.1016/j.pjnns.2018.06.006, 52:6, (731-735), Online publication date: 1-Nov-2018. January 26, 2010Vol 121, Issue 3 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.109.908186PMID: 20100988 Originally publishedJanuary 26, 2010 PDF download Advertisement SubjectsAortic Dissection

Predicting the physical properties of tablets from ATR-FTIR spectra using partial least squares regression

Context: The formulation of a new tablet is a time-consuming activity involving the preparation and testing of many different formulations with the aim of identifying one with the desired properties. In complex formulations it may not be clear which excipient is responsible for eliciting a particular property.Objective: To investigate partial least squares (PLS) regression analysis of ATR-FTIR spectra of tablets as a predictive and investigative tool in the formulation of novel tablet formulations.Materials: Magnesium stearate, lactose, acetylsalicylic acid and Ac-Di-Sol.Results and discussion: ATR-FTIR spectra of a simple aspirin tablet formulation with varying amounts of the lubricant magnesium stearate were obtained. PLS models were built using the spectral data as the multivariate variable and various physical properties of the tablets as the univariate variables. PLS models that allowed good predications to be made for samples not included in the training set were obtained for tablet hardness and disintegration time. It was clear from PLS model regression coefficients that magnesium stearate was responsible for the variation in the tablets’ physical properties.Conclusion: PLS regression in combination with ATR-FTIR spectroscopy has been shown to be a useful approach for the prediction of the physical properties of tablets.

Novel multifunctional pharmaceutical excipients derived from microcrystalline cellulose–starch microparticulate composites prepared by compatibilized reactive polymer blending

The choice of excipients remains a critical factor in pharmaceutical formulations. Microcrystalline cellulose–maize starch composites (MCC–Mst) have been prepared by mixing colloidal dispersions of microcrystalline cellulose (MCC) with 10% (w/w) of chemically gelatinized maize starch (Mst) at controlled temperature conditions for use as multifunctional excipients with direct compression and enhanced disintegration abilities. The novel excipient was evaluated for its direct compression and enhanced disintegrant properties and the result compared with the properties of the individual components. Some of its physicochemical and thermal properties were also determined together with effects of freeze–thaw cycles of processing on the functional and physicochemical properties. The scanning electron micrograph (SEM) shows that the particles of the MCC–Mst were irregular in shape and multiparticulate with a marked degree of asperity. The indirect assessment of the powder flow properties as determined by Carr's compressibility index and angle of repose showed that the MCC–Mst possesses better flow compared with MCC and Mst. MCC–Mst is moderately hygroscopic and shows a Type III moisture sorption isotherm. The FT-IR spectra and DSC thermograms of the composite were different from those of MCC and Mst. The hardness of aspirin tablets was enhanced by incorporating MCC–Mst and MCC, but was reduced by Mst. While the tablets prepared with MCC–Mst and Mst disintegrated within 7 min, aspirin compacts devoid of any excipient and those prepared with MCC did not disintegrate even after 2 h. Acetaminophen compacts prepared with MCC and MCC–Mst showed similar compact hardness characteristics and loading properties. The loading capacity of the different samples of the composite decreased with increase in the freeze–thaw cycles. The loading capacity of the different materials as assessed by their compact hardness efficiency can be represented as follows (MCC > T0 > T1 > T4 > T3 > T2 > Mst). Generally, the different samples of MCC–Mst are characterized by physicochemical and functional properties that are similar at different degrees to MCC and Mst.

Novel application of hydrotropic solubilizing additives in the estimation of aspirin in tablets

Highly concentrated aqueous solutions of various hydrotropic agents like sodium benzoate, sodium salicylate, sodium acetate, sodium citrate, nicotinamide and sodium ascorbate have been observed to enhance aqueous solubilities of a large number of poorly water-soluble drugs. In the present investigation hydrotropic solubilization technique has been employed to solubilize poorly water-soluble aspirin (analgesic and antipyretic drug) by 0.5 M ibuprofen sodium solution to carry out titrimetric analysis of aspirin in tablet dosage form. Results of analysis by proposed method and Phamacopoeial method are very comparable. Proposed method is new, rapid, simple, accurate, and reproducible. Statistical data proved the accuracy, reproducibility and the precision of proposed method.

