Nurses Compass
Drug Guide
Aspirin
Classification
Therapeutic: Analgesic, Antipyretic, Anti-inflammatory
Pharmacological: Nonsteroidal Anti-inflammatory Drug (NSAID)
FDA Approved Indications
- Pain relief (mild to moderate pain)
- Fever reduction
- Anti-inflammatory purposes
Mechanism of Action
Aspirin irreversibly inhibits cyclooxygenase (COX-1 and COX-2), leading to decreased formation of prostaglandins and thromboxanes, thus exerting analgesic, antipyretic, and anti-inflammatory effects.
Dosage and Administration
Adult: Dosage varies based on indication; for pain, typically 325-650 mg every 4-6 hours as needed. Always follow specific prescribing information.
Pediatric: Not generally recommended for children under 16 due to risk of Reye's syndrome.
Geriatric: Dose adjustments may be necessary due to increased susceptibility to side effects.
Renal Impairment: Use with caution; dose adjustments may be necessary.
Hepatic Impairment: Use with caution; monitor liver function.
Pharmacokinetics
Absorption: Rapidly absorbed from the gastrointestinal tract.
Distribution: Widely distributed; crosses the placenta and enters breast milk.
Metabolism: Metabolized in the liver to salicylic acid.
Excretion: Excreted mainly in urine.
Half Life: Approximately 15-20 minutes for aspirin; duration of action varies.
Contraindications
- Hypersensitivity to aspirin or NSAIDs
- Bleeding disorders
- Children or teenagers with viral infections (risk of Reye's syndrome)
Precautions
- Gastric ulcers or bleeding history
- Asthma or hypersensitivity to NSAIDs.
- Use with caution in renal or hepatic impairment.
Adverse Reactions - Common
- Gastrointestinal upset, bleeding (Common)
- Allergic reactions including rash, bronchospasm (Uncommon)
Adverse Reactions - Serious
- Gastrointestinal bleeding, ulceration (Serious)
- Reye's syndrome in children (Rare)
- Anaphylaxis (Rare)
Drug-Drug Interactions
- Anticoagulants (warfarin, heparin) – increased bleeding risk
- Other NSAIDs – increased gastrointestinal side effects
Drug-Food Interactions
- Alcohol – increased gastrointestinal bleeding risk
Drug-Herb Interactions
N/ANursing Implications
Assessment: Monitor for signs of bleeding, allergy, and gastrointestinal discomfort.
Diagnoses:
- Risk for bleeding
- Acute pain related to inflammatory process
Implementation: Administer with food or milk to minimize gastrointestinal upset. Monitor bleeding parameters.
Evaluation: Assess pain relief, reduction in inflammation, and adverse effects.
Patient/Family Teaching
- Take with food or milk to reduce stomach upset.
- Report signs of bleeding, allergic reactions, or unusual symptoms.
- Avoid alcohol while taking aspirin.
Special Considerations
Black Box Warnings:
- Serious, sometimes fatal, gastrointestinal bleeding.
- Reye's syndrome risk in children and teenagers with viral infections.
Genetic Factors: Genetic variations can affect metabolism and response.
Lab Test Interference: May affect bleeding time, platelet function tests.
Overdose Management
Signs/Symptoms: Tinnitus, deafness, hyperventilation, metabolic acidosis, coma.
Treatment: Supportive care, activated charcoal, alkalinization of urine, and monitoring in a hospital setting.
Storage and Handling
Storage: Store at room temperature, away from moisture and heat.
Stability: Stable under recommended storage conditions.