Anesthesia Implications

Pt should abstain from using this drug for 7 days prior to surgery. An exception to this rule is for patients who have received a coronary stent and are receiving aspirin as a part of dual antiplatelet therapy. Unless absolutely contraindicated, these patients should continue taking aspirin throughout the perioperative period. If absolutely contraindicated patient should stop aspirin 3 days prior to surgery. ALWAYS consult with a cardiologist before discontinuing dual antiplatelet therapy.

Well known drug to cause bronchoconstriction / bronchospasm. Be especially conscious of this in patients with reactive airways.

Prolongs bleeding time by causing platelet dysfunction that lasts the platelet’s entire life span (8-9 days). The effects are irreversible.

Prolongs the bleeding time test (which isn’t used too often anymore).

Platelet infusion will be necessary in cases where platelet function has been severely compromised by aspirin.

Toxic doses of aspirin stimulate the respiratory center of the brain leading to hyperpnea (hyperventilation), hypocapnea, and respiratory acidosis. Other toxic effects include hypoglycemia, metabolic acidosis, fluid/electrolyte losses, and hypermetabolism.

Can exacerbate symptoms of thyroid storm. Aspirin frees T4 from plasma proteins which increases the free fraction of T4.

Classification: NSAID, Nonspecific COX inhibitor

Method of Action: Nonspecific COX inhibitor

Metabolism: Hepatic (zero order)

Additional Notes:
Higher doses (ie 325 mg tablets) inhibit prostacyclin (PGI-2) and are used for anti-inflammatory analgesic effects.

Typically taken as the 81 mg tablet to help prevent clotting/thrombosis.