Aspirin - Queensland Ambulance Service

Drug Therapy Protocols: Aspirin
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Date
April, 2016
Purpose
Scope
Author
To ensure a consistent procedural approach to Aspirin administration.
Applies to all QAS clinical staff.
Clinical Quality & Patient Safety Unit, QAS
Review date
April, 2018
URL
https://ambulance.qld.gov.au/clinical.html
This work is licensed under the Creative Commons
Attribution-NonCommercial-NoDerivatives 4.0
International License. To view a copy of this license,
visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Aspirin
April, 2016
Drug class
Precautions
Antiplatelet
UNCONTROLLED WHEN PRINTED
• Possible aortic aneurysm or any other condition that may require surgery[7,8]
Pharmacology
Aspirin inhibits platelet aggregation by irreversibly inhibiting cyclo-oxygenase, reducing the synthesis of thromboxane A2 (an inducer
of platelet aggregation) for the life of the platelet. This action forms the basis of preventing platelets from aggregating to exposed collagen
fibres at the site of vascular injury.[1–3]
• Pregnancy
• History of GI bleeding or peptic ulcers
• Concurrent anticoagulant therapy (e.g. warfarin)
UNCONTROLLED WHEN PRINTED
Metabolism
Side effects
Aspirin is converted to salicyclic acid in many tissues, but primarily in the GI mucosa and liver. It is subsequently excreted by the kidneys.[1–3]
• Epigastric pain/discomfort
• Nausea and/or vomiting
Indications
• Gastritis
• GI bleeding
UNCONTROLLED WHEN PRINTED
• Suspected ACS[4,5]
• NSAID induced bronchospasm
• Acute cardiogenic pulmonary oedema
Contraindications
• KSAR or hypersensitivity to aspirin or other NSAIDs
UNCONTROLLED WHEN PRINTED
• Chest pain associated with psychostimulant overdose[6]
• Bleeding OR clotting disorders (e.g. haemophilia)
• Current GI bleeding OR peptic ulcers
• Patients < 18 years
Figure 4.3
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Aspirin
April, 2016
Special notes
Presentation
UNCONTROLLED WHEN PRINTED
• In suspected ACS or acute cardiogenic pulmonary oedema
aspirin should be administered following the initial dose of GTN (if indicated).
• Tablet (white), 300 mg aspirin
• Aspirin administration is indicated for patients with suspected
ACS or acute cardiogenic pulmonary oedema, even if pain free.
Onset
Duration
Half-life
≈ 10 minutes
(variable)
≈ 1 week
(antiplatelet)
3.2 hours
(300–650 mg)
• Patients who have had < 300 mg aspirin in the previous 24 hours and who present with suspected ACS or acute
pulmonary oedema should be administered a dose of aspirin
that equates to a total daily dose of 300–450 mg.
UNCONTROLLED WHEN PRINTED
Schedule
• S2 (Therapeutic poisons).
Adult dosages
UNCONTROLLED
WHEN
PRINTED
P
CCP
ACP2
P
ACP1
• Suspected ACS
• Acute cardiogenic pulmonary oedema
CCP
ACP2
Per oral (PO)
ACP1
Routes of administration
PO
≥ 18 years – 300 mg
Chewed and followed by a small
sip of water (where possible).[9]
UNCONTROLLED WHEN PRINTED
Paediatric dosages
Note: QAS officers are NOT authorised to administer aspirin to patients under 18 years of age.
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