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Aspirin

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Question
Answer
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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Created by: heatherbrown2020
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