Aspirin

Question 1

What is the dose for secondary prevention?

Answer 1

75mg daily

Question 2

What is the dose for management of unstable angina and NSTEMI, STEMI (heart attacks)?

Answer 2

300mg chewed or dispersed in water

Question 3

What is the dose for transient ischaemic attack (long-term treatment in combo with dipyridamole), ischaemic stroke not associated with AF?

Answer 3

75mg od

Question 4

What is the dose for acute ischaemic stroke?

Answer 4

300mg od for 14 days, to be initiated 24 hours after thrombolysis or as soon as possible within 48 hours of symptom onset

Question 5

What is the dose for AF following a disabling ischaemic stroke (as stroke requiring inpatient rehabilitation or skilled nursing care.) ?

Answer 5

300mg od for 14 days

Question 6

What is the dose for mild-moderate pain/pyrexia?

Answer 6

300-900mg every 4-6 hours as required, max 4g per day

Question 7

What is the dose for acute migraine?

Answer 7

900mg for one dose, to be taken as soon as migraine symptoms develop

Question 8

What is the dose for prevention of pre-eclampsia in women?

Answer 8

75-150mg od from 12 weeks gestation until the birth of the baby

Question 9

What are the contraindications?

Answer 9

Active peptic ulceration, bleeding disorders, children <16yrs (risk of reye’s syndrome), haemophilia, previous peptic ulceration, severe cardiac failure

Question 10

What are the cautions?

Answer 10

Allergic disease, anaemia, asthma, elderly, G6PD deficiency, thyrotoxicosis

Question 11

What are the drugs that interact with aspirin - increase the risk of bleeding when given with aspirin?

Answer 11

alteplase, apixaban, dabigatran, dalteparin, danaparoid, enoxaparin, nicotinic acid, phenindione, rivaroxaban, warfarin

Question 12

What are the drugs that interact with aspirin -increases the risk of acute renal failure?

Answer 12

Bendroflumethiazide, chlorothiazide, clodronate, hydrochlorothiazide, hydroflumethiazide, indapamide

Question 13

What is a big interaction with aspirin?

Answer 13

Methotrexate - aspirin is predicted to increase the toxicity

Question 14

What are the common s/e of aspirin?

Answer 14

Dyspepsia, haemorrhage. Dyspnoea, severe cutaneous adverse reactions, skin reactions. aplastic anaemia, renal impairment, granulocytosis, thrombocytopenia, hearing loss, hyperuricaemia, iron deficiency anaemia

Question 15

What are the symptoms with aspirin overdose?

Answer 15

Hyperventilation, tinnitus, deafness, vasodilation, sweating

Question 16

Pregnancy?

Answer 16

With caution during third trimester, impaired platelet function and risk of haemorrhage, delayed onset and increased duration of labour with increased blood loss; avoid analgesic doses if possible in last few weeks. High-doses may be related to intra-uterine growth restriction, teratogenic effects

Question 17

Breast feeding?

Answer 17

Avoid - possible risk of reye’s syndrome

Question 18

Hepatic impairment?

Answer 18

Use with mild-moderate impairment, avoid in severe impairment

Question 19

Renal impairment?

Answer 19

Use with caution, avoid in severe impairment; sodium and water retention; deterioration in renal function; increased risk of GI bleeding

Question 20

Dental practitioners formulary?

Answer 20

aspirin dispersible tablets 300mg may be prescribed

Question 21

exceptions to legal category?

Answer 21

can be sold to the public provided packs contain no more than 32 capsules or tablets, pharmacists can sell multiple packs up to a total quantity of 100 capsules or tablets

Question 22

What are the cautionary and advisory labels with aspirin?

Answer 22

take with food or just after a meal, contains aspirin do not take anything else containing aspirin. gastro-resistant prep - do not take indigestion remedies 2 hours before or after you take this medicine, swallow this medicine whole do not chew or crush