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Presentation of Aspirin
Indications of Aspirin
Suspected AMI or myocardial ischaemia even if pain free
Contra-Indications of Aspirin
- Known severe adverse reaction
- Bleeding disorders
- Current GI bleed or peptic ulcers
- Children less than 12
Pharmacology of Aspirin
Aspirin works by assisting in inhibiting the synthesis of prostaglandins and thromboxane in the circulating platelets. This antithrombotic action forms the basis of preventing platelets from aggregating to exposed collagen fibres at sites of vascular injury.
Metabolism of Aspirin
Aspirin is converted to salicyclic acid in many tissues but primarily in the GI mucosa and liver and excreted by the kidneys.
Precautions of Aspirin
- Possible AAA or other condition requiring surgery
- Hx of peptic ulcers or GI bleeding
- Concomitant anti-coagulent therapy-does not apply to Clopidogrel
Side effects of Aspirin
- Epigastric pain/discomfort
- GI bleeding
- Bronchoconstriction in some asthmatics
Drug effect of Aspirin
10 minutes but frequently depends on stomach contents
Anti-platelet action - lasting several days
Dosage of Aspirin
300mg orally, chewed and followed with water
Pt's who have had less than 300mg Aspirin in the previous 24 hours and present with suspected cardiac ischaemia or AMI, even if pain free, should be given a dose that equates to a daily dose of 300-450mg.
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