Aspirin (Bayer, Ecotrin, St. Joseph, Norwich, Easprin, Zorprin)

Category:

  • Miscellaneous

Description:

  • Nonnarcotic analgesic, anti-inflammatory, antiplatelet agent, antipyretic

Indications:

  • Mild to moderated pain/fever, inflammatory conditions such as rheumatoid arthritis and osteoarthritis, rheumatic fever

  • Thromboembolic disorders

  • Reducing risk of transient ischemic attacks; reducing risk of death or nonfatal MI in patients with previous MI or unstable angina

Contraindications:

  • Hypersensitivity to salicylates, NSAIDs, or tartrazine (FDA yellow dye #5)

  • GI bleeding, hemophilia, hemorrhagic states

Precautions:

  • Pregnancy category C (D in full doses during 3rd trimester)

  • Anemia, asthma, nasal polyps, nasal allergies, hepatic disease, renal disease

  • Pre/postoperatively, children/teenagers with flu-like symptoms (may be associated with the development of Reye’s syndrome)

  • Gout, history of coagulation defects, bleeding disorders

Adverse Reactions (Side Effects):

  • CNS: confusion, dizziness, drowsiness, headache

  • EENT: dimness of vision, reversible hearing loss, tinnitus

  • GI: acute reversible hepatotoxicity, anorexia, cholestasis, dyspepsia, epigastric discomfort, GI bleeding, heartburn, nausea, increased aminase levels

  • HEME: hyperuricemia (low dose), hyperuricemia (high dose), leukopenia, prolonged bleeding time, shortened erythrocyte survival time, thrombocytopenia

  • METAB: hypoglycemia, hypokalemia, hyponatremia

  • RESP: hyperpnea, wheezing

  • SKIN: angioedema, bruising, hives, rash, urticaria

 

Dosage:

Administered orally and rectally

  • Adult:            

    • Arthritis: PO 2.6-5.2 g/day in divided doses every 4-6 hours

    • Pain/fever: PO/PR 325-650mg every 4 hours as needed, not to exceed 4g daily

    • Transient ischemic attacks:

      • 325-650mg 1-2 times daily (325mg daily may be as effective as larger doses and associated with fewer side effects)

    • MI prophylaxis: PO 165-325mg daily

  • Child:            

    • Arthritis: PO 60-90 mg/kg per day in divided doses; usually maintenance dose 80-100 mg/kg daily divided every 6-8 hours; maintain serum salicylate level of 150-300 mcg/ml

    • Pain/fever: PO/PR 10-15 mg/kg per dose every 4-6 hours as needed

Drug Interactions:

  • Methotrexate: increased serum concentration and enhanced methotrexate toxicity

  • Oral anticoagulants: increased risk of bleeding by inhibiting platelet function and possibly by producing gastric erosions

  • Warfarin: enhanced hypoprothrombinemic effect of warfarin

Note:

  • Not to be given to children with flu-like symptoms, Reye’s syndrome may develop

  • Therapeutic response may take two weeks (arthritis)

  • Administer with food

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