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Drug monograph

Generic name: Acetyl salicylic acid or Aspirin Brand names: Disprin, loprin, Bayer Aspirin. Pharmacological category: NSAID Indications/uses: Aspirin is used to treat mild to moderate pain, and also to reduce fever or inflammation. It is sometimes used to treat or prevent heart attacks, strokes, and angina. Aspirin should be used for cardiovascular conditions only under the supervision of a doctor. Mechanism of action: Inhibits prostaglandin synthesis, acts on the hypothalamus heat-regulating center to reduce fever, blocks prostaglandin synthetase action which prevents formation of the platelet-aggregating substance thromboxane A2 Adverse reactions: Cardiovascular: Hypotension, tachycardia, dysrhythmias, edema Dermatologic: Rash Gastrointestinal: Nausea, vomiting, dyspepsia, epigastric discomfort, heartburn, stomach pains, gastrointestinal ulceration (6% to 31%), duodenal ulcers Hematologic: Anemia, thrombocytopenia, hemolytic anemia, bleeding, iron deficiency anemia Hepatic: Hepatotoxicity, increased transaminases, hepatitis (reversible) Otic: Hearing loss, tinnitus Renal: Interstitial nephritis, papillary necrosis, proteinuria, renal impairment,

Warnings/precautions: Use with caution in patients with platelet and bleeding disorders, renal dysfunction, dehydration, erosive gastritis, or peptic ulcer disease. Avoid use in severe renal or heart failiure. Pregnancy category: C (D if full-dose aspirin in 3rd trimester) Contraindications: Hypersensitivity to salicylates or other NSAIDs; asthma; rhinitis; nasal polyps; inherited or acquired bleeding disorders (including factor VII and factor IX deficiency); pregnancy (in 3rd trimester especially); do not use in children (<16 years of age) for viral infections (chickenpox or flu symptoms), with or without fever, due to a potential association with Reye's syndrome Dose: Child: Adults: Analgesic and antipyretic: Oral, rectal: 325-650 mg every 4-6 hours up to 4 g/day Anti-inflammatory: Oral: Initial: 2.4-3.6 g/day in divided doses; usual maintenance: 3.6-5.4 g/day; monitor serum concentrations Analgesic and antipyretic: Oral, rectal: 10-15 mg/kg/dose every 4-6 hours, up to a total of 60-80 mg/kg/24 hours Anti-inflammatory: Oral: Initial: 60-90 mg/kg/day in divided doses; usual maintenance: 80-100 mg/kg/day divided every 6-8 hours, maximum dose: 3.6 g/day; monitor serum concentrations

Reference: lexicomp