Vocalist.org archive


From:  "John Messmer, M.D." <jjm23@p...>
Date:  Sat Nov 30, 2002  3:44 pm
Subject:  RE: [vocalist] Osteoarthritis drugs and voice

You quoted my previous post on NSAID's and their effects. Aspirin's
effects are to block the enzymes COX-1 and COX-2 as are most other
NSAID's (Vioxx, Celebrex and Bextra affect COX-2 with almost no effect
on COX-1). COX-2 is involved in inflammation so when it is inhibited,
pain is reduced.

A form of COX-1 in the stomach produces a chemical which protects the
lining of the stomach so if it is inhibited, acid can damage the
stomach. Another form of COX-1 is in platelets and makes a chemical
that allows platelets to stick together and plug leaks in blood vessels.
NSAID's that block COX-1 can increase bleeding since platelets do not
stick together well.

The difference between aspirin and other NSAID's is that aspirin's
effect is permanent for the entire life of the platelet (ten days) while
other NSAID's stop working as they leave the system (hours). We make
platelets constantly, but one dose of aspirin as small as 40 mg (one
eighth of a regular aspirin) will inhibit every platelet in circulation
at the time of dosing. It can take days to make enough platelets to
overcome this effect.

As a singer, you can take aspirin with no effect at all on your vocal
folds. The problem arises with abuse of the voice which can irritate
the folds and cause bleeding. With platelets inhibited, the bleeding
and swelling can be worse.

A fairly healthy person can take aspirin and other NSAID's without
stomach injury. Some people have less COX-1 activity than others and
are more susceptible to the adverse stomach effects. Smoking, alcohol,
illness, stress, diabetes, age, other medications can combine to weaken
the stomach and increase the adverse effects of NSAID's. Each person
must consult his/her own doctor for specific recommendations.

John

John Messmer, M.D.
Assistant Professor, Family and Community Medicine
Penn State Hershey Medical Center



> -----Original Message-----
> From: norma bowen [mailto:normasings2000@y...]
> Sent: Saturday, November 30, 2002 6:36 AM
> To: vocalist-temporary@yahoogroups.com
> Subject: RE: [vocalist] Osteoarthritis drugs and voice
>
>
>
> What is the effect of aspirin on the mucosal tissue of the
> stomach and the vocal fold?





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