Aspirin
Indications
Aspirin is indicated in the following indications-
- Prophylaxis against arterial occlusive events: Myocardial infarction, myocardial re-infarction, after bypass surgery, acute ischaemic stroke/TIA.
- Mild to moderate pain: Headache, muscle pain, dysmenorrhoea and toothache etc.
- Chronic disease accompanied by pain and inflammation: Osteoarthritis.
- Antipyretic: Cold fever and influenzae.
Pharmacology
By decreasing platelet aggregation, Aspirin
inhibits thrombus formation on the arterial side of the circulation,
where thrombi are formed by platelet aggregation and anticoagulants have
little effect. Aspirin is the analgesic of choice for headache,
transient musculoskeletal pain and dysmenorrhoea. It has
anti-inflammatory and antipyretic properties, which may be useful.
Enteric-coated Aspirin reduces intestinal disturbance and
gastrointestinal ulceration due to aspirin.
Dosage & Administration
Pain, inflammatory diseases and as antipyretic: Aspirin 300 mg 1-3 tablets 6 hourly with a maximum daily dose of 4 gm.
Suspected acute coronary syndrome: 150 mg-300 mg immediately unless there are clear contraindications.
After myocardial infarction: Aspirin 150 mg daily for 1 month. Long-term use of aspirin in a dose of 75 mg daily is recommended thereafter.
Acute ischaemic stroke/Transient ischaemic stroke (TIA): The starting dose is 150 mg-300 mg daily and Aspirin 75 mg daily thereafter.
Following bypass surgery: 75 mg-300 mg daily starting 6 hours post-procedure.
Suspected acute coronary syndrome: 150 mg-300 mg immediately unless there are clear contraindications.
After myocardial infarction: Aspirin 150 mg daily for 1 month. Long-term use of aspirin in a dose of 75 mg daily is recommended thereafter.
Acute ischaemic stroke/Transient ischaemic stroke (TIA): The starting dose is 150 mg-300 mg daily and Aspirin 75 mg daily thereafter.
Following bypass surgery: 75 mg-300 mg daily starting 6 hours post-procedure.
Interaction
Salicylates may enhance the effect of
anticoagulants, oral hypoglycaemic agents, phenytoin and sodium
valporate. They inhibit the uricosuric effect of probenecid and may
increase the toxicity of sulphonamides. They may also precipitate
bronchospasm or induce attacks of asthma in susceptible subjects.
Contraindications
Aspirin is contraindicated to the children
(Reye's syndrome) less than 12 years, in breast-feeding and active
peptic ulcer. It is also contraindicated in bleeding due to haemophilia,
intracranial haemorrhage and other ulceration.
Side Effects
Side effects for the usual dosage of
Aspirin are mild including nausea, dyspepsia, gastrointestinal
ulceration and bronchospasm etc.
Pregnancy & Lactation
It is especially important not to use
aspirin during the last 3 months of pregnancy unless specifically
directed to do so by a doctor because it may cause problems in the
unborn child or complications during delivery. Aspirin penetrates into
breast milk. So, it should be administered with caution to lactating
mothers.
Precautions & Warnings
It should be administered cautiously in
asthma, uncontrolled blood pressure, and pregnant women. It should be
administered with caution to patients with a nasal polyp and nasal
allergy.
Overdose Effects
Overdosage produces dizziness, tinnitus,
sweating, nausea and vomiting, confusion and hyperventilation. Gross
overdosage may lead to CNS depression with coma, cardiovascular collapse
and respiratory depression. If the overdosage is suspected, the patient
should be kept under observation for at least 24 hours, as symptoms and
salicylate blood levels may not become apparent for several hours.
Treatment of overdosage consists of gastric lavage and forced alkaline
diuresis. Haemodialysis may be necessary in severe cases.
Therapeutic Class
Anti-platelet drugs
Storage Conditions
Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.
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