Aspirin contraindications

Aspirin decreases the risk of death, recurrent MI, and stroke after MI. All patients should receive aspirin indefinitely (or clopidogrel if there are aspirin contraindications). 

The antiplatelet action of aspirin contraindicates its use by patients with hemophilia. Although previously not recommended during pregnancy, aspirin may be valuable in treating preeclampsia-edampsia. 

The NSAIDs are contraindicated in patients with known hypersensitivity. There is a cross-sensitivity to other NSAIDs. Therefore, if a patient is allergic to one NSAID, there is an increased risk of an allergic reaction with any other NSAID. Hypersensitivity to aspirin is a contraindication for all NSAIDs. In general, the NSAIDs are contraindicated during the third trimester of pregnancy and during lactation. 

Celecoxib is contraindicated in patients who are allergic to die drug itself, die sulfonamides, odier NSAIDs, or aspirin it also is contraindicated during pregnancy (Category C) and lactation. 

Willow bark (weidenrinde, white willow, purple osier willow, crack willow) S lixalba, purpurea, fragilis Analgesic Adverse reactions are those associated with the salicylates Do not use with aspirin or other NSAIDs. Do not use in patients with peptic ulcers and other medical conditions in which the salicylates are contraindicated. 

We do not discontinue use of any of the patient s medications including anticoagulants, aspirin or nonsteroidal anti-inflammatory drugs. Systemic isotretinoin (Acutane) is considered to be a contraindication to any external treatment of the skin. We feel that the minimal... 

Once diagnosed, patients with AlA should avoid aspirin and any other NSAIDs strongly inhibiting COX-1 their education is of utmost importance. They should receive a list of contraindicated and well-tolerated analgesics (table 2). Even topical administration (intravascular or by iontophoresis) of a NSAID may cause an asthma attack and should be avoided. 

Antiplatelet therapy with aspirin should be considered for all patients without contraindications, particularly in patients with a history of myocardial infarction. Clopidogrel may be considered in patients with allergies or intolerance to aspirin. In some patients, combination antiplatelet therapy with aspirin and clopidogrel may be used. 

Doses and contraindications to glycoprotein Ilb/IIIa receptor blockers are described in Table 5-2. Major bleeding and rates of transfusion are increased with administration of a glycoprotein Ilb/IIIa receptor inhibitor in combination with aspirin and an anticoagulant,30 but there is no increased risk of intracranial hemorrhage in the absence of concomitant fibrinolytic treatment. The risk of thrombocytopenia with tirofiban and eptifibatide appears lower than that with abciximab. Bleeding risks appear similar between agents. 

Review patient s medical record to determine contraindications for each medication. For aspirin, P-blockers, ACE inhibitors, and ARBs, document contraindications in patient s medical record. 

Stroke Prevention All patients with paroxysmal, persistent, or permanent AF should receive therapy for stroke prevention, unless compelling contraindications exist. A decision strategy for stroke prevention in AF is presented in Fig. 6-9.27 In general, most patients require therapy with warfarin in some patients with no additional risk factors for stroke, aspirin may be acceptable. For some patients, serious consideration of the benefits of warfarin versus the risks of bleeding associated with warfarin therapy is warranted. The potential bleeding risks associated with warfarin may outweigh the benefits in... 

Nearly two-thirds of patients with DM will die of coronary heart disease (CHD). Interventions targeting smoking cessation, glycemic control, blood pressure control, lipid management, antiplatelet therapy, and lifestyle changes, including diet and exercise, can reduce the risk of cardiovascular events. Patients with diabetes should receive at least an aspirin daily unless contraindicated. Refer to appropriate chapters in the text concerning CHD. 

Probenecid is a uricosuric agent that blocks the tubular reabsorption of uric acid, increasing its excretion. Because of its mechanism of action, probenecid is contraindicated in patients with a history of uric acid stones or nephropathy. Probenecid loses its effectiveness as renal function declines and should be avoided when the creatinine clearance is 50 mL/minute or less. Its uricosuric effect is counteracted by low aspirin doses, which many patients receive for prophylaxis of coronary heart disease. 

Application of topical salicylates can lead to systemic effects, especially if the product is applied liberally. Repeated application and occlusion with a wrap or bandage also can increase systemic concentrations.41 Salicylate-containing counterirritants should be used with caution in patients in whom systemic salicylates are contraindicated, such as patients with severe asthma or aspirin allergy.42 Topical salicylates have been reported to increase prothrombin time in patients on warfarin and should be used with caution in patients on oral anticoagulants.43... 

Aspirin is maximally effective as an antithrombotic agent at the comparatively low dose of 81 to 325 mg per day. (The antipyretic dose of aspirin in adults is 325 to 650 mg every 4 h.) Higher doses of aspirin are actually contraindicated in patients prone to thromboembolism. At higher doses, aspirin also reduces synthesis of prostacyclin, another arachidonic acid metabolite. Prostacyclin normally inhibits platelet aggregation. The prophylactic administration of low-dose aspirin has been shown to increase survival following myocardial infarction, decrease incidence of stroke, and assist in maintenance of patency of coronary bypass grafts. 

Aspirin should be administered to all patients without contraindications within the first 24 hours of hospital admission. It provides an additional... 

Clopidogrel may be substituted for aspirin when aspirin is absolutely contraindicated Long-acting nondihydropyridine calcium antagonists instead of /3-blockers as initial therapy ACEIs are recommended in patients with CAD or other vascular disease Low-intensity anticoagulation with warfarin, in addition to aspirin, is recommended but bleeding would be increased Therapies to be avoided include ... 

Hypersensitivity to dipyridamole, aspirin, or any of the other product components. Allergy Aspirin is contraindicated in patients with a known allergy to NSAIDs and in patients with asthma, rhinitis, and nasal polyps. Aspirin may cause severe urticaria, angioedema, or bronchospasms (asthma). 

Unstable angina/Non-Q-wave Ml - The recommended dose is 120 units/kg of body weight (but not more than 10,000 units) subcutaneously every 12 hours with concurrent oral aspirin (75 to 165 mg/day) therapy. Concurrent aspirin therapy is recommended except when contraindicated. Continue treatment until the patient is clinically stabilized. The usual duration of treatment is 5 to 8 days. 

Controlled-release aspirin Controlled-release aspirin, because of its relatively long onset of action, is not recommended for antipyresis or short-term analgesia. Not recommended in children older than 12 years of age contraindicated in all children with fever accompanied by dehydration. 

Concomitant use with NSAiDs - Ketorolac is contraindicated in patients currently receiving aspirin or other NSAIDs ketorolac also is contraindicated with the concomitant use of probenecid. 

Aspirin is epidemiologically associated with Reye s syndrome, a rare but often fatal consequence of infection with varicella, influenza and various other viruses, and salicylates are therefore contraindicated in children with chicken pox or influenza. 

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