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Clinician’s Corner: Aspirin

Aspirin has been around 120 years now, and we still are getting clarification on its appropriate use.

Aspirin Dosage: for relief of mild to moderate pain is 325-1000mg every 4-6 hours., with a maximum dose = 4000 mg/day. Up to 3-4 g per day has been used for the treatment for rheumatoid arthritis, lupus, and other rheumatologic conditions.

Most of us pharmacists seldom see aspirin used for pain and inflammation, but rather for aspirin’s antiplatelet activity with the dose being 81-325mg/day. For a heart attack it is recommended that you chew 162 to 325 mg immediately, unless you already taking daily aspirin. Of course, 911 should be called immediately.

PLATELETS before PAIN

Aspirin’s cardiovascular benefits stem from its permanent inactivation platelet function and vasoconstriction. Platelets form clots, that can block blood vessels in the heart and brain. Aspirin blocks platelets for their lifetime of 7 days. Complete blocking of platelet activity can be achieved with only 75 to 150 mg of aspirin.

DOES EVERYONE GET ASPIRIN?

New guidelines say that daily, low-dose aspirin should be used infrequently to prevent primary cardiovascular disease. The bleed risk isn’t worth the benefit, until you have had an event. The American College of Cardiology and the American Heart Association conclude that aspirin should be reserved for people with the highest cardiovascular risk and the lowest risk for bleeding.

Not everyone should be taking aspirin without a doctor’s order because of lack of net benefit. Men seem to benefit by prevention of heart attacks, while women get their benefit from reduction of strokes.

RISKS vs BENEFITS- Your Thompson Pharmacists recommends:

  • Take aspirin if heart/stroke benefits are greater than bleeding risks.
  • Make sure blood pressure is controlled before starting aspirin to reduce the risk of hemorrhagic stroke.
  • Stomach bleeds can occur especially when aspirin is combined with other NSAIDS. Don’t forget to include over the counter ibuprofen (Advil) and naproxen (Aleve).
  • Stop Aspirin with a 7 to 10-day washout before major surgical procedures.
  • Stopping aspirin in patients with a prior heart attack leads to 4 extra heart attacks per 1000 patients per year.  Aspirin is serious therapy and your Thompson Pharmacist does not want you to miss a single dose.

Not sure whether to take aspirin to prevent a heart attack or stroke?  Ask your Thompson Pharmacist to review your current medication.  Go Ahead and ASK… at Thompson Pharmacy it’s for YOU!