Created by Andrew Street
over 7 years ago
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Question | Answer |
Give indications for aspirin. | • ACS & acute ischaemic stroke - to rapidly inhibit platelet aggregation & prevent or limit arterial thrombosis • Long term secondary prevention of thrombotic arterial events with CVS, cerebrovascular, & peripheral arterial DS • AF where warfarin & NOAC's are CI • Mild-to-moderate P & fever - NSAID's may be preferable |
MOA of aspirin. | Thrombotic events occur when platelet-rich thrombus forms in atheromatous arteries & occludes the circulation. Aspirin irreversibly inhibits cyclooxygenase (COX) to reduce production of the pro-aggregatory factor thromboxane from arachidonic acid, reducing platelet aggregation & the risk of arterial occlusion. The antiplatelet effect of aspirin occurs at low doses and lasts for the lifetime of a platelet (which does not have a nucleus to allow synthesis of new COX) and thus only wears off as new platelets are made. |
SE's of aspirin. | • GI irritation • GI ulceration & haemorrhage • Bronchospasm • Tinnitus - in high doses |
CI's, cautions, & important interactions of aspirin. | CI's: • <16 YO • Aspirin hypersensitivity • 3rd trimester of pregnancy Cautions: • Peptic ulcer (eg prescribe gastroprotection) • Gout Important interactions: Aspirin acts synergistically with other antiplatelet agents, which although therapeutically beneficial can lead to increased risk of bleeding. Thus, although it may be given with antiplatelet drugs (e.g. clopidogrel, dipyridamole) & anticoagulants (e.g. heparin, warfarin) in some situations (e.g. acute coronary syndrome), caution is required. |
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