Aspirin
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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)
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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)
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increased urine pH = ? excretion of salicylate | increased, alteration of pH is used in treatment of salicylate poisoning
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salicylates affect uric acid accumulation how? | decrease uric acid secretion and raise serum levels
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aspirin is pregnancy category | D
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aspirin max dose | pain/fever: 4gm/day; ra 5-8g/day
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cross sensitivity for allergies between | asa and nsaids, asa and tartrazine dye, except with choline salicylate (Arthropan)
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salicylates at increased levels are | ototoxic and should be discontinued
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lethal dose of salicylates | adults: 10-30 grams; children: 4 grams
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chronic salicylate toxicity can occur when | more than 100mg/kg is ingested daily for 2 or more days
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at what serum levels are salicylates toxic | signs can appear at 200mcg/ml; severe toxicity at 400mcg/ml
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s/s of salicylate toxicity | resp alkalosis, hyperpnea, tachypnea d/t increased CO2 production, n/v, hypokalemia, tinnitus, disorientation, irritability, seizures, dehydration, hyperthermia, thrombocytopenia
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foods high in salicylate | curry, paprika, licorice, Benedictine liqueur, prunes, raisins, tea, gherkins
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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
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therapeutic salicylate levels in ra | 20-25 mg/dL (15-20 in older adults)
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earliest manifestation of toxicity | tinnitus or mild deafness
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recommended dosing for oa | 1.2-2.4 g/day
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recommended dosing for tia's and stroke prevention | 50-325mg/d alone or in combination with extended release dipyridamole (Persantine), which is preferred
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sudden acidification of the urine can | double the plasma level resulting in toxicity
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