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Monday, October 10, 2011

Aspirin: Clinical use, Adverse effects, Contraindications of aspirin, Why aspirin is not used in pregnancy?


Clinical use / Indication of aspirin:

1. Relieve mild to moderate pain:


·         Headache(non-visceral pain)
·         Myalgia (non-visceral pain)·        
Arthalgia (non-visceral pain)

·         Osteoarthritis (non-visceral pain)
·         Dysmenorrhoea (visceral pain)

2. Rheumatic fever

3. Rheumatoid arthritis

4. Thromboembolic disorders

5. Myocardial infarction

6. Migrane

7. Increase sperm motility


Cardiovascular indications of aspirin:

1.       Acute myocardial infarction:

·         Loading dose: 300 mg
·         Maintenance dose: 100-150 mg/day

2.       Acute rheumatic fever:

·         Dose: 75-100 mg/kg body weight/day

3.       Acute pericarditis:

4.       Prophylaxis of arterial thromboembolism

Adverse effects of aspirin:

1.       Peptic ulcer disease (both gastric and duodenal)

2.       Impaired clotting

3.       Liver damage

4.       Kidney damage

5.       Allergic manifestations (urticaria, rhinitis, angioedema)

6.       Tinnitus, deagness

7.       Reye’s syndrome

Contraindications of aspirin

1.       Existing peptic ulcer disease

2.       Coagulation disorders (hyprothrombinaemia, haemophilia)

3.       Liver disease

4.       Renal disease

5.       Pregnancy (last trimester)

6.       Gout

7.       Any hypersensitivity to aspirin

Why aspirin is contraindicated in the last trimester of pregnancy?

Aspirin is contraindicated in the last trimester of pregnancy because of the following 3

reasons:


    1. Aspirin decreases the synthesis of prostaglandins (PG), especially PG E2 and PG F2, which are partly responsible  for uterine contraction during labor. Since these are not produced the labor is prolonged. So the fetus suffers from respiratory distress.
 
    2. Aspirin causes premature closure of ductus arteriosus. The patency of ductus arteriosus is maintained by PG I2 and PG E2. Aspirin inhibits the synthesis of these PG. Normally after birth the concentration of PG I2 and PG E2 falls and the ductus closes.

   3. Transplacental passage of aspirin in the fetus causes coagulation disorders in the fetus and there is chance of intracranial haemorrhage.








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