Generic Name aspirin (acetylsalicylic acid)

Classification Dose Route Time/frequency NONNARCOTIC 325mg Oral Morning ANALGESIC, SALICYLATE; ANTIPYRETIC; ANTIPLATELET Peak Onset Duration Normal dosage range 15 min to 2 h. 5-30min Mild to Moderate Pain, Fever Adult: PO/PR 350650 mg q4h 3-6hr (max: 4 g/day) Child: PO/PR 1015 mg/kg in 46 h (max: 3.6 g/day) Arthritic Conditions Adult: PO 3.65.4 g/day in 46 divided doses Child: PO 80100 mg/kg/day in 46 divided doses (max: 130 mg/kg/day) Thromboembolic Disorders Adult: PO 81325 mg daily TIA Prophylaxis Adult: PO 650 mg b.i.d. MI Prophylaxis Adult: PO 80325 mg/day Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions High Blood Pressure N/a

Trade Name Bayer, Cosprin, Halfprin

Mechanism of action and indications (Why would this med be ordered) . Major action is primarily due to inhibiting the formation of prostaglandins involved in the production of inflammation, pain, and fever. Anti-inflammatory action: Inhibits prostaglandin synthesis. As an anti-inflammatory agent, aspirin appears to be involved in enhancing antigen removal and in reducing the spread of inflammatory substances. Analgesic action: Principally peripheral with limited action in the CNS in the hypothalamus; results in relief of mild to moderate pain. Antipyretic action: Suppress the synthesis of prostaglandin in or near the hypothalamus. Aspirin also lowers body temperature in fever by indirectly causing centrally mediated peripheral vasodilation and sweating. Antiplatelet action: Aspirin (but not other salicylates) powerfully inhibits platelet aggregation. High serum salicylate concentrations can impair hepatic synthesis of blood coagulation factors VII, IX, and X. Reduces inflammation, pain, and fever. Also inhibits platelet aggregation, reducing ability of blood to clot.

Nursing Implications (what to focus on) Contraindications/warnings/interactions Monitor for loss of tolerance to aspirin. Symptoms usually occur 15 min to 3 h after ingestion: Profuse rhinorrhea, erythema, nausea, vomiting, intestinal cramps, diarrhea. Monitor the diabetic child carefully for need to adjust insulin dose. Children on high doses of aspirin are particularly prone to hypoglycemia ( see Appendix F"). Monitor for salicylate toxicity. In adults, a sensation of fullness in the ears, tinnitus, and decreased or muffled hearing are the most frequent symptoms. Monitor children for S&S of salicylate toxicity manifested by: hyperventilation, agitation, mental confusion, or other behavioral changes, drowsiness, lethargy, sweating, and constipation.

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Drug: Aminosalicylic acid increases risk of SALICYLATE toxicity. Ammonium chloride and other ACIDIFYING

Common side effects Body as a Whole: Hypersensitivity (urticaria, bronchospasm, anaphylactic shock (laryngeal edema). CNS: Dizziness, confusion, drowsiness. Special Senses: Tinnitus, hearing loss. GI: Nausea, vomiting, diarrhea, anorexia, heartburn, stomach pains, ulceration, occult bleeding, GI bleeding. Hematologic: Thrombocytopenia, hemolytic anemia, prolonged bleeding time. Skin: Petechiae, easy bruising, rash. Urogenital: Impaired renal function. Other: Prolonged pregnancy and labor with increased bleeding Lab value alterations caused by medicine N/A

AGENTS decrease renal elimination and increase risk of SALICYLATE toxicity. ANTICOAGULANTS increase risk of bleeding. ORAL HYPOGLYCEMIC AGENTS increase hypoglycemic activity with aspirin doses greater than 2 g/day. CARBONIC ANHYDRASE INHIBITORS enhance SALICYLATE toxicity. CORTICOSTEROIDS add to ulcerogenic effects. Methotrexate toxicity is increased. Low doses of SALICYLATES may antagonize uricosuric effects of probenecid and sulfinpyrazone.

Be sure to teach the patient the following about this medication Rinse mouth with clear water or chew sugar-free gum or candy to relieve the mildly sour or bitter aftertaste of aminosalicylic acid. Hypersensitivity reactions may occur after a few days, but most commonly in the fourth or fifth week; report promptly. Notify physician if sore throat or mouth, malaise, unusual fatigue, bleeding or bruising occurs (symptoms of blood dyscrasia). Therapy generally lasts about 2 y. Adhere to the established drug regimen, and remain under close medical supervision to detect possible adverse drug effects during the treatment period. Herbal: Feverfew, garlic, ginger, ginkgo, evening primrose oil may increase bleeding potential. Resistant TB strains develop more rapidly when drug regimen is interrupted or is sporadic. Urine may turn red on contact with bleach used in commercial toilet bowl cleaners. Do not take aspirin or other OTC drugs without physician's approval. Discard drug if it discolors (brownish or purplish); this signifies decomposition. Nursing Process- Assessment Assessment Evaluation (Pre-administration assessment) Why would you hold or not give this med? Check after giving Assess pain and limitation of movement. Assess Onset of tinnitus, headache, hyperventilation, Relief of mile to moderate fever and note associated signs of diaphoresis, agitation, mental confusion, lethargy, diarrhea, discomfort tachycardia, malaise, and chills. Vital signs. and sweating. Increased ease of joint movement Reduction of fever Prevention of TIAs Prevention of MI