Ranger Medic Handbook by Defense

Author:Defense
Language: eng
Format: epub
Publisher: Skyhorse Publishing
Published: 2014-09-16T16:00:00+00:00

2. ACETYLSALICYLIC ACID (ASPIRIN)

Class: CNS agent – NSAID; salicylate; anti-inflammatory, analgesic, antipyretic

Action: Inhibits prostaglandin synthesis involved in the production of inflammation, pain, and fever; enhances antigen removal and reduces spread of inflammation; peripheral analgesic action with limited CNS action in the hypothalamus; antipyretic by indirect centrally mediated peripheral vasodilation and sweating; powerfully inhibits platelet aggregation and ability of blood to clot; high levels can impair hepatic synthesis of blood coagulation factors VII, IX, and X, possibly by inhibiting action of vitamin K

Dose: 325-650 mg PO/PR q4-6h (max: 4 g/d); MI prophylaxis PO 80-325 mg/d (chewable or coated)

Indications: For mild to moderate pain management, fever reduction, and to decrease inflammation; also used for acute rheumatic fever, Systemic Lupus, rheumatoid arthritis, osteoarthritis, bursitis, calcific tendonitis, to reduce recurrence of TIA and risk of stroke, as prophylaxis and to prevent recurrence of MI

Contraindications: Salicylate and NSAID hypersensitivity; patients with "aspirin triad" (aspirin sensitivity, nasal polyps, asthma); chronic rhinitis or urticaria; GI ulcer, bleeding; hypoprothrombinemia, vitamin K deficiency, hemophilia, bleeding disorders; CHF; pregnancy category D; do NOT use in children or teenagers with viral illnesses due to link with Reye's syndrome

Adverse Effects: Rash, urticaria, easy bruising, petechiae, bronchospasm, laryngeal edema; confusion, dizziness, drowsiness; tinnitus, hearing loss; nausea, vomiting, diarrhea, anorexia, heartburn, stomach pain, GI bleeding, ulceration; thrombocytopenia, hemolytic anemia, prolonged bleeding time

Interactions: Aminosalicylic acid and carbonic anhydrase inhibitors increase risk of toxicity; ammonium chloride, acidifying agents decrease renal elimination and increase toxicity; oral hypoglycemic agents increase hypoglycemic activity; corticosteroids increase ulcer potential; methotrexate toxicity is increased; anticoagulants and herbals (feverfew, garlic, ginger, ginkgo) increase bleeding potential

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