Aspirin drug reaction

Some side effects, or adverse effects, of drugs can be fatal. Adverse drug reactions are one of the top 10 causes of death in hospitalized patients in the United States—as many as 100,000 deaths per year Even aspirin at low doses, recommended to prevent heart attacks and stroke, can kill under the right conditions Fatal bleeding can occur in patients who have an undetected clotting disorder and take aspirin r ularly. 

Younger Hepatic drug reactions are rare in children, but may occur with certain drugs such as aspirin and sodium valproate... 

A 72-year-old woman with an anterior Ml was admitted to the hospital 7 days ago and has developed swelling of her lips and tongue, and bradycardia. She also complains of flushing and hallucinations. During the hospital course, the patient was started on metoprolol, captopril, isosorbide dinitrate, aspirin, and morphine. Which of the following adverse drug reactions is mostly likely caused by captopril ... 

Benoral benorylate. benorilate benorylate. benorylate [ban] (benorilate [inn] paracetamol acetylsallcylate BenoraP ) is an aspirin-paracetamol ester, and these two pharmacologically active constituents are released systemically at different rates. It has cyclooxygenase inhibitor, nsaid analgesic, antiinflammatory and antirheumatic activity. It is used orally, particularly to treat the pain of rheumatic disease and other musculoskeletal disorders, as well as to treat fever, benoxaprofen [ban, inn, usan] (Opren ) is one of the propionic acid series of CYCLOOXYGENASE INHIBITORS with nsaid ANALGESIC. ANTIINFLAMMATORY and ANTIPYRETIC activity also effective for psoriasis. It was withdrawn due to adverse drug reactions. 

Adverse drug reactions relevant to girls and women likely to be using aspirin for PD include ... 

Davis M, Williams R (1978) Drugs and the liver. In Davies DM (ed) Textbook of adverse drug reactions. Oxford University Press, Oxford de Week AL (1971) Immunological effects of aspirin anhydride, a contaminant of commercial acetylsalicylic acid preparations. Int Arch Allergy Appl Immunol 41 393-418 Duberstein JL, Kaufman DM (1972) Heroin intoxication in adolescents. Pediatrics 50 746-753... 

Fig. 2.2 An example of generalized urticaria (hives) showing smooth, erythematous, and pruritic confluent papules and plaques. Aspirin and other nonsteroidal rmti-inflammatory drugs are a frequent cause of hives but virtually any drug can precipitate the condition. From Anderson J, Lieberman P, Blaiss M. Allergic drug reactions. Atlas of allergic diseases 2002 IS 26. With kind permission from Springer Science-tBusiness Media B.V...

Kawakami T, Fujita A, Takeuchi S, Muto S, Soma Y. Drug-induced hypersensitivity syndrome drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome induced by aspirin treatment of Kawasaki disease. J Am Acad Dermatol 2009 60(1) 146-9. 

Headache is a common adverse reaction but should decrease widi continued therapy. If headache persists or becomes severe, notify die primary healdi care provider because a change in dosage may be needed. In patients who get headaches, die headaches may be a marker of the drug s effectiveness. Fhtients should not try to avoid headaches by altering die treatment schedule because loss of headache may be associated with simultaneous loss of drug effectiveness. Aspirin or acetaminophen may be used for headache relief. 

Plasma digoxin levels may decrease when the drug is administered with bleomycin. When bleomycin is used witii cisplatin, there is an increased risk of bleomycin toxicity Pulmonary toxicity may occur when bleomycin is administered with other antineoplastic drugs. Plicamycin, mitomycin, mitoxantrone, and dactino-mycin have an additive bone marrow depressant effect when administered with other antineoplastic drugs. In addition, mitomycin, mitoxantrone, and dactinomycin decrease antibody response to live virus vaccines. Dactinomycin potentiates or reactivates skin or gastrointestinal reactions of radiation therapy There is an increased risk of bleeding when plicamycin is administered witii aspirin, warfarin, heparin, and the NSAIDs. 

Cross-reactions with aspirin and NSAIDs are of practical importance. Typically, AIA patients are sensitive to all NSAIDs that preferentially inhibit COX-1 (table 2). Acetaminophen (paracetamol), a weak inhibitor of COX-1, is regarded as a relatively safe therapeutic alternative for almost all patients with AIA. High doses of the drug (>1,000 mg) have been reported to provoke mild, easily reversed bronchos-pasm in some AIA patients [13]. Some rare, well-documented cases of coexistence of aspirin and paracetamol sensitivity have been described. However, according to a recent meta-analysis, less that 2% of asthmatics are sensitive to both aspirin and paracetamol [14]. 

Patients with chronic idiopathic urticaria, who develop cutaneous reactions in response to aspirin, display certain similarities in eicosanoid profile with AIA. The mechanism of the reactions is often related to COX-1 inhibition [18]. Therefore, aspirin and all drugs that inhibit COX-1 should be avoided in patients who already have had cutaneous reactions to NSAID. Coxibs are usually well tolerated, although occasional adverse reactions have been reported [19, 20]. For treatment of the reactions, antihistamines are usually sufficient, but in more severe cases adrenaline and corticosteroids may be warranted. 

IgE-mediated urticarial/angioedema reactions and anaphylaxis are associated with aspirin and non-steroidal antiinflammatory drugs. Urticaria is the most common form of IgE-mediated reaction. This class is second only to P-lactams in causing anaphylaxis. 

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