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Student Nurses’ Community

Student Nurses’ Community

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Published by deric

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Published by: deric on Aug 11, 2009
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07/10/2013

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DRUG STUDY-AspirinDrug NameDosage & RouteActionIndicationAdverse EffectsContraindicationNursing responsibilityAspirin
(
ass'
pir in)
Apo-ASA (CAN),Aspergum, Bayer,Easprin, Ecotrin,Empirin,Entrophen (CAN),Genprin, Halfprin81, 1/2 Halfprin,Heartline,Norwich,Novasen (CAN),PMS-ASA (CAN),ZORprinBuffered aspirinproducts:Alka-Seltzer,Ascriptin,Asprimox,Bufferin, Buffex,MagnaprinClassification:
Antipyretic
Analgesic(nonopioid)
Anti-inflammatory
Antirheumatic
Antiplatelet
Salicylate
NSAID
Available in oral andsuppository forms.Also available aschewable tablets,gum; enteric coated,SR, and bufferedpreparations (SRaspirin is notrecommended for antipyresis, short-term analgesia, or children < 12 yr.)
ADULTS
Minor aches andpains: 325–650mg q 4 hr.
Arthritis andrheumaticconditions: 3.2–6g/day in divideddoses.
Acute rheumaticfever: 5–8 g/day;modify tomaintain serumsalicylate level of 15–30 mg/dL.
TIAs inmen:1,300mg/day individed doses(650 mg bid or 325 mg qid).
MI prophylaxis:75–325 mg/day.Analgesic andantirheumaticeffects areattributable toaspirin's ability toinhibit thesynthesis of prostaglandins,importantmediators of inflammation.Antipyretic effectsare not fullyunderstood, butaspirin probablyacts in thethermoregulatorycenter of thehypothalamus toblock effects of endogenouspyrogen byinhibiting synthesisof theprostaglandinintermediary.Inhibition of plateletaggregation isattributable to theinhibition of plateletsynthesis of thromboxane A
2
, apotentvasoconstrictor and inducer of plateletaggregation. Thiseffect occurs at lowdoses and lasts for the life of theplatelet (8 days).
Mild tomoderate pain
Fever 
Inflammatoryconditions—rheumaticfever,rheumatoidarthritis,osteoarthritis
Reduction of risk of recurrent TIAsor stroke inmales withhistory of TIAdue to fibrinplatelet emboli
Reduction of risk of death or nonfatal MI inpatients withhistory of infarction or unstableangina pectoris
MI prophylaxis
Unlabeled use:Prophylaxisagainstcataractformation withlong-term use
Acute aspirintoxicity:
Respiratoryalkalosis,hyperpnea,tachypnea,hemorrhage,excitement,confusion,asterixis,pulmonary edema,seizures, tetany,metabolic acidosis,fever, coma, CVcollapse, renal andrespiratory failure(dose related, 20–25 g in adults, 4 gin children)
Aspirinintolerance:
Exacerbation of bronchospasm,rhinitis (with nasalpolyps, asthma,rhinitis)
GI:
Nausea,dyspepsia,heartburn,epigastricdiscomfort,anorexia,hepatotoxicity
Hematologic:
Occult blood loss,hemostatic defects
Hypersensitivity:
Anaphylactoidreactions to
Contraindicatedwith allergy tosalicylates or NSAIDs (morecommon withnasal polyps,asthma, chronicurticaria); allergyto tartrazine(cross-sensitivityto aspirin iscommon);hemophilia,bleeding ulcers,hemorrhagicstates, bloodcoagulationdefects,hypoprothrombinemia, vitamin Kdeficiency(increased risk of bleeding)
Use cautiouslywith impairedrenal function;chickenpox,influenza (risk of Reye's syndromein children andteenagers);children with fever accompanied bydehydration;surgeryscheduled within1 wk; pregnancy(maternal anemia,antepartal andpostpartal
BLACK BOXWARNING:
Do notuse in children andteenagers to treatchickenpox or flusymptoms withoutreview for Reye’ssyndrome, a rarebut fatal disorder.
Give drug with foodor after meals if GIupset occurs.
Give drug with fullglass of water toreduce risk of tabletor capsule lodgingin the esophagus.
Do not crush, andensure that patientdoes not chew SRpreparations.
Do not use aspirinthat has a strongvinegar-like odor.
WARNING:
Institute emergencyprocedures if overdose occurs:Gastric lavage,induction of emesis,activated charcoal,supportive therapy.
Teaching points
Take extraprecautions to keepthis drug out of thereach of children;
 
 Student Nurses’ Community
PEDIATRICPATIENTS
Analgesic andantipyretic:65 mg/kg per 24hr in four to sixdivided doses,not to exceed3.6 g/day.Dosagerecommendations by age:
 
Age(yr)Dosage(mg q 4 hr)23162452436832491040511486³ 12648
Juvenilerheumatoidarthritis: 60–110mg/kg per 24 hr in divided dosesat 6- to 8-hr intervals.Maintain a serumlevel of 150–300mcg/mL.
Acute rheumaticfever: Initially,100 mg/kg/day,then decrease toHigher dosesinhibit thesynthesis of prostacyclin, apotent vasodilator and inhibitor of plateletaggregation.anaphylactic shock
Salicylism:
Dizziness, tinnitus,difficulty hearing,nausea, vomiting,diarrhea, mentalconfusion,lassitude (doserelated)hemorrhage,prolongedgestation, andprolonged labor have beenreported; readilycrosses theplacenta; possiblyteratogenic;maternalingestion of aspirin during latepregnancy hasbeen associatedwith the followingadverse fetaleffects: low birthweight, increasedintracranialhemorrhage,stillbirths,neonatal death);lactation.this drug can bevery dangerous for children.
Use the drug onlyas suggested;avoid overdose.Avoid the use of other over-the-counter drugs whiletaking this drug.Many of thesedrugs containaspirin, and seriousoverdose canoccur.
Take the drug withfood or after mealsif GI upset occurs.
Do not cut, crush,or chew sustained-release products.
Over-the-counter aspirins areequivalent. Pricedoes not reflecteffectiveness.
You mayexperience theseside effects:Nausea, GI upset,heartburn (takedrug with food);easy bruising, gumbleeding (related toaspirin's effects onblood clotting).
Report ringing inthe ears; dizziness,confusion;abdominal pain;rapid or difficult

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