Aspirin risks

ANGIOTENSIN II RECEPTOR BLOCKERS ASPIRIN Risk of renal impairment when olmesartan is administered with high-dose aspirin (>3g daily). Effect not noted with low-dose aspirin Additive effect on reducing glomerular filtration rate Monitor renal function regularly until stable... 

SIBUTRAMINE ANTIPLATELET AGENTS-ASPIRIN Risk of bleeding Additive effect sibutramine may cause thrombocytopenia Warn the patient to report any signs of t bleeding... 

INSULIN ANTIPLATELET AGENTS-ASPIRIN Risk of hypoglycaemia when high-dose aspirin (3.5—7.5 g/day) is given with antidiabetic drugs Additive effect aspirin has a hypoglycaemic effect Avoid high-dose aspirin... 

POTASSIUM ASPIRIN Risk of hypokalaemia Aspirin is considered to T excretion of potassium Be aware, particularly in people on long-term aspirin therapy, although it is uncertain whether 75-100 mg doses of aspirin cause significant effects... 

The understanding of these actions of aspirin started in 1971 (45) and resulted in the recommendations of the medical community that small doses of aspirin, used under the care of the doctor, may be a prevention measure for heart attack, and stroke for those considered at risk in the population. Further reported work may expand health benefits to prevention of certain kinds of cancer (46). 

When linezolid is used with antiplatelet drugs such as aspirin or die NSAIDs (see Chap. 18) diere is an increased risk of bleeding and thrombocytopenia When administered widi die MAOIs (see Chap. 31) the effects of the MAOIs are decreased. There is a risk of severe hypertension if linezolid is combined widi large amounts of food containingtyramine (eg, aged cheese, caffeinated beverages, yogurt, chocolate, red wine, beer, pepperoni). 

Reduction of the risk of myocardial infarction in those with unstable angina or previous myocardial infarction (aspirin only) and... 

Reduction of the risk of transient ischemic attacks or strokes in men who have had transient ischemia of the brain due to fibrin platelet emboli (aspirin only). This use has been found to be effective only in men (not women). 

Food containing salicylate (curry powder, paprika, licorice, prunes, raisins, and tea) may increase the risk of adverse reactions. Coadministration of the salicylates with activated charcoal decreases the absorption of the salicylates. Antacids may decrease the effects of the salicylates. Coadministration with the carbonic anhydrase inhibitors increases the risk of salicylism. Aspirin may increase the risk of bleeding during... 

A nurse instructs the patient taking aspirin to avoid foods containing salicylates because tiiis increases the risk of adverse reactions. Which foods should the patient avoid ... 

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. 

Administration of the thrombolytic drugp with aspirin, dipyridamole, or the anticoagulants may increase the risk of bleeding. 

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. 

This was largely influenced by the high-dose UFH group in 1ST (OR 1.38, 95% Cl 1.05-1.82). An interaction by UFH dose (p = 0.01) on recurrent stroke risk with combination UFH-aspirin therapy compared to aspirin monotherapy was observed, with a trend toward increased risk of recurrent stroke with high-dose UFH + aspirin (OR 1.22, 95% Cl 0.92-1.62) and a trend toward reduced risk with low-dose UFH + aspirin (OR 0.75, 95% Cl 0.56-1.03), equivalent to 10 fewer (95% Cl 0-20 fewer) recurrent strokes per 1000 patients treated. They found a small, but significant beneht of LMWH over aspirin in the prevention of symptomatic DVT, equivalent to 10 (95% Cl 0-30) fewer DVTs per 1000 patients treated. Compared with aspirin, anticoagulants were associated with nonsignificantly fewer symptomatic PEs (OR 0.85, 95% Cl 0.55-1.32). There were fewer PEs with the combination of UEH and aspirin (OR 0.58, 95% Cl 0.34—1.00), equivalent to 5 fewer (Cl 0-10) PEs per 1000 patients treated. However, the overall incidence of symptomatic DVT and PE was low (1.1% and 0.7%). 

Despite the low overall risk of the CAST population, the trial was large and included substantial numbers of patients at high risk of early death (e.g., 2600 of patients were drowsy or comotase at entry, of whom 16.2% randomized to aspirin died or suffered nonfatal recurrent stroke compared to 18.5% of placebo). It is reasonable to conclude that the results of CAST and 1ST can therefore be applied to both low- and high-risk patients following acute stroke. 

The European Stroke Prevention Study 2 (ESPS-2) trial examined four treatment arms—extended-release dipyridamole (ER-DP) 200 mg twice daily alone, aspirin 25 mg twice daily alone, ER-DP 200 mg twice daily + aspirin 25 mg twice daily, or placebo. In comparison with placebo the overall reduction in stroke risk was 16% with ER-DP alone and 18% with aspirin alone. The combination of ER-DP and aspirin led to a 37% reduction in stroke risk compared to placebo. Compared with aspirin alone, the combination of ER-DP with aspirin reduced the risk of stroke by 23%. 

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