Hydroxypropyl methylcellulose-graft-poly(ethyl acrylate-co-methyl methacrylate) particles by resin-fortified emulsion polymerization

This article describes the preparation and characterization of hydroxypropyl methylcellulose-graft-poly(ethylacrylate-co-methyl methacrylate) particles [HPMC-g-poly(EA-co-MMA) NPs]. The particles were prepared by resin-fortified emulsion polymerization using ceric ammonium nitrate (CAN). In this study, a series of HPMC-g-poly(EA-co-MMA) NPs were synthesized by varying the CAN: HPMC and HPMC: (EA/MMA) ratios to determine the effects of these variables on the physical properties of HPMC-g-poly(EA-co-MMA) as well as the dissolution behavior of an aspirin tablet, as a model drug. The drug dissolution profiles of the coated tablets were affected significantly by the HPMC: (EA/MMA) molar ratio.

Comparative in vitro dissolution assessment of soluble and plain brands of aspirin tablets marketed in Nigeria

The in vitro dissolution profiles of four commercial brands of aspirin tablets (one soluble brand of aspirin, A1, and three plain brands of aspirin labeled A2-A4) were assessed using the USP XXI dissolution method. Various dissolution parameters such as percent dissolution in 30 min, dissolution rate constant (k), and time for 50% dissolution (DT50%) were obtained. The results indicate that A1 (the soluble aspirin brand) exhibited the highest dissolution profile while brand A3 had the least dissolution profile. The relative ranking in terms of percent dissolution in 30 min and dissolution rate constant (K) are in the order of A1>A4>A2>A3, while the ranking of time for 50% dissolution (DT50%) is in the reverse order of A1 0.05) among all the brands. They all indicated similar statistical behaviour in terms of their dissolution profiles. Keywords: Aspirin, dissolution profile, Nigeria.

COLORIMETRIC ASSAY OF ASPIRIN USING MODIFIED METHOD

In this research, we did this qualitative and quantitative study in order to improve the assay of aspirin colorimetrically using visible spectrophotometer. This method depends on aqueous hydrolysis of aspirin and then treating it with the ferric chloride acidic solution to give violet colored complex with salicylic acid, as a result of aspirin hydrolysis, which has a maximum absorption at 530nm. This procedure was applied to determine the purity of aspirin powder and tablet. The results were approximately comparative so that the linearity was observed in the high value of both correlation coefficient (R = 0.998) and Determination Coefficient or Linearity (R 2 = 0.996) while the molar absorpitivity was 1.3×10 3 mole -1 .L.cm -1 . This improvement cancelled the acid or base aided hydrolysis which is widely used during aspirin assay. This method could be also applied to salicylic acid.

Trace element impurity determination in aspirin tablets by INAA

Instrumental neutron activation analysis (INAA) was applied to assess trace element concentrations in six samples of aspirin tablets acquired in Sao Paulo city, Brazil. Concentrations of the elements Br, Ca, Co, Cr, Fe, K, La, Na, Sc and Zn were determined. Comparisons were made between the results obtained with published data for aspirins from foreign countries. Certified reference materials, INCT-MPH-2 Mixed Polish Herbs were analyzed for quality control of the analytical results.

Preparation of Oil of Wintergreen from Commercial Aspirin Tablets. A Microscale Experiment Highlighting Acyl Substitutions

A single-pot procedure for the preparation of methyl salicylate (oil of wintergreen) from commercial aspirin tablets has been developed. The synthesis proceeds via a tandem transesterification–Fischer esterification using acidic methanol and can be carried out using either conventional or microwave heating. The experiment helps demonstrate acyl substitution chemistry while generating student interest in chemistry. The experiment can be performed in approximately three hours, and the product can be used to demonstrate acquisition and interpretation of 1H and 13C NMR spectroscopy.

Determination of Aspirin Tablet Manufacturers by an NMR-based Metabolomic Approach

Aspirin or acetylsalicylic acid, a member of the salicylate family, is frequently used as an analgesic, antipyretic, anti-inflammatory and antiplatelet drug. Because aspirin is chemically unstable in water and heat for tablet formulation, additives including lubricants are used in preparing aspirin tablets, using a dry-granulation process. Aspirin tablets are produced by a number of manufacturers which usually use their own unique combination of additives during the manufacturing process. In this study, we employed an NMR based metabolomics technique to identify the manufacturers of various aspirin tablets. Aspirin tablets from six different companies were analyzed by 1H 400 MHz NMR. The acquired data was then integrated and processed by principal component analysis (PCA). Based on the NMR data, we were able to identify peaks corresponding to acetylsalicylic acid in all of the six samples, whereas different NMR patterns were found in the aromatic and aliphatic regions depending on the unique additive used. These observations led to the conclusion that the differences in the NMR patterns among the different aspirin tablets were due to the presence of additives.

