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Acetylation of platelet cyclo-oxygenase prevents synthesis of ? thromboxane A a potent vasoconstrictor and inducer of platelet aggregation for the life of the platelet (7-10d)
nonacetylated salicylates are saliclylic acid derivatives not metabolized to salicylic acid, not as potent as asa, and not antiplatelet activity salsalate, trilisate, arthropan, diflunisal (dolobid)
increased urine pH = ? excretion of salicylate increased, alteration of pH is used in treatment of salicylate poisoning
salicylates affect uric acid accumulation how? decrease uric acid secretion and raise serum levels
aspirin is pregnancy category D
aspirin max dose pain/fever: 4gm/day; ra 5-8g/day
cross sensitivity for allergies between asa and nsaids, asa and tartrazine dye, except with choline salicylate (Arthropan)
salicylates at increased levels are ototoxic and should be discontinued
lethal dose of salicylates adults: 10-30 grams; children: 4 grams
chronic salicylate toxicity can occur when more than 100mg/kg is ingested daily for 2 or more days
at what serum levels are salicylates toxic signs can appear at 200mcg/ml; severe toxicity at 400mcg/ml
s/s of salicylate toxicity resp alkalosis, hyperpnea, tachypnea d/t increased CO2 production, n/v, hypokalemia, tinnitus, disorientation, irritability, seizures, dehydration, hyperthermia, thrombocytopenia
foods high in salicylate curry, paprika, licorice, Benedictine liqueur, prunes, raisins, tea, gherkins
trial of therapy for ra 3-4g/day (older adults 2-3g/d)for 4-6 days, 70-80% who will respond do so in this time frame
therapeutic salicylate levels in ra 20-25 mg/dL (15-20 in older adults)
earliest manifestation of toxicity tinnitus or mild deafness
recommended dosing for oa 1.2-2.4 g/day
recommended dosing for tia's and stroke prevention 50-325mg/d alone or in combination with extended release dipyridamole (Persantine), which is preferred
sudden acidification of the urine can double the plasma level resulting in toxicity
Created by: heatherbrown2020