Revascularization PO: ADULTS, ELDERLY: 80–325 mg/day

CLINICAL: Anti-inflammatory, antipyretic, anticoagulant

 Assess history of GI bleed, peptic ulcer disease, OTC use of products that may contain aspirin. Assess type, location, duration of pain, inflammation. Inspect appearance of affected joints for immobility, deformities, skin condition. Therapeutic serum level for antiarthritic effect: 20–30 mg/dL (toxicity occurs if level is greater than 30 mg/dL). 

Monitor urinary pH (sudden acidification, pH from 6.5 to 5.5, may result in toxicity). Assess skin for evidence of ecchymosis. If given as antipyretic, assess temperature directly before and 1 hr after giving medication. Evaluate for therapeutic response: relief of pain, stiffness, swelling; increased joint mobility; reduced joint tenderness; improved grip strength. 

Do not chew, crush, dissolve, or divide enteric-coated tablets. 

Avoid alcohol, OTC pain/cold products that may contain aspirin. 

Report ringing of the ears or persistent abdominal GI pain, bleeding. 

Therapeutic anti-inflammatory effect noted in 1–3 wks.

Behavioral changes, persistent vomiting may be early signs of Reye’s syndrome; contact physician. 

PO: ADULTS: Initially, 50 mg once daily. May increase dose up to 200 mg once daily. ELDERLY: Usual initial dose, 25 mg/day.

Post-MI PO: ADULTS: 100 mg once daily or 50 mg twice daily for 6–9 days post-MI.

CLINICAL: Antihypertensive, antianginal, antiarrhythmic

Assess B/P, apical pulse immediately before drug is administered (if pulse is 60/min or less, or systolic B/P is less than 90 mm Hg, withhold medication, contact physician). Antianginal: Record onset, quality (sharp, dull, squeezing), radiation, location, intensity, duration of anginal pain, precipitating factors (exertion, emotional stress). Assess baseline renal/hepatic function tests. 

Monitor B/P for hypotension, pulse for bradycardia, respiration for difficulty in breathing, EKG. Monitor daily pattern of bowel activity, stool consistency. Assess for evidence of HF: dyspnea (particularly on exertion or lying down), nocturnal cough, peripheral edema, distended neck veins. Monitor I&O (increased weight, decreased urinary output may indicate HF). Assess extremities for pulse quality, changes in temperature (may indicate worsening peripheral vascular disease). Assist with ambulation if dizziness occurs.

Do not abruptly discontinue medication. 

Compliance with therapy essential to control hypertension, angina. 

To reduce hypotensive effects, go from lying to standing slowly. 

Avoid tasks that require alertness, motor skills until response to drug is established. Advise diabetic pts to monitor blood glucose carefully (may mask signs of hypoglycemia). 

Report dizziness, depression, confusion, rash, unusual bruising/bleeding. 

Outpatients should monitor B/P, pulse before taking medication, following correct technique. 

Restrict salt, alcohol intake. 

Therapeutic antihypertensive effect noted in 1–2 wks.

Bs, R. K. J., & Hodgson, K. (2019). Saunders Nursing Drug Handbook 2020 (1st ed.). Saunders.