Aspirin and other non-steroidal anti-inflammatory drugs and risk of colorectal cancer: A Danish cohort study

The optimal duration and dose of aspirin and non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) in the potential prevention of colorectal cancer (CRC) have not been established. We examined this issue in the Danish Diet, Cancer, and Health Study. Self-reported NSAID use at entry (January 1995-May 1997) was updated through June 2006, using a nationwide prescription database. CRC incidence was ascertained from nationwide registers. Cox proportional hazards regression was used to compute confounder-adjusted incidence rate ratios (RRs) and 95% confidence intervals (CIs). From 51,053 cohort subjects, we identified 615 CRC cases during 1995-2006. Daily aspirin use at entry was associated with a decreased risk of CRC (RR, 0.73; 95% CI, 0.49-1.10). A similar risk reduction was seen among subjects with 10 or more prescriptions for aspirin or non-aspirin NSAIDs and five or more years of follow-up. Most aspirin prescriptions were for 75-150 mg aspirin tablets. Among non-aspirin NSAID users, only those with body mass index (BMI) above 25 showed risk reductions [RR, 0.69 (0.47-1.03) for 10 or more prescriptions]. Long-term consistent use of aspirin or non-aspirin NSAIDs appears necessary to achieve a protective effect against CRC. Further studies of the effective dose of aspirin and the potential interaction between NSAID use and BMI are warranted.

Feasibility of conducting a primary prevention trial of low‐dose aspirin for major adverse cardiovascular events in older people in Australia: results from the ASPirin in Reducing Events in the Elderly (ASPREE) pilot study

To determine the feasibility of performing a large clinical trial of the use of aspirin for the primary prevention of cardiovascular disease in older participants--the ASPirin in Reducing Events in the Elderly (ASPREE) trial. A randomised double-blind placebo-controlled pilot trial of 100 mg of enteric-coated aspirin tablets daily, in men and women aged 70 years and over who did not have overt cardiovascular disease, and who were followed for 12 months. Participants were identified from the computer databases of general practitioners who were co-investigators in a previous trial. The Melbourne metropolitan area between March 2003 and June 2005. The level of response to participation by GPs; the level of response from potential trial participants; the screening-to-randomisation rate to ensure the recruitment target could be achieved; and the retention of participants in the trial after 12 months. Forty-two GPs (23% of 180 mailed) expressed interest in participating in the pilot trial. Nineteen became co-investigators, of whom six were not required to meet recruitment targets. Letters were sent to 2614 patients, of whom 243 were screened and 209 (86%) were randomly allocated to receive aspirin or placebo. At 12 months,192 (92%) returned for follow-up, and 153 of these (80%) were still taking trial medication. There was a significant reduction in mean haemoglobin level in those taking aspirin. The recruitment strategy for ASPREE, based on methods developed for the conduct of a previous large-scale trial conducted in general practice, was successfully redeployed in this pilot study, with improved efficiency resulting from computerised database searching, telephone pre-screening, a simpler run-in phase and participant familiarity with the trial drug. We conclude that conducting ASPREE in Australian general practice with 18 000 participants is feasible. International Standard Randomised Controlled Trial Number Register ISRCTN83772183.

