DRUG STUDY: ASPIRIN (ASA)
Drug Name Drug Classification Mechanism of Action and
Generic Name: Pharmacologic:
Aspirin salicylates
Therapeutic:
Trade Name: antipyretics, nonopioid
analgesics
Zorprin
Bayer Buffered Aspirin Dosage:
Adprin-B Recommended:
Pain/Fever - PO, Rect
(Adults): 325–1000 mg
every 4–6 hr (notmto exceed
4 g/day). Extended-release
tablets—650 mg every 8 hr
or 800 mg every 12 hr.
Inflammation - PO (Adults):
2.4 g/day initially; increase
to maintenance dose of 3.6–
5.4 g/day in divided doses
(up to 7.8 g/day for acute
rheumatic fever).
Janeirah Q. Manalundong
Faculty, College of Health Sciences
Indications
Mechanism of Action:
Produce analgesia and reduce
inflammation and fever by
inhibiting the production of
prostaglandins. Decreases
platelet aggregation.
Therapeutic Effects:
Analgesia. Reduction of
inflammation. Reduction of
fever. Decreased incidence of
transient ischemic attacks and
MI.
Indication(s):
Inflammatory disorders
including: Rheumatoid arthritis,
Osteoarthritis. Mild to moderate
pain. Fever. Prophylaxis of
transient ischemic attacks and
MI. Unlabeled Use: Adjunctive
treatment of Kawasaki disease.
Drug Action
Pharmacokinetics
A: Well absorbed from the
upper small intestine;
absorption from enteric-coated
preparations may be
unreliable; rectal absorption is
slow and variable.
D: Widely distributed. Crosses
the placenta; enters breast milk
M: Extensively metabolized
by the liver. Half-life: 2–3 hr
for low doses; up to 15–30 hr
with larger doses because of
saturation of liver metabolism.
E: inactive metabolites
excreted by the kidneys.
Amount excreted unchanged
by the kidneys depends on
urine pH; as pH increases,
amount excreted unchanged
increases from 2–3% up to
80%.
Drug Effects
Side effects (common by
system):
EENT: tinnitus
GI: dyspepsia, epigastric
distress, nausea, abdominal
pain, anorexia,
hepatotoxicity, vomiting.
Hemat: anemia, hemolysis
Derm: rash, urticaria
Misc: physical dependence,
psychological dependence,
tolerance.
Adverse Reactions
(Serious, life-threatening)
Life-threatening
GI: GI bleeding
Misc: Allergic reactions
including Anaphylaxis
and Laryngeal Edema.
Contraindication
NSG 105: PHARMACOLOGY DRUG STUDY 1
Interactions
(Serious/Common)
Drug – Drug
May increase the risk of
bleeding with warfarin,
heparin, heparin-like agents,
thrombolytic agents,
dipyridamole, clopidogrel,
tirofiban, or eptifibatide,
although these agents are
frequently used safely in
combination and in sequence.
Ibuprofen:
May negate the cardioprotective
antiplatelet effects of
low-dose aspirin.
May increase risk of bleeding
with cefotetan
and valproic acid.
May increase activity of
penicillins, phenytoin,
methotrexate, valproic acid,
oral hypoglycemic agents, and
sulfonamides.
 Prevention of Transient
Ischemic Attacks - PO
(Adults): 50–325 mg once
daily.
Prevention of Myocardial
Infarction/Antiplatelet
Effects - PO (Adults): 80–
325 mg once daily.
Suspected acute MI—160 mg
as soon as MI is suspected.
Janeirah Q. Manalundong
Faculty, College of Health Sciences
Pharmacodynamics Contraindicated in:
Route: P.O Hypersensitivity to aspirin
Onset: 5 – 30 min
or other salicylates;
Peak: 1- 3 hr
Duration: 3 - 6 hr
Cross-sensitivity with other
NSAIDs may exist (less
with non-aspirin
salicylates);
Bleeding disorders or
thrombocytopenia.
NSG 105: PHARMACOLOGY DRUG STUDY 2
Urinary acidification increase
reabsorption and may increase
serum salicylate levels.
Alkalinization of the urine or
the ingestion of large amounts of
antacids increase excretion and
decrease serum salicylate levels.
May blunt the therapeutic
response to diuretics and ACE
inhibitors.
Increase risk of GI irritation with
NSAIDs.
Drug – Food
Foods capable of acidifying the
Urine may increase serum
salicylate levels.
Drug – Laboratory
Monitor hepatic function before
antirheumatic therapy and if
symptoms of hepatotoxicity
occur; more likely in patients,
especially children, with
rheumatic fever, systemic lupus
erythematosus, juvenile arthritis,
or pre-existing hepatic disease.
