Acetylsalicylic Acid ' Aspirin ' :
Trade name: AspirinClassification:
Non-narcotic analgesic, antipyretic, anti-inflammatory, antirhumatic, ant platelet,
NSAID.
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 "ant 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:
Children e chicken pox (rays syndrome).
Heartburn, nausea, anorexia, occult blood loss..
GI bleeding, potentation of peptic ulcer.
Bronchospasm.
Anaphylaxis
Skin rashes.
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.
