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Aspirin is a nonsteroidal antiinflammatory drug that irreversibly inhibits the COX or cyclooxygenase enzymes. Low doses of aspirin target COX1 preferentially, while high doses of aspirin target both COX1 and COX2. COX enzymes typically produce prostaglandins and thromboxanes, so aspirin works to inhibit production of these inflammatory derivatives. Aspirin is clinically used as an analgesic, antiinflammatory, and antipyretic agent. Importantly, aspirin is used as an antiplatelet agent, reducing formation of blood clots that lead to complications like myocardial infarction or stroke. Aspirin is also often given with niacin to reduce the side effect of cutaneous flushing. Finally, aspirin helps reduce the risk of colon cancer by suppressing the growth of adenomatous polyps. A common side effect of aspirin use is the development of GI ulcers. Acute overdose leads to findings of tinnitus and metabolic acidosis. Importantly, aspirin should be avoided in children with febrile illnesses due to the risk of causing Reye’s syndrome, or aspirinmediated liver failure.

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