Trade name: Aspirin
Classification:
NSAID, Non-narcotic
analgesic, antipyretic, anti-inflammatory, antirhumatic, anti platelet,.
Pregnancy:
(Category C)
Action:
§
The
antipyretic effect is due to an action on the hypothalamus that results in heat
loss by vasodilatation of peripheral blood vessels & promoting sweating.
§
The
anti-inflammatory effects probably by decreasing prostaglandin synthesis &
other mediators of the pain response.
§
The
analgesic action is not fully known but may be due to improvement of the
inflammatory condition .
N.B.: Aspirin also produces
inhibition of platelet aggregation.
Uses:
- Pain -
Myalgia
- Arthralgia -
Headache
- Dysmenorrhea - Antipyretic
(reduce fever)
- Anti-inflammatory
(arthritis, gout, rheumatic fever)
-
To
reduce the risk of recurrent ischemic attacks & strokes in men.
-
Reduction
of risk of death or nonfatal MI in patients with history of infarction or
unstable angina pectoris.
Dose:
As "anti platelet" A single dose of aspirin
150–300 mg is given
As soon as possible after an ischemic event, preferably
Dispersed in water or chewed.
The initial dose is followed by maintenance treatment with
Aspirin 75–150 mg daily.
Anti-inflammatory: 0.3–1 g every 4 hours after food; max.
In acute conditions 8 g daily; CHILD, juvenile
arthritis, up
to 80 mg/kg daily
in 5–6 divided doses after food,
Increased in acute
exacerbations to 130 mg/kg
Note: High doses of aspirin are very rarely required
and are now
Given under specialist
supervision only, and with plasma
Monitoring (especially
in children)
Contraindications:
§
Hypersensitivity
to salicylates.
§
Asthma
in conjunction with anticoagulant therapy.
§
Vitamin
deficiency (risk for bleeding increase with Vitamin K deficiency).
§
Chickenpox
or influenza (potential risk for Reye’s syndrome among children and teenagers).
§
Pregnancy
and lactation.
§
One week
before & after surgery.
§
Patients
receiving anticoagulants.
§
Patients
with bleeding disorders (ie, hemophilia)
§
GI
bleeding or hemorrhage from other sites.
§
History
of GI ulcers.
Side effects:
ü
Children
e chicken pox (rays syndrome).
ü
Heartburn,
nausea, anorexia, occult blood loss..
ü
GI
bleeding, potentation of peptic ulcer.
ü
Bronchospasm.
ü
Anaphylaxis
ü
Skin
rashes.
ü
Increase
bleeding time.
Salicylate toxicity
-
Salicylism: nausea, vomiting, dizziness, tinnitus, difficulty hearing,
diarrhea, mental confusion.
-
Acute
aspirin poisoning: Respiratory alkalosis, hyperpnea, tachpnea, hemorrhage,
confusion, pulmonary edema, convulsion, tetany, metabolic acidosis.
Drug
interactions:
Risk for
bleeding increase if taken with other anticoagulants.
Risk of
GI bleeding increase if taken with steroids, alcohol, or other NSAINDs.
Increased
risk for salicylate toxicity if taken with frusimide (lasix)
Hypotension
may occur if taken with nitroglycerin.
Nursing
considerations:
1. Take drug with or after food or with milk to
decrease GI irritation.
2. Assess for history of asthma and history of
hypersensitivity.
3. Do not use with other anticoagulants.
4. Note any history of peptic ulcer.
5. Report signs of side effect e.g. gastric
irritation if occurs.
6. Aspirin is not given 1 week before &
after surgery to prevent bleeding.
7.
If
patient is diabetic, discuss the possibility of hypoglycemia occurring Patients
should monitor their blood glucose level frequently.
8.
Teaches patient about the toxic symptoms
(ringing in the ears) dizziness, mental
confusion-etc) and
ask him/her to
report it to physician.
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