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ACETYLSALICYLIC ACID (Aspirin)

CLASS:

  • Non-Narcotic Analgesic

  • Antipyretic

  • Salicylate

ACTIONS:

  • A. nonsteroidal salicylate that inhibits prostaglandin synthesis-thus reducing inflammatory response and intensity of pain.

  • Acts on the hypothalamus heat-regulating center- thus decreasing fever (antipyretic)

  • Blocks the production of thromboxane A2, which stimulates platelet aggregation, and causes arteries to constrict (ACLS)- thus by blocking it, inhibits platelet aggregation and constriction of these arteries.

INDICATIONS:

  • Chest pain with suspected myocardial infarction / ACS

  • Fever or needed anti-inflammatory

  • Kawasaki’s disease

CONTRAINDICATION:

  • Children and teenagers with chicken pox and flu syndrome because of the potential of causing Reye's syndrome (a combination of acute encephalopathy and fatty infiltration of internal organs that may follow acute viral infections)

  • Gastric or peptic ulcer disease

  • Last trimester of pregnancy

  • Hypersensitivity

DOSE/ROUTE

  • Usual dose is 160 - 325 mg for AMI protocol

STANDARD PREP:

  • 81 mg chewable tablet, 325 mg tablet

SIDE EFFECTS:

  • Anaphylaxis / Angioedema

  • GI bleed

  • Stomach pain / Nausea and Vomiting

  • Tinnitus / Deafness

PRECAUTION:

  • May prolong gestation and labor with resultant birth complications - if given in last trimester

*Ingestion of <150mg/kg may cause mild toxicity- N/V, GI irritation
Ingestion of 150-300mg/kg may produce moderate toxicity- N/V tachypnea, diaphoresis, tinnitus, acid-base disturbances. >300mg/kg will cause severe toxicity.

*Salicylate toxidrome- tinnitus, tachypnea (respiratory alkalosis followed by metabolic acidosis) Vomiting, dehydration, AMS (confusion), Sz, fever (rare).

*Ibuprofen OD- Life threatening can occur with ingestion of 400mg/kg or more. Mild s/sx may occur with doses of 150mg/kg