Aspirin(ass’ pir in)
Bayer, Bayer Advanced Aspirin, Easprin, Ecotrin, Empirin, Genprin, Halfprin 81, Heartline, Norwich, St. Joseph, ZORprinDNC
Buffered aspirin products:
Adprin-B, Alka-Seltzer, Ascriptin, Bufferin, Buffex
PREGNANCY CATEGORY D
Drug Classes
Analgesic (nonopioid)
Anti-inflammatory
Antiplatelet
Antipyretic
Antirheumatic
NSAID
Salicylate
Therapeutic Actions
Analgesic and antirheumatic effects are attributable to aspirin’s ability to inhibit the synthesis of prostaglandins by inhibiting cyclooxygenase 1 and 2, important mediators of inflammation. Antipyretic effects are not fully understood, but aspirin probably acts in the thermoregulatory center of the hypothalamus to block effects of endogenous pyrogen by inhibiting synthesis of the prostaglandin intermediary. Inhibition of platelet aggregation is attributable to the inhibition of platelet synthesis of thromboxane A2, a potent vasoconstrictor and inducer of platelet aggregation. This effect occurs at low doses and lasts for the life of the platelet (8 days). Higher doses inhibit the synthesis of prostacyclin, a potent vasodilator and inhibitor of platelet aggregation.
Indications
Mild to moderate pain
Fever
Inflammatory conditions—rheumatic fever, rheumatoid arthritis, osteoarthritis, juvenile rheumatoid arthritis, spondyloarthropathies
Reduction of risk of recurrent TIAs or stroke in patients with history of TIA due to fibrin platelet emboli or ischemic stroke
Reduction of risk of death or nonfatal MI in patients with history of infarction or unstable angina pectoris or suspected acute MI
Patients who have undergone revascularization procedures (eg, coronary artery bypass graft [CABG], percutaneous transluminal coronary angioplasty [PTCA], endarterectomy)
Unlabeled uses: Prophylaxis against cataract formation with long-term use; prosthetic valve thromboprophylaxis, Kawasaki disease, antithrombotic therapy in children with Blalock-Taussig shunt and after Fontan procedure
Contraindications and Cautions
Contraindicated with allergy to salicylates or NSAIDs (more common with nasal polyps, asthma, chronic urticaria); allergy to tartrazine (cross-sensitivity to aspirin is common); hemophilia, bleeding ulcers, hemorrhagic states, blood coagulation defects, hypoprothrombinemia, vitamin K deficiency (increased risk of bleeding); Reye syndrome.
Use cautiously with impaired renal function; chickenpox, influenza (risk of Reye syndrome in children and teenagers); children with fever accompanied by dehydration; surgery scheduled within 1 wk; peptic ulcer disease; gout; pregnancy (maternal anemia, antepartal and postpartal hemorrhage, prolonged gestation, and prolonged labor have been reported; readily crosses the placenta; possibly teratogenic; maternal ingestion of aspirin during late pregnancy has been associated with the following adverse fetal effects: low birth weight, increased intracranial hemorrhage, stillbirths, neonatal death); lactation.
Available Forms
Tablets—81, 165, 325, 500, 650, 975 mg; SR tabletsDNC—650, 800 mg; suppositories—120, 200, 300, 600 mg; rapidly dissolving tablets—325, 500 mg
Dosages
Available in oral and suppository forms. Also available as chewable tablets; enteric-coated, SR, and buffered preparations (SR aspirin is not recommended for antipyresis, short-term analgesia, or children younger than 12 yr).
Adults
Ischemic stroke, TIA: 50–325 mg/day.
Angina, recurrent MI prevention: 75–325 mg/day.
Suspected MI: 160–325 mg as soon as possible; continue daily for 30 days.
CABG: 325 mg 6 hr after procedure, then daily for 1 yr.
PTCA: 325 mg 2 hr before procedure, then 160–325 mg/day.
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