Generic Name: Trade Name:

aspirin Bayer Aspirin, Bufferin, Ecotrin, Equaline, Good Sense Aspirin, Halfprin, St. Joseph's Children's, St. Joseph's Adult, Walgreen's Aspirin

Mechanism of Action:
Blocks pain impulses in CNS, reduces inflammation by nhibition of prostaglanding synthesisantipyretic action results from vasodilation of peripheral vessels, decreases platelet aggregation

Classification:

Nonopiod analgesic, nonsteroidal Uses: Mild to moderate pain or fever including RA, antiinflammatory, antipyretic, osteoarthritis, thromboembolic disorders; TIAs, rheumatic antiplatelet fever, post MI, prophylaxis of MI, ischemic stroke, angina, acute MI Available Forms: Tabs 81, 325, 500, 650, 800 mg; chewable tabs 81 mg; supp 300, Administer: DO not break crush or chew enteric product; 600 mg; gum 227 mg; enteric hr before planned exercise; with food or milk to decrease coated tabs 81, 325, 500, 975 GI upset; with 8 oz water; sit upright to facilitate product mg; ext rel tabs 800 mg; del rel passing into stomach tabs 325, 500 mg

Dose:

Arthritis: Adult PO: 3 g/day in divided doses q4-6hr Child >25 kg (55 lbs): PO/RECT 90-130 mg/kg/day in divided doses Pain/Fever: Adult PO/RECT: 325-650 mg/ q4hr prn, max 4 g day Child 2-11 yr: PO 10-15 mg/kg/dose q4hr, max 4 g/day

Thromboembolic disorders: Adult: PO 325-650 mg/day or bid Transient Ischemic attacks (risk): Adult: PO 50-325 mg/day (grade 1A) Evolving MI with ST segment elevation (STEMI): Adult: PO 160-325 mg nonenteric, chewed and swallowed immediately, maintenance 75-162 mg daily MI, stroke prophylaxis: Adult: PO 50-325 mg/day Prevention of recurrent MI: Adult: PO 75-162 mg/day

Onset: Peak: Half-life: Duration: Route: Elimination:

PO: 15-30 min; RECT: onset slow 1-2 hr 15-20 min, up to 9 hr in large dose 4-6 hr, well absorbed By mouth or rectally

CABG: Adult: PO 75-325 mg/day starting 6hr postprocedure, continue for 1 yr PTCA: Adult: PO 325 mg 2 hr before surgery

Common Side Effects:

CNS: Stimulation, drowsiness, dizziness, confusion, seizures, headache, flushing, hallucinations, coma; CV:Rapid pulse, pulmonadry edema; EENT: Tinnitus, hearing loss; ENDO: hypoglycemia, hyponatremia, hypoalkemia; GI: Nausea, vomiting, GI bleeding, diarrhea, heartburn, anorexia, hepatitis; HEMA: Thrombocytopenia, agranulocytosis, leukopenia, neutropenia, hemolytic anemia, increased PT, aPTT, bleeding time; INTEG: Rash, urticaria, bruising; RESP: wheezing, hyperpnea; SYST: Reye's syndrome (children), anaphylaxis, laryngeal syndrome

Time/Frequency: See dosage

Enteric metabolized by liver; inactive metabolites excreted by kidneys; ; crosses placenta, excreted in breast milk

Contraindications: Pregnancy (D) 3rd trimester, breastfeeding, children <12 yr, children with flulike symptoms, hypersensitivity to salicylates, tartrazine GI bleeding, bleeding disorders, vit K deficiency, peptic ulcer, acute bronchospasm, agranulocytosis, increased intracranial pressure, intracranial bleeding, nasal polyps, urticaria Precautions: Abrupt discontinuation, acetaminophen/NSAIDs hypersensitivity, acid/base imbalance, alcoholism, ascites, asthma, bone marrow suppression in elderly patients, dehydration, G6PD deficiency, gout, heart failure, anemia, renal/hepatic diseaase, pre/postoperatively, gastritis

Interactions: Increase: gastric ulcer corticosteroids, antiinflammatories, NSAIDs, alcohol; Increase: bleeding alcohol, plycamicin, cefamandole, thrombolytics, ticlopidine, clopidogrel, tirofiban, eptifibatide, anticoagulants; Increase: effects of warfarin, insulin, methotrexate, thrombolytic agents, penicillins, phenytoin, valproic acid, oral hypoglycemics, sulfonamides; Increase: hypostension nitroglycerin; Decrease effects of aspirin: antacids (high doses), urinary alkalizers, corticosteroids, Decrease: antihypertensive effect ACE inhibitors; Decrease: effects of probenecid, spironolactone, sulfinpyrazone, sulfonamides, NSAIDs, -blockers, loop diuretics Drug/Herb: Increase: risk of bleeding: feverfew, garlic, ginger, ginko, ginseng, horse chestnut; Drug/Food: Increase risk of bleeding fish oil (omega-3) Nursing Implications: Assess: Pain: character, location, intensity, ROM before and 1 hr after administration; Fever: temp before and 1 hr after administration; Hepatic studies; Renal studies; Blood studies; Allergic reactions: rash, urticaria; patients with asthma, nasal polyps: severe allegic reaction may occur; Ototoxicity: Tinnitus, ringing, roaring in ears; Salicylate level, Edema in feet, ankles, legs; Hepatotoxicity: dark urine, clay-colored stools, yellowing of skin, sclera, itching, abdominal pain, fever, diarrhea; Product history; many product interactions may occur Evaluate: Therapeutic Response: decreased pain, inflammation, fever Patient Teaching: To report any symptoms of hepatotoxicity, renal toxicity, visual changes, ototoxicity, allergic reactions, bleeding; to avoid if allergic to tartrazine; not to exceed recommended dosage acute poisoning may occur; to avoid alcohol GI bleeding may occur; That medication is not to be given to children and teenagers with flulike symptoms or chickenpox because Reye's syndrome may develop