 May cause increase serum AST,
ALT, and alkaline phosphatase,
especially when plasma
concentrations exceed 25
mg/100 mL.

Treatment of Overdose/
Antidote (if any):
Monitor for the onset of tinnitus,
headache, hyperventilation,
agitation, mental confusion,
lethargy, diarrhea, and sweating.
If these symptoms appear,
withhold medication and notify
health care professional
immediately.

Janeirah Q. Manalundong
Faculty, College of Health Sciences NSG 105: PHARMACOLOGY DRUG STUDY 3
Nursing Process: Aspirin (ASA)
Assessment
▪ Patients who have
asthma, allergies, and
nasal polyps or who are
allergic to tartrazine are
at an increased risk for
developing
hypersensitivity
reactions.
▪ Assess pain and
limitation of movement;
note type, location, and
intensity before and at the
peak after administration.
▪ Assess fever and note
associated signs
(diaphoresis, tachycardia,
malaise, chills).
Janeirah Q. Manalundong
Faculty, College of Health Sciences
Nursing Diagnoses Planning Nursing Interventions with Appropriate Patient Evaluation/ Expected
(Priority Problems) Rationale (Italic) Teaching/Education Outcomes of Care
The patient will: General
▪ Acute pain ▪ Report pain relief or ▪ Exercise extreme caution in ▪ Instruct patient to take ▪ Relief of mild to
▪ Impaired physical decrease in pain intensity administering ASA to children salicylates with a full glass of moderate discomfort.
mobility ▪ Demonstrate and teenagers. ASA has been water and to remain in an
understanding of the implicated in the development of upright position for 15– 30 ▪ Increased ease of joint
drug’s action by Reye’s syndrome in conjunction min after administration. movement. May take 2–
accurately describing with “flu-like” illnesses. 3 week for maximum
drug side effects and Febrile, dehydrated children ▪ Advise patient to report effectiveness.
precautions. can rapidly develop ASA tinnitus; unusual bleeding of
▪ Immediately report toxicity. gums; bruising; black, tarry ▪ Reduction of fever.
effects such as ▪ Monitor vital signs, especially stools; or fever lasting longer
unresolved, untoward or temperature. Increased pulse than 3 days. ▪ Prevention of transient
rebound pain persistent and BP may indicate ischemic attacks.
fever, blurred vision, discomfort: accompanied by ▪ Teach patients on a sodium-
tinnitus, bleeding, and pallor and/or dizziness may restricted diet to avoid ▪ Prevention of MI.
changes in color of stool indicate bleeding. effervescent tablets or
or urine. ▪ Monitor for signs of buffered-aspirin preparations.
gastrointestinal bleeding or Tablets with an acetic
hepatic toxicity. ASA is a local (vinegar-like) odor should be
irritant to the GI tract with discarded.
anticoagulant action that is
metabolized in the liver. ▪ Advise patients on long-term
▪ Monitor gastrointestinal therapy to inform health care
elimination; conduct guiac stool professional of medication
testing for occult blood. regimen before surgery.
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Baseline assessment prior to
administration:
▪ Monitor serum salicylate
levels periodically with
prolonged high-dose
therapy to determine
dose, safety, and efficacy,
especially in children
with Kawasaki disease.
▪ Prolongs bleeding time
for 4–7 days and, in large
doses, may cause
prolonged prothrombin
time. Monitor hematocrit
periodically in prolonged
high dose therapy to
assess for GI blood loss.
Janeirah Q. Manalundong
Faculty, College of Health Sciences
▪ Monitor CBC for signs of
anemia related to blood loss.
▪ Obtain charcter, duration,
location, and intensity of pain
and the presence of
inflammation.
▪ Monitor for allergic responses.
▪ Monitor urinary output and
edema in feet or ankles.
Medication is excreted through
the kidneys. Long term use may
lead to renal dysfunction.
▪ Monitor CBC, BUN< creatine
and urinalysis.
▪ Monitor for sensory changes
indicative of drug toxicity:
tinnitus, blurred vision.
▪ Evaluate blood salicylate levels,
especially in the elderly. Elderly
patients are particularly at risk
due to diminished kidney and
liver function related to aging.
Aspirin may need to be
withheld for 1 week before
surgery.
Side Effects
▪ Caution patient to avoid
concurrent use of alcohol with
this medication to minimize
possible gastric irritation; 3 or
more glasses of alcohol per
day may increase risk of GI
bleeding.
▪ Caution patient to avoid
taking concurrently with
acetaminophen or NSAIDs for
more than a few days, unless
directed by health care
professional to prevent
analgesic nephropathy.
▪ Transient Ischemic Attacks
or MI: Advise patients
receiving aspirin
prophylactically to take only
prescribed dose. Increasing
dose has not been found to
provide additional benefits.
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