ASPIRIN

Generic Name ASPIRIN

(ACETYLSALICYLIC
ACID)
Brand Name Alka-Seltzer, A.S.A.,
Aspergum, Astrin ,
Bayer, Bayer
Children's, Cosprin,
Easprin, Ecotrin,
Empirin, Entrophen ,
Halfprin, Measurin,
Novasen , St. Joseph
Children's, Supasa ,
Triaphen-10 , ZORprin

Classification CENTRAL NERVOUS SYSTEM AGENT; ANALGESIC,

SALICYLATE; ANTIPYRETIC; ANTIPLATELET
General Action Major actions appear to be associated primarily with inhibiting the
formation of prostaglandins involved in the production of inflammation,
pain, and fever. Antiinflammatory action: Inhibits prostaglandin synthesis.
As an antiinflammatory agent, aspirin appears to be involved in enhancing
antigen removal and in reducing the spread of inflammation in ground
substances. These antiinflammatory actions also contribute to analgesic
effects. Analgesic action: Principally peripheral with limited action in the
CNS, possibly on the hypothalamus; results in relief of mild to moderate
pain. Antipyretic action: In addition to inhibiting prostaglandin synthesis,
aspirin lowers body temperature in fever by indirectly causing centrally
mediated peripheral vasodilation and sweating. Antiplatelet
action: Aspirin (but not other salicylates) powerfully inhibits platelet
aggregation. High serum salicylate concentrations can impair hepatic
synthesis of blood coagulation factors VII, IX, and X, possibly by inhibiting
action of vitamin K.
Dose and Route Mild to Moderate Pain, Fever
Adult: PO/PR 350–650 mg q4h (max: 4 g/d)
Child: PO/PR 10–15 mg/kg in 4–6 h (max: 3.6 g/d)

Arthritic Conditions
Adult: PO 3.6–5.4 g/d in 4–6 divided doses
 Child: PO 80–100 mg/kg/d in 4–6 divided doses; max 130 mg/kg/d

Thromboembolic Disorders
Adult: PO 81–325 mg qd

TIA Prophylaxis
Adult: PO 650 mg b.i.d.

MI Prophylaxis
Adult: PO 80–325 mg/d
Indications or To relieve pain of low to moderate intensity. Also for various inflammatory
Purposes conditions, such as acute rheumatic fever, Systemic Lupus, rheumatoid
arthritis, osteoarthritis, bursitis, and calcific tendonitis, and to reduce fever
in selected febrile conditions. Used to reduce recurrence of TIA due to
fibrin platelet emboli and risk of stroke in men; to prevent recurrence of
MI; as prophylaxis against MI in men with unstable angina.
Side effects Body as a Whole: Hypersensitivity (urticaria, bronchospasm,
anaphylactic shock (laryngeal edema).
CNS: Dizziness, confusion, drowsiness.
Special Senses: Tinnitus, hearing loss.
GI: Nausea, vomiting, diarrhea, anorexia, heartburn, stomach
pains, ulceration, occult bleeding, GI bleeding.
Hematologic: Thrombocytopenia, hemolytic anemia, prolonged bleeding
time.
Skin: Petechiae, easy bruising, rash.
Urogenital: Impaired renal function.
Other: Prolonged pregnancy and labor with increased bleeding.
Contraindications History of hypersensitivity to salicylates including methyl salicylate (oil of
wintergreen); sensitivity to other NSAIDs; patients with "aspirin triad"
(aspirin sensitivity, nasal polyps, asthma); chronic rhinitis; chronic
urticaria; history of GI ulceration, bleeding, or other problems;
hypoprothrombinemia, vitamin K deficiency, hemophilia, or other
bleeding disorders; CHF. Do not use aspirin during pregnancy (category D),
especially in third trimester; lactation; or in prematures, neonates, or
children under 2 y, except under advice and supervision of physician. Do
not use in children or teenagers with chickenpox or influenza-like illnesses
because of possible association with Reye's syndrome.
Nursing Assessment & Drug Effects
Responsibilities
 Monitor for loss of tolerance to aspirin. The reaction is
nonimmunologic; symptoms usually occur 15 min to 3 h after
 ingestion: profuse rhinorrhea, erythema, nausea, vomiting, intestinal
cramps, diarrhea.
 Lab tests: frequent PT and IRN with concurrent anticoagulant
therapy; more frequent fasting blood glucose levels with diabetes.
 Monitor the diabetic child carefully for need to adjust insulin dose.
Children on high doses of aspirin are particularly prone to
hypoglycemia (see Appendix F).
 Monitor for salicylate toxicity. In adults, a sensation of fullness in
the ears, tinnitus, and decreased or muffled hearing are the most
frequent symptoms associated with chronic salicylate overdosage.
 Monitor children closely because salicylate toxicity is enhanced by
the dehydration that frequently accompanies fever or illness.
Children tend to manifest salicylate toxicity by hyperventilation,
agitation, mental confusion, or other behavioral changes,
drowsiness, lethargy, sweating, and constipation.
 Note: Potential for toxicity is high in older adults and patients with
asthma, nasal polyps, perennial vasomotor rhinitis, hay fever, or
chronic urticaria.

Patient & Family Education

 Do not give aspirin to children or teenagers with symptoms of

varicella (chickenpox) or influenza-like illnesses because of
association of aspirin usage with Reye's syndrome.
 Use enteric-coated tablets, extended release tablets, buffered
aspirin, or aspirin administered with an antacid to reduce GI
disturbances.
 Take aspirin 1–2 d before menses when prescribed for
dysmenorrhea. When experiencing heavy menstrual blood loss, take
another analgesic, such as acetaminophen, instead of aspirin.
 Discontinue aspirin therapy about 1 wk before surgery to reduce
risk of bleeding. Do not use aspirin-containing gum or gargles or
chew aspirin products for at least 1 wk following oral surgery.
 Note: Chronic use of high-dose aspirin during the last 3 mo of
pregnancy can prolong pregnancy and labor, increase maternal
bleeding before and after-delivery, and cause weight increase and
hemorrhage in the neonate.
 Discontinue aspirin use with onset of ringing or buzzing in the ears,
impaired hearing, dizziness, GI discomfort or bleeding, and report
to physician.
 Do not use aspirin for self-medication of pain (adults) beyond 5 d
without consulting a physician. Do not use aspirin longer than 3 d
for fever (adults and children), never for fever over 38.9° C (102° F)
in older adults or 39.5° C (103° F) in children and adults under 60
yrs or for recurrent fever without medical direction.
 Consult physician before using aspirin for any fever accompanied
 by rash, severe headache, stiff neck, marked irritability, or
confusion (all possible symptoms of meningitis).
 Avoid alcohol when taking large doses of aspirin.
 Observe and report signs of bleeding (e.g., petechiae, ecchymoses,
bleeding gums, bloody or black stools, cloudy or bloody urine).
 Maintain adequate fluid intake when taking repeated doses of
aspirin.
 Avoid other medications containing aspirin unless directed by
physician, because of danger of overdosing (there are more than 500
OTC aspirin-containing compounds).
 Do not breast feed while taking this drug.