Acetylsalicylic Acid (Aspirin)


General Information


Indications


Contraindications


Pharmacology

Metabolism


Administration

Dose Adjustment

Management of Aspirin Therapy for Minor Dental, Dermatologic, or Ophthalmologic Procedures

3.4 Patients Undergoing a Minor Dental, Dermatologic, or Ophthalmologic Procedure
3.4. In patients who are receiving acetylsali- cylic acid (ASA) for the secondary prevention of cardiovascular disease and are having minor dental or dermatologic procedures or cataract surgery, we suggest continuing ASA around the time of the procedure instead of stopping ASA 7 to 10 days before the procedure (Grade 2C).

3.5. In patients at moderate to high risk for cardiovascular events who are receiving ASA therapy and require noncardiac surgery, we suggest continuing ASA around the time of sur- gery instead of stopping ASA 7 to 10 days before surgery (Grade 2C). In patients at low risk for cardiovascular events who are receiving ASA therapy, we suggest stopping ASA 7 to 10 days before surgery instead of continuation of ASA (Grade 2C).

3.6 Patients Undergoing Coronary Artery Bypass Graft Surgery
3.6. In patients who are receiving ASA and require coronary artery bypass graft (CABG) surgery, we suggest continuing ASA around the time of surgery instead of stopping ASA 7 to 10 days before surgery (Grade 2C). In patients who are receiving dual antiplatelet drug therapy and require CABG surgery, we suggest con- tinuing ASA around the time of surgery and stopping clopidogrel/prasugrel 5 days before surgery instead of continuing dual antiplatelet therapy around the time of surgery (Grade 2C).

3.7. In patients with a coronary stent who are receiving dual antiplatelet therapy and require surgery, we recommend deferring surgery for at least 6 weeks after placement of a bare-metal stent and for at least 6 months after placement of a drug-eluting stent instead of undertaking surgery within these time periods (Grade 1C). In patients who require surgery within 6 weeks of placement of a bare-metal stent or within 6 months of placement of a drug-eluting stent, we suggest continuing dual antiplatelet therapy around the time of surgery instead of stopping dual antiplatelet therapy 7 to 10 days before surgery (Grade 2C).

Remarks: Patients who are more concerned about avoiding the unknown, but potentially large increase in bleeding risk associated with the perioperative continuation of dual antiplatelet therapy than avoid- ing the risk for coronary stent thrombosis are unlikely to choose continuation of dual antiplatelet therapy.


Adverse Effects

Cardiovascular Adverse Effects

Pseudo-Sepsis Syndrome (see Hypotension, [[Hypotension]])

Endocrinologic Adverse Effects

Drug-Induced Hyporeninemic Hypoaldosteronism (see Hypoaldosteronism, [[Hypoaldosteronism]])

Gastrointestinal Adverse Effects

Peptic Ulcer Disease (PUD) (see Peptic Ulcer Disease, [[Peptic Ulcer Disease]])

Hematologic Adverse Effects

Pulmonary Adverse Effects

Aspirin-Intolerant Asthma (see Asthma, [[Asthma]])

Drug-Induced Pulmonary Eosinophilia (see Drug-Induced Pulmonary Eosinophilia, [[Drug-Induced Pulmonary Eosinophilia]])

Renal Adverse Effects

Acute Interstitial Nephritis (see Acute Interstitial Nephritis, [[Acute Interstitial Nephritis]])

Acute Kidney Injury (AKI) (see Acute Kidney Injury, [[Acute Kidney Injury]])

Hyperkalemia (see Hyperkalemia, [[Hyperkalemia]])

Increased Renal Sodium Reabsorption with Peripheral Edema

Type 4 Renal Tubular Acidosis (RTA) (see Type 4 Renal Tubular Acidosis, [[Type 4 Renal Tubular Acidosis]])

Other Adverse Effects


Salicylate Intoxication


Aspirin Desensitization Therapy


References