Aspirin
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Trade Name
Bayer Aspirin (common brand name); also available as generic acetylsalicylic acid (ASA).
Classification
Nonsteroidal Anti-Inflammatory Drug (NSAID); analgesic, antipyretic, antiplatelet, and anti-inflammatory.
Dosage/Route
- * Dosage: Tablets in 81 mg (low-dose), 325 mg (regular strength); enteric-coated options available
- * Route: Oral (PO); rectal suppositories also exist but are less common
Usual Dosage
- * Pain/Fever: 325-650 mg every 4-6 hours; max 4000 mg/day (4 g)
- * Antiplatelet (e.g., MI prevention): 81-325 mg once daily
- * Children: Avoid unless prescribed (risk of Reye’s syndrome); historically 10-15 mg/kg/dose
Mechanism of Action
Inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis. This decreases pain, inflammation, and fever. Irreversibly inhibits platelet aggregation (antiplatelet effect lasts 7-10 days).
Side Effects & Adverse Effects
- * Side Effects: Nausea, heartburn, stomach upset
- * Adverse Effects:
- – GI bleeding/ulcers (due to mucosal irritation)
- – Bleeding risk (prolonged bleeding time)
- – Reye’s syndrome in children with viral infections (rare, serious)
- – Salicylate toxicity (tinnitus, hyperventilation, confusion at high doses)
Nursing Management (Implications & Teachings)
- Implications:
- – Monitor for bleeding signs (e.g., black stools, bruising)
- – Assess hearing (tinnitus = early toxicity sign)
- – Avoid in children <16 with flu-like symptoms (Reye’s risk)
- – Check for NSAID allergies or asthma (risk of bronchospasm)
- Teachings:
- – Take with food or milk to reduce GI upset.
- – Report tinnitus, dark stools, or unusual bleeding
- – Avoid alcohol (increases GI bleed risk)
- – Stop 5-7 days before surgery (if directed) due to antiplatelet effect
Indication for This Patient
- * Mild to moderate pain (e.g., headache, arthritis)
- * Fever reduction
- * Cardiovascular prevention (e.g., post-MI, stroke risk; low-dose 81 mg)
- * Inflammation (e.g., rheumatoid arthritis at higher doses)
Time
- * Timing: Every 4-6 hours for pain/fever; once daily for antiplatelet use.
- * Onset: Pain relief/fever reduction in 30 minutes; peak in 1-2 hours.
- * Antiplatelet effect: Starts within hours, lasts 7-10 days.
