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In which aspect, Salicylate is different from NSAIDs? [Select ALL THAT APPLY]

a. May provide greater pain control with equivalent doses.
b. May cause more GI side effects than NSAIDs.
c. Inhibits prostaglandin synthesis irreversibly; where NSAIDs do reversibly.
d. May cause more renal damage than NSAIDs.
e. May increase the risk of bleeding more compared to NSAIDs.

Answer (b,c): Salicylates, like NSAIDs, work by inhibiting prostaglandin synthesis by inhibiting both COX-1 and COX-2 enzymes; however, salicylates do so in an irreversible manner, while NSAIDs do so reversibly.

Absorption in the gut is affected by the dosage form, gastric pH, gastric emptying time, dissolution rate, and food/antacids.

Aspirin is widely bioavailable with an onset of analgesia within 30 minutes and lasting 4 to 6 hours.

FDA-approved uses for salicylates include treatment of symptoms for osteoarthritis, rheumatoid arthritis, and other rheumatologic diseases, as well as temporary relief of minor aches and pains associated with backache or muscle aches.

High-dose aspirin (900-1000 mg) has been established as an effective treatment option for acute migraine.

Aspirin causes dyspepsia and GI irritation even more frequently than OTC NSAIDs.

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