ASPIRIN

Question 1

Aspirin - what type of drug is it?

Answer 1

Antiplatelet drug (NSAID)

Question 2

Aspirin - what are the indications for its use (treatment)?

Hint: 2 things

Answer 2

For treatment of:
→ Acute coronary syndrome (ACS) - part of MONA
→ Acute ischaemic stroke

Question 3

Aspirin - what are the indications for its use (prevention)?

Hint: 3 things

Answer 3

For long-term SECONDARY PREVENTION of thrombotic arterial events in patients with:
→ Cardiovascular disease
→ Cerebrovascular disease
→ Peripheral arterial disease

Question 4

Aspirin - administration?

Answer 4

Orally

After food to minimise gastric irritation

Question 5

Aspirin - what should be considered in patient with high risk gastro complications who are taking low-dose aspirin

Answer 5

In patients with high risk gastro complications who are taking low dose aspirin, gastroprotection such as Omeprazole (20mg) should be considered

Question 6

Aspirin - does antiplatelet action of aspirin work better at high doses or low doses?

Answer 6

Low doses

Question 7

Aspirin - mechanism of action?

Answer 7

1. Aspirin irreversibly inhibits cyclooxygenase (COX)
2. This reduces the production of pro-aggregatory factor thromboxane
3. This reduces platelet aggregation and therefore reduces the risk of arterial occlusion (blockage).

Question 8

Aspirin - adverse effects (most common)

Answer 8

MOST COMMON : GI irritation

Nausea
Abdominal pain
Vomiting

Question 9

Aspirin - adverse effects (more serious/life-threatening)

Answer 9

MOST SERIOUS:
→ Peptic ulceration

→ Haemorrhage

→ Bronchospasm

→ Tinnitus

LIFE-THREATENING
→ Overdose

Question 10

Aspirin - interactions

Answer 10

Aspirin can be taken with other antiplatelet drugs but in some situations (e.g.- ACS) CAUTION is required due to an increased risk of bleeding

Therefore, CAUTION is required with:
→ other antiplatelet drugs (e.g.- Clopidogrel)
→ anticoagulants (e.g.- Heparin, Warfarin)

Question 11

Aspirin - cautions

Answer 11

CAUTION in individuals with:
→ peptic ulcerations
Note: prescribe gastroprotection alongside

→ gout
why? may trigger an acute attack

Question 12

Aspirin - contraindications

Answer 12

AVOID in these individuals:
→ <16 years old
Why? Risk of Reye’s syndrome (affects liver and brain) which is life-threatening

→ aspirin hypersensitivity
Note: these are individuals who have had bronchospasms or other allergic reaction due to aspirin or other NSAIDs

→ third trimester of pregnancy
Why? leads to premature closure of ductus arteriosus in baby

Question 13

Aspirin - why do we avoid aspirin in patients <16 years old

Answer 13

Risk of Reye’s syndrome (affects liver and brain) which is life-threatening

Question 14

Acute ischaemic stroke management

Answer 14

300mg aspirin for 2wks

75mg clopidogrel life-long