INDICATIONS
- Acute Ischemic Stroke (AIS): Secondary prevention of recurrent AIS.
- Thrombosis; Prophylaxis: Aspirin is recommended as thromboprophylaxis after Fontan surgery, in patients with systemic-to-pulmonary shunts, in patients after ventricular assist device placement, and in patients with mechanical heart valves who have had thrombotic events while receiving therapeutic antithrombotic therapy or patients in whom there is a contraindication to full-dose vitamin K antagonists. In a prospective, multicenter, randomized study (n=111) of warfarin vs aspirin for primary thromboprophylaxis in children after Fontan surgery, the thrombosis event rate at 2 years was 19% with no significant difference between warfarin and aspirin therapy (24% vs 14%; p=0.45); minor bleeding was more common in the warfarin group (33% vs 14%)
PRECAUTIONS/PRECAUTIONS
Aspirin use has been associated with a potentially fatal condition called Reye’s syndrome. Association has been shown to be mainly dose dependent, occurring with anti-inflammatory doses (greater than 40 mg/kg/day), rather than lower doses used for antiplatelet effects . Use caution in patients with bleeding disorders, peptic ulcer disease, renal impairment, or severe hepatic impairment. Severe allergic reactions, including asthma, hives, and facial swelling, may occur.
ADVERSE EFFECTS
Mild gastrointestinal symptoms (nausea, vomiting, abdominal pain, GI upset) are the most common adverse effects. Headache and tinnitus have also been reported frequently in children. Elevations in serum transaminases may occur. Mild salicylism is characterized by headache, dizziness, tinnitus, hearing and vision impairment, sweating, nausea, vomiting, nasal congestion, and slight hyperpyrexia. Symptoms of severe salicylate toxicity include hyperventilation, mental confusion, restlessness, irritability, hyperthermia, and alterations in acid-base balance, primarily respiratory alkalosis.
ADMINISTRATION
Administer without regard to feedings.
MONITORING
Mild salicylism is characterized by headache, dizziness, tinnitus, hearing and vision impairment, sweating, nausea, vomiting, nasal congestion, and slight hyperpyrexia. Symptoms of severe salicylate toxicity include hyperventilation, mental confusion, restlessness, irritability, hyperthermia, and alterations in acid-base balance, primarily respiratory alkalosis.