Aspirin

INTRODUCTION

Indications

Inflammatory disorders, including Rheumatoid arthritis, Osteoarthritis. Mild-to-moderate pain. Fever. Prophylaxis of transient ischemic attacks and MI. Unlabeled Use: Adjunctive treatment of Kawasaki's disease.

Action

Produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins. Decreases platelet aggregation. Therapeutic Effects: Analgesia. Reduction of inflammation. Reduction of fever. Decreased incidence of transient ischemic attacks and MI.

Adverse Reactions/Side Effects

EENT: tinnitus. GI: GI BLEEDING, dyspepsia, epigastric distress, nausea, abdominal pain, anorexia, hepatotoxicity, vomiting. Hemat: anemia, hemolysis. Derm: rash, urticaria. Misc: ALLERGIC REACTIONS, INCLUDING ANAPHYLAXIS AND LARYNGEAL EDEMA.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Monitor signs of allergic reactions and anaphylaxis, including pulmonary symptoms (laryngeal edema, wheezing, cough, dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician immediately if these reactions occur. Allergic reactions are more common in people with asthma, nasal polyps, or aspirin-induced allergies.

• Be alert for signs of GI bleeding, including abdominal pain, vomiting blood, blood in stools, or black, tarry stools. Report these signs to the physician immediately.

• Watch for signs of hemolysis and anemia, including unusual fatigue, shortness of breath, dizziness, headache, coldness in your hands and feet, pale skin, and chest pain. Report these signs to the physician.

• Assess pain and other variables (range of motion, muscle strength) to document whether this drug is successful in helping manage the patient's pain and decreasing impairments.

• Assess blood pressure periodically and compare to normal values (See Appendix F). Aspirin and other NSAIDs can increase blood pressure (BP) in certain patients.

Interventions

• Implement appropriate manual therapy techniques, physical agents, and therapeutic exercises to reduce pain and decrease the need for aspirin and other NSAIDs.

• Use caution with any physical interventions that could increase bleeding, including wound débridement, chest percussion, joint mobilization, and application of local heat.

• Help patient explore other nonpharmacologic methods to reduce chronic pain, such as relaxation techniques, exercise, counseling, and so forth.

• If used to prevent myocardial infarction or transient ischemic attacks, use caution during aerobic exercise and other forms of therapeutic exercise. Assess exercise tolerance frequently (BP, heart rate, fatigue levels), and terminate exercise immediately if any untoward responses occur (See Appendix L).

Patient/Client-Related Instruction

• Advise patient that analgesics are usually more effective if given before pain becomes severe; emphasize that adequate pain control will ...