ASPIRIN

Question 1

Main indications for aspirin

Answer 1

1. ACUTE - ACS & stroke (300mg)
2. SECONDARY PREVENTION - MI, stroke, PAD (75mg)

Sometimes used for pain, but other NSAIDs preferred

Question 2

How does aspirin work? What class of drug is it?

Answer 2

NSAID

Inhibits COX - preventing platelet aggregation - lasts the entire lifecycle of the platelet

Question 3

ADRs of aspirin

Answer 3

GI bleeding
Peptic ulcers (reduces mucosal protection in stomach)
Tinnitus (in large doses)
Bronchospasm

Question 4

When should aspirin be avoided?

Answer 4

• Children <16 (Reye’s syndrome)
• 3rd trimester of pregnancy - closure of PDA
• Aspirin hypersensitivity (bronchospasm in asthma)

Question 5

When should aspirin be used with caution?

Answer 5

• Peptic ulcers
• Asthma (bronchospasm - depends on sensitivity to other NSAIDs)
• Uncontrolled htn

Question 6

Aspirin and its interactions with other drugs

Answer 6

Synergistic effect with other anticoags (heparin, warfarin) and antiplts (clopidogrel) = ++ bleeding risk

SSRIs = ++ bleeding risk

NSAIDs = renal impairment

Question 7

What should aspirin be co-prescribed with in at risk people?

Answer 7

Give with PPI - Omeprazole 20mg OD - reduces risk of GI bleeding

Question 8

Administration instructions

Answer 8

Take after food to minimise gastric irritation

Question 9

What other drug may it have a potential interaction with?

Answer 9

DO NOT GIVE WITH ACE-is
NSAIDs constrict AA & ACEi’s dilate EA

Together = reduce hydraulic pressure in glomerulus > low GFR = renal damage/failure