Tissues

Tissues Brett Kahr Every year, I spend a comparatively large amount of money on tissues. No doubt many householders purchase a few boxes of tissues from time to time, but I do so perhaps more regularly than most. I suspect that the young woman who operates the cash register at Boots the Chemist on Hampstead High Street must find me a bit dotty. Each month, I come into the shop and instead of purchasing shampoo, nail clippers, shaving foam, or aspirin tablets as all the other customers do, I buy six extremely large "Man-Sized" boxes of Kleenex. Although the salesgirl does seem to arch her eyebrow in curiosity, she has never asked me why I need quite so many tissues. Perhaps she has comforted herself with the thought that I have a particularly nasty, lingering head cold, and therefore need to blow my nose many, many times each day. My fellow comrades who work in the mental health field may have their own versions of this story, although I suspect that I buy more tissues than the average workaday psychotherapist. I use these "Man-Sized" Kleenex for two distinct functions. First, as one might expect, I place a box of tissues on the bottom shelf of my bookcase in my consulting room, within easy reach of the patient's leather chair, so that in the event of a sudden stream of weeping, those who feel so inclined can help themselves, and thus stem the tide of tears and mucus. But I also use the tissues for another purpose. Although I do work with patients who sit upright in the chair, and I also see couples and families who, likewise, adopt a vertical posture, I suspect that 65% of my patients use the analytic couch, and hence will lie down. This arrangement suits both me and my patient simultaneously. The couch provides [End Page 299] me with the opportunity to listen very acutely, unencumbered by the need to make eye contact; and the patient, likewise, can engage in the highly special experience of regressing in the service of the ego and embarking upon a magic-carpet ride of rich and intricate free association. Of course, when patients choose to lie down, they invariably rest their heads on a pillow, placed strategically at the upper end of the couch. This raises a very important question of both technique and hygiene: When patients utilise the pillow, do we provide them with some sort of coverlet, and if so, what variety should we offer? My beloved old training analyst used to have a selection of fabric squares which matched the upholstery on the couch. He claimed to have a different square for each patient and would change the squares moments before the arrival of each new analysand. One of my clinical supervisors—a playful Winnicottian—used to have a large and colorful selection of terry cloth towels, one for each patient. Another supervisor—a fervent Kleinian—used no covering at all. Each patient would rest his or her head on the same battered leather pillow for decades on end. I must confess that I warmed to none of these arrangements, and instead I have opted to cover my couch pillow with two large Kleenexes, which can be placed on the pillow shortly before the arrival of the patient and disposed immediately after the end of the session. Perhaps other colleagues have employed a similar system. Certainly, I find this satisfies my need for cleanliness; and although all of my patients seem to have very properly washed hair, some do have marked obsessional tendencies and would balk at having to rest their own heads on a cushion used by other people. Whatever the most felicitous arrangement might be, I have become quite happily accustomed to this one, spreading out two large tissues for each patient just before the start of the analytic session. Thus, I use tissues in a twofold manner—for drying tears, and for resting the head. As the years have unfolded, I have come to realize that the tissues function not only in practical ways, keeping the consulting room protected from dandruff and free from lachrymal floods. They also function as...

Comparison of four laboratory methods to assess aspirin sensitivity

The purpose of this study was to compare the ability of four commercial platelet function assays to detect aspirin response in normal individuals taking 81 or 325 mg aspirin in a single-dose response and then in a 7-day dosing regimen. We employed the Chronolog 570VS whole-blood aggregometer with agonists 1.0 microgram/ml collagen and 0.5 mmol/l arachidonic acid, the PFA-100 epinephrine/collagen cartridge closure time, the Accumetrics Verify/Now arachidonic acid cartridge, and the urine 11-dehydrothromboxane immunoassay normalized to urine creatinine. Fifty normal individuals who met the inclusion criteria were consented in the single-dose study. Blood and urine were collected at baseline, and then each participant was given a 81 mg enteric-coated aspirin tablet. Blood and urine were collected after 24 h. After a minimum of 14 days the process was repeated with a 325 mg aspirin dose. Forty-five individuals were enrolled in the 7-day study. Blood and urine were collected at baseline. Then each participant was given an 81 mg dose of aspirin daily for 7 days. After 7 days, blood and urine specimens were obtained and tested. After a minimum washout period of 14 days the process was repeated using a 7-day regimen of 325 mg enteric-coated aspirin tablet. Student's t-test indicated statistical significance between baseline and post responses in both dosing regimens (P < 0.05). Individuals were not consistently identified as aspirin responsive across all platforms. All assays discriminated between platelet response and nonresponse to aspirin at both dosages. It may be necessary to employ multiple assays to detect individual platelet response.

Concurrent estimation of clopidogrel bisulfate and aspirin in tablets by validated RP-HPLC method

A simple, rapid, precise RP-HPLC method was developed for simultaneous estimation of aspirin and clopidogrel bisulphate in tablet dosage form used in the treatment of cardiovascular diseases. To achieve the maximum resolution, acetonitrile:50 mM potassium dihydrogen phosphate buffer:methanol, solution pH adjusted to 3, in the ratio 50:30:20; v/v was selected as mobile phase. This mixture was found to be appropriate allowing good separation of both the components at a flow rate of 1.5 ml/min and detection wavelength 240 nm. In these conditions clopidogrel bisulfate and aspirin were eluated at the 7.47 and 2.2 min. The linearity was found in the concentration range 1.5-7.5 and 3.5-15.0 μg/ml, respectively. All the analytical validation parameters were determined and found with in the limit as per ICH guideline, which indicates the validity of method.