Aspirin

Question 1

What is aspirin?

Answer 1

prototypical analgesic to treat mild-mod pain.
contains anti-infam and anti-pyretic properties.
Inhibits platelet aggregation.

Question 2

What class of drugs does aspirin belong to?

Answer 2

anticoagulant
antithrombotic
simple analgesic and antipyretics

Question 3

What are other drugs in the same class as aspirin?

Answer 3

anticoagulant:
tirofiban HCl
Anagrelide HCl 
bivalirudin
clopidogrel
enoxaparin
warfarin

analgesic:
paracetamol

Question 4

What is aspirin indicated for?

Answer 4

mild-mod pain
pyrexia
prevention of thrombrotic, CVD and CBD
acute thrombotic conditions

Question 5

What is the mechanism of aspirin?

Answer 5

the acetyl and salicylate parts of the molecule as well as the active salicylate metabolite cause the analgesic, antipyretic and anti-inflammatory effects.

Aspirin directly and irreversibly inhibits COX 1 and COX2 decreasing the formation of the precursors of prostaglandins and thromboxanes from arachidonic acid.

Antiplatelet effect is due to aspirin being able to act as an acetyl donor to COX irreversible acetlation makes the COX enzyme inactive so cannot form aggregating agents in platelets.

Question 6

What is the dose of aspirin for prevention of thrombotic CBD and CVD?

Answer 6

oral: 75-100mg OD

Question 7

What is the dose of aspirin after coronary artery by-pass surgery?

Answer 7

oral: 75-300mg OD

Question 8

What is the dose of aspirin given for acute thrombotic conditions?

Answer 8

oral: 150-300mg at once or daily or follow local protocol

Question 9

What are the precautions with aspirin treatment?

Answer 9

Asthma
uncontrolled HT
Allergic disease
Dehydration
Elderly
G6PD deficiency
Concomitant use with drugs that increase risk of bleeding
Anaemia
Thryotoxitosis
Pregnancy class C: high doses related to intrauterine growth restriction and teratogenicity.
compatible with breastfeeding in occasional doses but avoid long term therapy if possible.

Question 10

What are the contraindications with aspirin use?

Answer 10

children s syndrome)
previous/active peptic ulceration
hamophilia
severe cardiac failure
NOT FOR TREATMENT OF GOUT

hypersensitivity to aspirin and other NSAIDs

Question 11

What are the adverse effects with aspirin use?

Answer 11

GI discomfort, nausea, bleeding, activation of peptic ulcer, bronchospasm, skin reactions in hypersensitive patients.

dizziness, tinnitus, vertigo, deafness, increased bleeding time, hypothrombinaemia, thrombocytopaenia have also been reported

Question 12

What are the interactions with aspirin?

Answer 12

increased risk of toxicity with acetazolamide, methotrexate,

increased risk of bleeding with SSRIs, Coumarins, heparins, phenindione and venlafaxine.

Question 13

What are the alarm bells associated with aspirin use?

Answer 13

Minimise dose in elderly and patients with renal impairment
Avoid in severe hepatic impairment
monitor platelet levels