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Acetylsalicylic Acid

Classification

Antiplatelet

Antithrombotic

Indications

EMR: Chest pain or signs and symptoms consistent with cardiac ischemia

Contraindications

Hypersensitivity to ASA or drug components
Patients who have experienced bronchospasm or other respiratory reaction precipitated by ASA or nonsteroidal anti-inflammatory drugs
Active or recent bleeding of any kind, including head injury or peptic ulcer disease
Pediatric patients with signs and symptoms consistent with viral illnesses (due to Reye's Syndrome)

Adult dosages

EMR: chest pain or signs and symptoms consistent with cardiac ischemia

162 mg PO chewed and swallowed

Pediatric Considerations And Dosing

CliniCall consultation required prior to pediatric administration.

Chest pain in children is unlikely to be the result of ischemia; ASA is therefore not indicated unless there are rare, specific histories of disease.

Mechanism Of Action

ASA inhibits the formation of thromboxane A2, which is a potent platelet aggregator and vasoconstrictor. The platelet effects are irreversible, and last for the life of the platelet (7-10 days).

Pharmacokinetics

Oral:

Onset: 5-30 minutes
Peak: 1-2 hours
Duration: 4-6 hours

Adverse Effects

The most common adverse effects involve irritation of the gastrointestinal tract
Antiplatelet effects may result in minor bruising or bleeding

Overdose

ASA can be toxic at doses higher than 150 mg/kg. Early symptoms include nausea, vomiting, diaphoresis, and tinnitus. Hyperventilation can occur.

Warning And Precautions

ASA should not be used in children, teenagers, or young adults with chickenpox, influenza, or other flu-like illness due to the risk of the development of Reye syndrome.

Alcohol use can increase the risk of gastrointestinal bleeding.

Drug Interactions

The antiplatelet effects of ASA may increase the risk of bleeding, particularly in patients who are already taking anticoagulant medications. These risks must be balanced against the benefit of ASA in patients who are experiencing cardiac ischemia. CliniCall consultation recommended to discuss care planning options.